• Specialist, Config Oversight (healthcare Medical…

    Molina Healthcare (Columbus, OH)
    …is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it ... applied to the appropriate modules within the core processing system (QNXT). * Conducts focal healthcare Medical claim...+ Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using… more
    Molina Healthcare (09/24/25)
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  • Analyst, Configuration Oversight ( Claims…

    Molina Healthcare (Akron, OH)
    …combination of education and experience **PREFERRED EXPERIENCE:** 3+ years of experience in claims as Adjuster or claims examiner in the healthcare ... * Apply previous experience and knowledge to verify accuracy of updates to claim /encounter and/or system update(s) as necessary. * Works with fluctuating volumes… more
    Molina Healthcare (09/17/25)
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  • Claims Care Associate

    Lincoln Financial (Columbus, OH)
    …environment. You will act as a liaison between the employee (member) and the claims examiner to provide a positive customer experience during their specific ... a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence...the day, answering questions and providing information regarding their claim through the utilization of multiple applications and platforms.… more
    Lincoln Financial (10/17/25)
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  • OSS Coordinator

    Sedgwick (Columbus, OH)
    …Services & Insurance OSS Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple office locations; ... policies within assigned group. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Completes examiner update reports, claim adjustments, provider requests and… more
    Sedgwick (10/03/25)
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  • Telephonic Case Manager

    Sedgwick (Columbus, OH)
    …support systems . + Effectively communicates and builds relationships with the claims ' examiner , client, injured worker, attorney and supervisor. + Identifies ... recovery. + Provides recommendations for alternate clinical resources to support claim resolution. + Maintains client's privacy and confidentiality, promotes client… more
    Sedgwick (09/19/25)
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  • Investigator, Special Investigative Unit - FLORIDA

    Molina Healthcare (Dayton, OH)
    …Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims ) to gather documentation pertinent to investigations. + Detects ... + Documents appropriately all case related information in the case management system in an accurate manner, including storage of case documentation following SIU… more
    Molina Healthcare (09/22/25)
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  • Investigator

    Highmark Health (Columbus, OH)
    …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... **Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC)… more
    Highmark Health (09/10/25)
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