- Molina Healthcare (Columbus, OH)
- JOB DESCRIPTION Job SummaryProvides customer service support for inbound/outbound pharmacy calls from members, providers, and pharmacies. Contributes to overarching ... of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other… more
- OhioHealth (Columbus, OH)
- … claims and incidents and the review and oversight of practitioner claim trends from the organization's claims /incidence database. In partnering with System ... claims defense when requested. The person will also support the patient grievance process at GMC and RMH....to patients and families when a physician or administrative representative is needed. The MDRM will attend the grievance… more
- CDM Smith (Columbus, OH)
- …strategies. Assist the project team in developing and maintaining a project risk register. Claim management: Early support for claims and disputes on the ... CDM Constructors' Pacific region, primarily projects in California. The role will support negotiation, setup, and implementation of all contracts necessary for a… more
- RxBenefits (Columbus, OH)
- …Manager also assists with resolving client issues involving performance discrepancies and claims issues. This role will support the Director, Pharmacy Pricing ... Deal Governance teams for At-Risk accounts + Manage and support the current account claim and data...enhanced visibility and efficiency + Act as a cross-functional representative throughout the organization to provide strategic insight and… more
- Nestle (Solon, OH)
- …is located in Cincinnati, OH.** **Key Responsibilities** Trade Auditing/Analysis (Deductions, Fines, Claims , Post-Audit Work) (40% of Role) + Support the Account ... Account Associate is a key member of the Account Management team, providing support to the Account Director and Account Managers. The primary responsibility of the… more
- J&J Family of Companies (Columbus, OH)
- …within a larger geography. + Conducts regular field visits with each representative to assess performance, skills, and support development through coaching ... transforming patient lives, we are expanding our CAPLYTA(R) medical team to support our growing impact in psychiatry. The District Manager has overall responsibility… more
- Towne Park (Cleveland, OH)
- …of this job description. - 15% Efficiently allocates labor resources to support service delivery and reduces staffing levels if business conditions dictate. ... - 15% Understands and drives business metrics for forecasting, productivity, claims , customer service, and turnover. Ensures all associates accurately identify and… more
- Towne Park (Cleveland, OH)
- …the ability to positively move the metrics for forecasting, productivity, claims , customer service, and turnover + Manages scheduling, overtime for associates ... on all shifts + Efficiently allocates labor resources to support service delivery + Works with the Area/District Manager...trained in safety and loss prevention procedures + Ensures claims are reported timely and accurately and cooperates with… more
- Bon Secours Mercy Health (Warren, OH)
- …Packaging and selling a prescription drug to a patient or patient representative and assisting with insurance claim processing. Performing diagnostic laboratory ... Robotic Dispensing Systems Prioritization Performance Improvement Packaging Medications Insurance Claim Processing Compounding Medications Attention to Detail Customer Service… more
- Sedgwick (Toledo, OH)
- …performance development plans; conducts colleague performance discussions. + Provides support , guidance, leadership and motivation to promote maximum performance. ... of experience and education required to include three (3) years as an Account Representative **OR** five (5) years adjuster experience including one (1) year in a… more