- Prime Therapeutics (Columbus, OH)
- …drives every decision we make. **Job Posting Title** Business Intelligence Specialist - Sacramento, California market **Job Description** Delivers against business ... that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.). + Consideration will be given… more
- GAP Solutions Inc (Columbus, OH)
- **Position Objective:** As a Junior Human Resource Specialist , apply HR skills in support of managers, program staff and customers on the full range of HR topics ... Assisting with drafting SOP's. + Processing personal liability insurance reimbursement claims . + Initiating tentative selection notifications, notice of results or… more
- ProMedica Health System (Toledo, OH)
- …work with management to resolve. 17. Maintains current payor knowledge for effective claims management and follow up of unresolved claims . 18. Routinely reviews ... workflows for process improvement and efficiencies and provides feedback to management for implementation of changes. 19. Independently reviews assigned workloads and completion to ensure goals are being met. 20. Perform other duties as assigned. Location:… more
- Molina Healthcare (Akron, OH)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems ... when applicable, and the application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and… more
- Acosta Group (Cleveland, OH)
- …to perform the essential duties. _Responsibilities With Regard to Workers' Compensation Claims :_ You are responsible for reporting all employment related injury you ... incur to your direct supervisor as soon as possible following an incident resulting in an injury. **QUALIFICATIONS** _Education/Experience:_ High school diploma or general education degree (GED); or one to three months' related experience and/or training; or… more
- Molina Healthcare (OH)
- …credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. * ... Completes follow-up for provider files on 'watch' status, as necessary, following department guidelines and production goals. * Reviews and processes daily alerts for federal/state and license sanctions and exclusions reports to determine if providers have… more
- EMCOR Group (Cincinnati, OH)
- …+ Assist Fleet Manager with vehicle accidents and tracking of accidents and claims . + Assist Fleet Manager with GPS system, tracking and running location reports. ... + Assist with minor mechanical installations, including installing batteries GPS systems, etc. + Moving vehicles around holding lot, delivering vehicles when necessary, performing quality inspections of new vehicles delivered to Fleet Office and cleaning units… more
- ProMedica Health System (Toledo, OH)
- …practices, including regulatory changes or updates. Reviews medical record documentation and claims data to ensure compliance with CMS and payer guidelines and ... regulations. ACCOUNTABILITIES *All duties listed below are essential unless noted otherwise* 1. Assist in coordinating and developing an educational plan that encompasses accurate documentation, coding, and billing procedures to obtain appropriate… more
- IDEX (Mansfield, OH)
- …brokers and send all export and import documentation to file duty drawback claims . + Responsible for being knowledgeable on new regulations and relaying information ... to the Warren Rupp team + Maintain US supplier documentation on manufacturing affidavits, free trade documentation, and country of origin on an annual basis. + Assist with miscellaneous projects and reporting requests as needed. EDUCATION AND/OR EXPERIENCE… more
- Sedgwick (Cincinnati, OH)
- …to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to ... specifications in assisting with questions and solving problems related to the claims application and servicing processes. + Educates and informs the customer via… more