- Humana (Columbus, OH)
- …an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... researching medical claims + Proficient in Microsoft Office (Word, Excel, Access, PowerPoint) + Working knowledge of SQL **Demonstrated understanding of healthcare… more
- Sedgwick Government Solutions (Dublin, OH)
- …for federal agencies across the US, helping them confidently manage risk and claims . With decades of experience and deep regulatory expertise, we keep agencies ... technology, our tailored solutions help agencies navigate the complexities of federal risk and claims management. Sedgwick Government Solutions… more
- Walgreens (Columbus, OH)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Elevance Health (Columbus, OH)
- …healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **Primary duties may include, but are not limited to:** + Claim reviews ... and claim systems for review of facility, professional and pharmacy claims . + Responsible for identifying and developing enterprise-wide specific healthcare… more
- Sedgwick (Cincinnati, OH)
- …for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With… more
- Molina Healthcare (OH)
- …and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, ... + 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider Network Administration. + 3+ years' experience in Medical Terminology,… more
- The Robison Group (Columbus, OH)
- …the position will be expected to perform investigations of workers compensation claims , liability investigations, multi-line insurance claims , criminal and civil ... background checks, and other investigative tasks. The majority of cases worked in this position require stationary and mobile surveillance . PRINCIPAL RESPONSIBILITIES FOR SURVEILLANCE: + Thoroughly complete assigned cases. + Testify to the collected facts… more
- Cardinal Health (Columbus, OH)
- …service lines, and closing facilities. + Assists the Revenue Cycle Team with claims denial research; finding out whether we are in-network with specific products, ... and specialty contracts to ensure accurate and timely billing and payment of claims . + Ability to work a flexible schedule (including overtime, and weekends), as… more
- CVS Health (Columbus, OH)
- …working with insurance companies to resolve issues associated with our patients' insurance claims . In this role you will ensure timely follow-up on all patient ... accounts, identify and prepare adjustments and write-offs; correct and resubmit claims (subject to policy); follow-up on daily correspondence (denials, short-pays);… more
- The Hartford (Columbus, OH)
- …and a passion for innovation to help shape the future of underwriting, claims , and customer experience in Employee Benefits. You will lead the development and ... agentic workflows, LLM-based systems, and multimodal pipelines tailored to underwriting and claims processes. + Drive the development of reusable AI components and… more