- UIC Government Services and the Bowhead Family of Companies (Cleveland, OH)
- …and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual ... based on the provisions contained within The Alaska Native Claims Settlement Act. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. All… more
- Evolent (Columbus, OH)
- …You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population ... with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including prior authorization data… more
- Meta (Columbus, OH)
- …projects. Provide leadership to site teams for Delay Tracking, EOT requests and claims . Responsible for making recommendations that are in line with contract and ... performance 19. Experience negotiating schedule changes or complex construction claims 20. Successful development and implementation of scheduling or project… more
- CVS Health (Columbus, OH)
- …work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... Linux OS, GCP/ AWS/ Azure * Experience working with medical and/or pharmacy claims data * Experience in healthcare industry, including health insurance, PBM or… more
- Banner Health (OH)
- …coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing multiple ... base and indices, and must be familiar with coding and abstracting software, claims processing tools, as well as common office software and electronic medical… more
- Highmark Health (Columbus, OH)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior ... school diploma or GED + Experience in pharmacy prescription claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician… more
- Saia, Inc (Riverside, OH)
- …and ensures a positive customer experience. + Investigates freight issues, manages claims processes, and applies policies to resolve disputes fairly and efficiently. ... issues promptly in accordance with company procedures to minimize potential claims . + Identifies recurring service issues and recommends improvements to enhance… more
- Sedgwick (Dublin, 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
- Centene Corporation (Columbus, OH)
- …+ Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics + Perform ... care or medical group experience, provider relations, quality improvement, claims , contracting utilization management, or clinical operations. Project management… more
- Evolent (Columbus, OH)
- …+ Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to identify cost drivers, utilization patterns, ... Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and various… more