- Prime Therapeutics (Columbus, OH)
- …Knowledge of PBM functions such as but not limited to customer service, claims , benefits, prior authorizations, rebates, and networks. + Build business case for all ... client-facing initiatives, working with internal roles to create input to the business cases. + Support Sr. Director/Director and other key leaders in communication with clients. + Manages small scale projects on behalf of Prime and our Blue partners. +… more
- Walgreens (West Chester, OH)
- …to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... insurance companies as well as medical providers and participates in 3rd party audit. + Follows-up with medical providers' offices to clarify prescribed medications, dosages, refills, interactions and allergies to suggest alternative medications, and answer… more
- Robert Half Office Team (Cincinnati, OH)
- …organizational standards. * Process payments, verify insurance details, and handle claims to ensure seamless transactions. * Monitor office supplies, place orders, ... and maintain inventory to support smooth daily operations. * Perform various administrative tasks as assigned to support the team and ensure operational efficiency. Requirements * A minimum of 1 year of experience in patient registration, medical front office,… more
- Evolent (Columbus, OH)
- …to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication to key ... internal and external executive stakeholders + Partner with team members across the organization to ensure accurate and timely delivery of quarterly forecast updates + Build tools and capabilities to quantify and narrow range of expected outcomes for financial… more
- Evolent (Columbus, OH)
- …+ Participates in continuing education initiatives. + Collaborates with Claims , Quality Management and Provider Relations Departments as requested. + ... Availability on some weekends and holidays may be required + Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, unrestricted license. + High School Diploma or… more
- ASRC Industrial Services (Cincinnati, OH)
- …Regional Corporation (ASRC), an Alaska Native Corporation (ANC) established under the Alaska Native Claims Settlement Act of 1971. As part of an ANC, EQM is a ... certified 8(a) Small Disadvantaged Business, offering further contracting advantages to government agencies. These designations help clients meet their diversity spending objectives, while also providing sustainable returns for 13,600 Inupiat shareholders. We… more
- Meta (Columbus, OH)
- …on prescription wearer and channel needs and mindsets 8. Manage prescription product claims , content, and pricing in B2C and B2B contexts, and for wearers with ... and without insurance **Minimum Qualifications:** Minimum Qualifications: 9. 7+ years of experience in product marketing, product management, management consulting, business strategy in vision correction and/or eye health fields 10. In-depth knowledge of… more
- Elevance Health (Mason, OH)
- …management. + Respond to and resolve issues related to member/provider complaints, claims processing issues and appeals. **Minimum requirements:** + PharmD from an ... accredited school of pharmacy by start date. + Registered Pharmacist; must possess an active, unrestricted state license to practice pharmacy as an RPh or able to obtain one within 90 days of start date + Authorized to work in the US without future visa… more
- Ryder System (Etna, OH)
- …times, product cuts, loads not picked up by the carrier, and damage claims , problem solving. + Conduct accuracy/quality reviews of CS processes to ensure that ... quality is being maintained. + Assist with training employees in processes when necessary. + Ensure that any escalated issues are handled either personally or brought to the attention of manager for resolution. + Perform and support all job requirements as… more
- Elevance Health (Independence, OH)
- …of reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of utilization/care management ... policies and procedures, chairs and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and participates in interdepartmental and/or cross brand workgroups. + May require the development of a focused skill set… more