- Trinity Health (Westerville, OH)
- …and billing support. The technician will also process insurance claims , resolve third-party rejections, and coordinate refills and prior authorizations ... with providers and payers. Additional duties include delivering medications through the meds-to-beds program, maintaining a clean and compliant work environment, and providing exceptional customer service by addressing patient questions and concerns. The… more
- Cardinal Health (Twinsburg, OH)
- …between dispensing pharmacies + Review patient insurance coverage status and adjudicate claims for patient orders + Enter prescriptions in pharmacy system + Maintain ... knowledge of and abide by applicable pharmacy laws and regulations + Communicate with all customers (patients, clinics, care-givers, physicians) in a pleasant and professional manner **_Qualifications_** + High School diploma, GED or equivalent, or equivalent… more
- City of Cincinnati (Cincinnati, OH)
- …clients; schedules appointments; interprets and evaluates medical terminology and claims . Orders and maintains nutritional supplies as needed. Performs nutritional ... assessment of participants by assessing height/weight, hemoglobin, and diet history; includes performance of noninvasive finger stick of participants. Performs routine follow-up counseling on clients and identifies opportunities for improving service delivery… more
- The Cigna Group (Cleveland, OH)
- …of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales ... and Marketing and Service. + Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements. + Contributes to the development of alternative network initiatives.… more
- Capgemini (Cincinnati, OH)
- …Medicaid or Exchange program/ product build knowledge (Enrollment, Eligibility, Claims , Provider network, encounters etc) (Highly Recommended having exposure to ... one or many functions) E2E set of Pharmacy Benefits Experience in working with Plan and Pharmacy Benefits Manager Setting up Pharmacy call center Pharmacy member materials Provider Materials State Connections Manage large to high complexity programs… more
- Turner & Townsend (Columbus, OH)
- …Review construction progress and approve recovery plans. + Review the claims resolutions recommendations. + Collaborate with appropriate internal and external ... stakeholders to achieve consent. + Establishes ongoing risk process and coordinates regular Monte Carlo analyses. + Project intake: Consider expansion of deliverables to ensure more robust business cases/estimates/schedules are developed. + Consider the… 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.… more
- Molina Healthcare (Cincinnati, OH)
- …setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed ... healthcare administration and/or Provider Services. + 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie, physician, group and hospital contracting, etc. + Working… more
- Advatix, Inc. (Zanesville, OH)
- …to property risk management, environmental compliance, and workers' compensation claims + Help integrate safety processes into business operations, including ... audits and oversight at various sites + Stay informed about relevant safety laws and regulations affecting HR for Growth + Aid in sustainability reporting initiatives + Assist in developing the "Safety playbook" to guide customers in managing audits and… more
- Thrivent Financial (Maumee, OH)
- …S&P Global Ratings. Ratings are based on Thrivent's financial strength and claims -paying ability, but do not apply to investment product performance. Thrivent values ... diversity and inclusion, and we're committed to providing an Equal Employment Opportunity (EEO) without regard to race, religion, color, gender, gender identity, national origin, age, disability, marital status, citizenship status, military or veteran status,… more
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