- Baylor Scott & White Health (Columbus, OH)
- …and outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter data, submission ... Performs analysis and reporting activities related to risk score calculation, claims /encounters data submission, chart review programs and audits, and related… more
- OhioHealth (Columbus, OH)
- …addressing concerns impacting OhioHealth's liability with respect to professional liability claims and incidents and the review and oversight of practitioner claim ... trends from the organization's claims /incidence database. In partnering with System Quality, this role...reputational, or financial. This position will include reviewing potential claims for reporting to the OGC. This role is… more
- Molina Healthcare (Columbus, OH)
- …clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains ... days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and...fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions… more
- Sedgwick (Columbus, OH)
- …you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your ... of clients across the globe, handling complex cases and claims + Collaborate with a talented and supportive team...to be accredited or qualified by experience + **Insurance claims experience:** it is imperative that you have experience… more
- Molina Healthcare (OH)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system configurations… more
- Molina Healthcare (Cincinnati, OH)
- …Responsible for accurate and timely auditing of critical information on claims databases. Maintains critical auditing and outcome information. Synchronizes data ... among operational and claims systems and application of business rules as they...life cycle * Gains a deep understanding of Molina claims life cycle and all processes that affect … more
- Cardinal Health (Columbus, OH)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
- Sedgwick (Hilliard, OH)
- …their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more ... To provide excellent service displaying empathy to callers regarding claims for multiple lines of business, including but not...of business, including but not limited to, expediting the claims process and providing detailed claim notes on all… more
- Sedgwick (Columbus, OH)
- …& Insurance OSS Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple office locations; and to ... claim adjustments, provider requests and operational expense check requests. + Queues claims for Managed Care; transfers payment allocations; and runs manual pre-pay… more
- Molina Healthcare (Dayton, OH)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Hospital payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is… more