- Sedgwick (Columbus, OH)
- …monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex ... and documentation standards. + Providing technical and jurisdictional guidance on claims adjudication , including quality reviews and reserve evaluations for… more
- Sedgwick (Columbus, OH)
- …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
- Sedgwick (Cincinnati, OH)
- …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication . + Compiles reviews and analyzes management reports and… more
- Molina Healthcare (OH)
- …Job Summary Respond to inbound calls to provides support for provider claims adjudication activities including responding to providers to address claim ... issues, and researching, investigating and ensuring appropriate resolution of claims . **Essential Job Duties** * Responds to incoming calls from providers regarding … more
- Molina Healthcare (Columbus, OH)
- …**Job Summary** Respond to inbound calls to provides support for provider claims adjudication activities including responding to providers to address claim ... issues, and researching, investigating and ensuring appropriate resolution of claims . **Knowledge/Skills/Abilities** + Responds to incoming calls from providers… more
- Sedgwick (Cincinnati, OH)
- …individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication ; and to maintain a diary on claims ... Best Workplaces in Financial Services & Insurance General Liability Claims Team Lead | Premise Liability Experience | Blue...& supervisory knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +… more
- Molina Healthcare (Columbus, OH)
- …value hypothesis, and measurable success criteria (eg, first-pass resolution, auto- adjudication rate, claims cycle time, audit findings, cost-to-serve). ... + 5-7 years of project/program management with direct impact on Claims Operations ( adjudication , configuration, appeals/grievances, payment integrity, provider… more
- Elevance Health (Cincinnati, OH)
- …data; CAST Lights On mgmt., E2E claim lifecycle Vetting; FICR; MGCT# Post adjudication ; CPEC- Claims Payment Extract and Capitation; CIFT, CFE; GBD IT Pre/Post- ... **Business Architect Sr. - Claims Systems** **Location:** This role requires associates to...Adjudication ; COPS; UM MATCH LOGIC; PROVIDER/PRICING CONFIG utilization. +… more
- Elevance Health (Cincinnati, OH)
- …data; CAST Lights On mgmt., E2E claim lifecycle Vetting; FICR; MGCT# Post adjudication ; CPEC- Claims Payment Extract and Capitation; CIFT, CFE; GBD IT Pre/Post- ... **Business Architect Sr. - Government Claims ** **Location:** This role requires associates to be...Adjudication ; COPS; UM MATCH LOGIC; PROVIDER/PRICING CONFIG utilization. +… more
- Sedgwick (Columbus, OH)
- …behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and ... Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner | NC, SC, KY, WV Jurisdictions |...Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +… more