- JPMorgan Chase (Columbus, OH)
- …processes to enhance efficiency and speed to market. + Assist with the Marketing Claims process and collaborate with marketers to train them on claims ... + Proven leader with experience in regulatory, compliance, risk, and/or audit . + Working knowledge of advertising/marketing practices across various channels such… more
- Molina Healthcare (OH)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific program experience as… more
- Wells Enterprises (OH)
- …Kroger. Responsibilities Include: **Account Ownership** + KeHE East - VPFs, Claims , Inventory/Orders + Kroger **Kroger Execution** + Promo Validation/Analysis + ... Price Tracking + Price Advance Support + OOS/Scan Monitoring **Business Support** + Post- Audit research + Case projections for display ordering + Data for Sales… more
- Trinity Health (Columbus, OH)
- …wide variety of professional roles including information technology, financial analysis, audit , provider relations and more. **About the job:** Provider Service ... to Plan documentation policies + Review, investigate and advise providers regarding claims status and payment determinations + Maintain a comprehensive knowledge of… more
- OhioHealth (Columbus, OH)
- …+ Knowledge of healthcare provider contracts, operations in billing, claims submission, payment/reimbursement mechanisms & methodologies, health plan benefits ... + Understanding NCQA Accreditation elements, policies and procedures for successful audit , + Computer skill, expertise and experience with MicroSoft Word, Excel,… more
- Datavant (Columbus, OH)
- …**Quality, Compliance, and Scalability** + Ensure analytics products support audit defensibility, regulatory compliance, and documentation traceability. + Design ... SDLC. + **Technical Acumen:** Comfortable working with large datasets, EHR data, claims data, and HCC-based analytics. Familiarity with query languages such as SQL,… more
- Acosta Group (Sandusky, OH)
- …all work assigned. * Assists with preparation for client visits and completes audit corrections. * Builds and maintains rapport with store personnel to effectively ... to perform the essential duties. _Responsibilities With Regard to Workers' Compensation Claims :_ You are responsible for reporting all employment related injury you… more
- Walgreens (Youngstown, OH)
- …Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... companies as well as medical providers and conducts or participates in 3rd party audit . + Assists and supports Store Manager and Pharmacy Manager in analyzing and… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …as needed in creating, executing and monitoring a local ER strategy. + Audit policies and practices and take necessary actions to ensure compliance with local ... guidance where needed. + Coordinate supporting evidence for unemployment claims ; attend hearings as necessary. SUPERVISORY RESPONSIBILITIES: May supervise Employee… more
- BrightSpring Health Services (Columbus, OH)
- …in person(s) served service plan + Oversees implementation of and compliance with audit systems + Observes the implementation of client rights and coaches staff on ... timely reporting of all service site injuries and assist with the management of claims + Monitors service site expenses relative to budgets + Trains staff on… more