- Cardinal Health (Columbus, OH)
- …supervises and manages audits to determine organizational integrity of billing for professional (physician) services and/or hospital (technical) services, including: ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation of… more
- ProMedica Health System (Toledo, OH)
- …practices, including regulatory changes or updates. Reviews medical record documentation and claims data to ensure compliance with CMS and payer guidelines and ... an educational plan that encompasses accurate documentation, coding, and billing procedures to obtain appropriate reimbursement. 2. Provide regularly scheduled… more
- Sedgwick (Cleveland, OH)
- …and government entities. The auditor will apply client specified billing guidelines and/or Generally Accepted Principles and Standards ("GAPS"). **ESSENTIAL ... RESPONSIBILITIES** + Ability to understand and apply clients' billing guidelines and standards. + Work with client to develop or enhance billing protocol. +… more
- KPH Healthcare Services, Inc. (Maumee, OH)
- …balances. **Responsibilities** + Manage the collection process for outstanding claims , including contacting insurance companies, patients, and other responsible ... written correspondence. + Investigate and resolve denied or partially paid claims , identifying root causes and implementing corrective actions. + Collaborate with… more
- Medical Mutual of Ohio (OH)
- …+ Designs, tests and runs queries to generate monthly reports for premium, claims and enrollment to be used by several operating areas for financial reporting. ... needs including reinsurance reporting, group level analysis and TPA billing . + Creates new tools and reports for Finance...users. + Creates quarterly and annual reports for premium, claims and enrollment to be used in preparing the… more
- Evolent (Columbus, OH)
- …RVUs, bundled payments, etc. is preferred + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and ... into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant… more
- Bowman (Columbus, OH)
- …service to our clients. **Purpose** Responsible for the project billing process, including responding to client inquiries, verifying employee's chargeable ... time; in accordance with the established accounting standards and billing policy. **Responsibilities** **Leadership and Direction** + Perform work...that may arise as it relates to disputes, or claims + Act as liaison between operations and many… more
- KPH Healthcare Services, Inc. (Maumee, OH)
- …is to support the process of the company's billing function. **Responsibilities** **Job Duties:** + Reportanymisconduct,suspicious orunethicalactivitiesto the ... third party payersandobtainauthorizations as + Assist inthe preparationand submissionof claims for paymentfromthird party payers,andinvoices forpatientco-payments. + Support theresolutionofbilling… more
- Holzer Health System (Bidwell, OH)
- The insurance clerk is responsible for working claims , processing edits, and doing their due diligence to ensure correct claim processing and payments from insurance ... Athena. Prepare reviews/appeals as required; keep current on carrier specific billing guidelines, payer policies, and specific payer coding guidelines; follow-up on… more
- Cardinal Health (Columbus, OH)
- …attorney with expertise in healthcare regulatory compliance, including third party billing and reimbursement. The Assistant General Counsel - At-Home Solutions will ... but not limited to, laws and regulations relating to third party payor billing and reimbursement as well as other laws and regulations applicable to durable… more