- Highmark Health (Columbus, OH)
- …activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code ... which supports compliant coding. Interacts with external consultants regarding billing , coding and/or documentation and evaluates their recommendations and/or… more
- Molina Healthcare (OH)
- …executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical decision… more
- Aston Carter (Solon, OH)
- …for processing Credits/Debits in SAP that have the necessary approvals thru the Claims area or the normal Sales channel. This position will assist and backup ... finance department from documentation provided * Review and remove billing /credit blocks on other associate's entries * Create credits...blocks on other associate's entries * Create credits for claims approved to be processed out of CRM from… more
- Molina Healthcare (OH)
- …executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical decision… more
- Molina Healthcare (Cincinnati, OH)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete… more
- Norstella (Columbus, OH)
- …*4+ years of professional experience working hands on with RWD (eg, open/closed claims , APLD, lab, EMR/EHR, hospital chargemaster, billing codes, etc.) *Advanced ... unified Real World Data asset, NorstellaLinQ, a combination of claims , lab, SDOH and EMR data. You will be...quality. *Perform in-depth analyses on healthcare data sources, including claims , lab, EMR/EHR, and SDOH data, to uncover actionable… more
- Norstella (Columbus, OH)
- …years of professional experience working hands on with RWD (eg, open/closed claims , APLD, lab, EMR/EHR, hospital chargemaster, billing codes, etc.) ... Norstella's unified Real World Data asset, a combination of claims , lab, SDOH and EMR data. You will be...analyzing a wide range of healthcare data sources, including claims , lab results, electronic medical records (EMR), and other… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …digital health, or SaaS driven offerings. + Ability to educate on billing , coding, and reimbursement models particularly in digital health or specialty healthcare ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Walgreens (Akron, OH)
- …technology knowledge of pharmacy systems including workflow, prescription fulfillment, billing , clinical documentation, training, inventory management, and point of ... technology. Finds opportunities to improve productivity + Ensures insurance claims are processed accurately to prevent payment rejections. Resolves patient… more
- J&J Family of Companies (Cleveland, OH)
- …on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local ... both pharmacy and medical/buy & bill benefits (as applicable), coding, and billing . . Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill,… more