- J&J Family of Companies (Cincinnati, 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
- J&J Family of Companies (Columbus, 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
- Humana (Columbus, OH)
- …3 or more years of healthcare experience in revenue cycle management (related to billing , coding, collections for Medicare and Medicaid claims ) + Experience with ... federal and/or state requirements related to Provider Clinic operations, billing , investigations, and processes. Coordinates site visits for regulators, coordinates… more
- Holzer Health System (Bidwell, OH)
- …Insurance Clerk is a medical biller that is responsible for submitting medical claims to insurance carriers or companies, requires experience with the electronic and ... paper systems used in medical insurance billing and excellent attention to detail. Education, Work Experience...detail. Education, Work Experience and Licensure * High School Diploma or GED Required * Prior Insurance Billing experience… more
- Robert Half Office Team (Mason, OH)
- …records with precision and confidentiality. * Handle payment processing and insurance claims efficiently. * Manage inventory by ordering supplies and ensuring stock ... * Oversee insurance authorizations and benefit-related functions. * Collaborate on billing processes to ensure accuracy and compliance. * Support clinical trial… more
- Humana (Columbus, OH)
- …adjudication, where appropriate. Monitors/Leads investigations to ensuring appropriateness of billing practices using a variety of investigational tools. Prepares ... Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of...CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + Experience… more
- OhioHealth (Columbus, OH)
- …plans, ensuring accuracy of information placed in information systems and billing systems. Works electronic medical record work queues to correct registration ... C-86s, Medco 17s, Industrial appeal paperwork and retroactive C-9s. 6. Works Industrial claims in the electronic medical record system, to include but not limited… more
- Elevance Health (Mason, OH)
- …expertise, as well as single point of service support (eg, calls and claims ) to key client contacts (HR, Benefit Administrators, client key decision makers, etc.) ... benefit/plan changes as needed + Coordinates complaint resolution concerning billing or services rendered with appropriate department(s). + Coordinates client… more
- Elevance Health (Columbus, OH)
- …volume of provider. + Schedules review with provider, analyzes data to select claims to be reviewed, conducts review using medical charts, medical notes, itemized ... + Verifies dollar amount on claim is correct in claims system and writes report of the findings of...payments for any overpayments. + Identifies aberrant patterns of billing and detects potential abuse. + Participates in developing… more
- Aston Carter (Chagrin Falls, OH)
- …for the finance department from provided documentation. + Review and remove billing /credit blocks on other associates' entries. + Create credits for claims ... approved to be processed out of CRM from the Claims Team. + Enter credit orders in SAP with proper approvals and documentation. + Validate credit memo dollar values… more