• QA Analyst PBM Implementation - Remote

    Prime Therapeutics (Columbus, OH)
    …related work experience; HS diploma or GED is required + 2 years of experience within Claims Processing , Audit, Quality or Pharmacy + Must be eligible to work in ... the United States without need for work visa or residency sponsorship + If position sits within Clinical Review Department, the following qualifications are also required + 1 year of experience as a Clinical Review Technician or 2 years of experience in… more
    Prime Therapeutics (10/12/25)
    - Related Jobs

  • NetworX Product Consultant

    Cognizant (Columbus, OH)
    …to meet unique business needs. + Familiarity with healthcare payer systems and claims processing . + Ability to mentor junior consultants and contribute to ... knowledge sharing. **Salary and Other Compensation:** Applicants will be accepted till 10/30/2025 The annual salary for this position will be in the range of $113K-$132K depending on experience and other qualifications of the successful candidate. This… more
    Cognizant (10/10/25)
    - Related Jobs

  • Manager, Healthcare Analytics - Health Plan…

    Molina Healthcare (Cincinnati, OH)
    …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... SQL 2005/2008 SSRS report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. **Preferred Experience** 3 - 5… more
    Molina Healthcare (10/04/25)
    - Related Jobs

  • Coding Auditor Educator-Inpatient

    Highmark Health (Columbus, OH)
    …analytical and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong ... education/training background in coding and reimbursement + Registered Health Information Associate (RHIA) credential **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work… more
    Highmark Health (09/20/25)
    - Related Jobs

  • Investigator

    Highmark Health (Columbus, OH)
    …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... have understanding of technical and financial aspects of the health insurance industry + Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required + Must possess excellent communication skills and be detailed… more
    Highmark Health (09/10/25)
    - Related Jobs

  • HUB International Internship Program Summer

    HUB International (Columbus, OH)
    …experience in managing policies, endorsements, renewals, data management, and assisting in claims processing . + **Market Research** : Contribute to market ... analysis and research projects, to provide valuable insights for informed decision-making. + **Technical Training** : Participate in workshops, training sessions to strengthen your skills and industry knowledge. + **Reporting:** Prepare reports and… more
    HUB International (09/04/25)
    - Related Jobs

  • Medicaid State Technology Lead

    Humana (Columbus, OH)
    …and processes + Solid understanding of healthcare operations, particularly around claims processing , enrollment, provider data management and clinical ... operations; Medicaid preferred + Comprehensive understanding of a Medicaid Managed Care architecture, tools, utilities and processes utilized to deliver on core competences + Delivery focused - time, scope, quality + In-depth knowledge of Medicaid regulations,… more
    Humana (09/03/25)
    - Related Jobs

  • GEN AI Sr Data Scientist/Data Scientist

    The Hartford (Columbus, OH)
    …to our strategy. Join a team that's pioneering AI-driven solutions in underwriting, claims processing , and customer service, transforming how we operate and make ... decisions. As part of our horizontal language-focused Gen AI team, you'll tackle advanced use cases and shape the development of Gen AI capabilities across the organization. Here, your work will have a tangible impact, driving innovation and operational… more
    The Hartford (08/21/25)
    - Related Jobs

  • Encounter Data Management Professional

    Humana (Columbus, OH)
    …make an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... cross functional teams and support analyzing business processes, error processing , issues and ticket creations with the product management...researching medical claims + Proficient in Microsoft Office (Word, Excel, Access,… more
    Humana (10/08/25)
    - Related Jobs

  • Administrative Assistant Warehouse 1st Shift

    Ryder System (Etna, OH)
    …shipment times, product cuts, loads not picked up by the carrier, and damage claims + Coordinates processing of export orders, filling out export paperwork, ... generates export labels, maintaining export paperwork + Processes returns in Warehouse Management System (WMS) and maintains paperwork + Pallet management: orders CHEP and white wood pallets for the site, conducts reconciliation of pallet count, researches… more
    Ryder System (10/14/25)
    - Related Jobs