- Molina Healthcare (Akron, OH)
- …Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources to validate ... application. * Follows department processing policies and procedures including, claims processing (claim reversals and adjustments), claim recovery (refund… more
- Trinity Health (Columbus, OH)
- …+ In conjunction with the 3rd party vendor, create/maintain DLT's for claims processing staff **Minimum Qualifications** + .Education: Associate or Bachelor's ... **Description:** Successful candidates will have a strong understanding of Medical claims particularly within Medicare guidelines. Researching claims that do… more
- Molina Healthcare (Akron, OH)
- …communicate written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims ... incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions only_ )… more
- Molina Healthcare (OH)
- …concisely, accurately and in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
- Oracle (Columbus, OH)
- …+ **Regulatory Compliance** : Stay current with regulatory requirements related to claims processing across payers and government entities such as CMS/state ... this exciting arena. We are looking for a Senior Claims Denial Prevention and Appeals Specialist for providing clinical inputs to engineering for developing the… more
- Otsuka America Pharmaceutical Inc. (Cleveland, OH)
- …of everyday health. In its evolved customer engagement model, a Hospital Specialist engages healthcare providers (HCPs) using in-person, virtual, and digital tools, ... and healthcare providers, with a focus on customer-centricity. The Hospital Specialist will report directly to the respective Area Business Lead, coordinating… more
- Robert Half Accountemps (Dayton, OH)
- …Ohio. In this role, you will be responsible for ensuring accurate and efficient processing of claims related to pathology services. This position is a ... to billing accuracy and compliance. Responsibilities: * Process and submit claims for pathology services, adhering to federal, state, and insurance guidelines.… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …exception reports from escrow vendors to ensure the timely completion of payment processing for monthly transactions, monitored by FDICIA & Sarbanes Oxley. + Prepare ... Bancorp requirements. + Review, approve or deny & pay claims for tax provider that result in 5/3 charge...& affiliates on customer services issues relating to escrow processing ; make appropriate account adjustments to correct improper escrow… more
- OhioHealth (Van Wert, OH)
- …verification, providing support to staff members as assigned. The Office Specialist is well organized, highly motivated, customer service oriented, expresses good ... 2. Responsible for electronic and manual insurance verification and processing of insurance paperwork. When necessary obtains pre-authorization from insurance… more
- CVS Health (Columbus, OH)
- …and monitoring the quality and effectiveness of work processes in claim processing and customer service that impact customer satisfaction, medical cost management, ... both routine and non-routine business support tasks for the Sr Quality Specialist area under limited supervision, referring deviations from standard practices to… more