- Sedgwick (Columbus, OH)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY PURPOSE** ... **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to… more
- CVS Health (Columbus, OH)
- …amount levels on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical necessity guidelines, determine ... heart, each and every day. **Position Summary** The **Senior Claims Benefit Specialist ** will review and adjust...and interpersonal skills. + Previous experience with DG system claims processing . **Education** + Associate's degree or… more
- Molina Healthcare (Columbus, 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
- CVS Health (Columbus, OH)
- …Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
- Cognizant (Columbus, OH)
- … processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate ... * 1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. * Must… more
- Sedgwick (Dublin, OH)
- … claims and executes technical and jurisdictional requirements for accurate claims processing , benefit review and interpretation of regulations, financial ... Workplaces in Financial Services & Insurance Advocacy Coordination Team Specialist **PRIMARY PURPOSE** **:** Actively researches, resolves, and administers escalated… more
- Elevance Health (Mason, OH)
- …+ Requires a HS diploma or equivalent and minimum of 4 years claims processing and/or customer service experience; or any combination of education ... **Financial Operations Recovery Specialist Lead** **Location:** _Hybrid1:_ This role requires associates...higher level degree preferred. + Leadership experience in a claims processing environment preferred Please be advised… more
- Molina Healthcare (Akron, OH)
- …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... years operational managed care experience (call center, appeals or claims environment). + Health claims processing...center, appeals or claims environment). + Health claims processing background, including coordination of benefits,… more
- Otsuka America Pharmaceutical Inc. (Akron, OH)
- …of everyday health. In Otsuka's evolved customer engagement model, a Neuroscience LTC Specialist will engage HCPs through a variety of in-person, virtual and digital ... and the approved conditions they treat. The Neuroscience LTC Specialist will report directly to the respective Area Business...offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed,… more
- Elevance Health (Mason, OH)
- …+ Requires a HS diploma or equivalent and a minimum of 4 years of claims processing and/or customer service experience; or any combination of education and ... **Financial Operations Recovery Specialist III** **Location:** _Virtual:_ This role enables associate...responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the… more