- Lincoln Financial (Columbus, OH)
- …at a Glance** We are excited to bring on a highly motivated Integrated Absence Claims Specialist to staff our ever-growing claims organization. As an ... Integrated Absence Claims Specialist , you will manage a workload...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- Cognizant (Columbus, OH)
- …of claim 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 be able… more
- Nestle (Solon, OH)
- …data, identifying trends and areas of focus and coaching and developing the specialist team within the BSC. This role collaborates across key internal business ... + Create and foster high performance culture within the BSC specialist team focused on coaching, engagement, accountability, innovation, collaboration, continuous… 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
- Sedgwick (Columbus, OH)
- …for absence from work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims ; documents decision rationale; and completes ... Best Workplaces in Financial Services & Insurance Disability Clinical Specialist **PRIMARY PURPOSE** : To perform clinical evaluations, consult...medical review of all claims to ensure information substantiates disability. + Provides clear… more
- Prime Therapeutics (Columbus, OH)
- …results with limited supervision. + Demonstrated strategic and analytical abilities to review and evaluate information such as claims data, suspicious patterns ... drives every decision we make. **Job Posting Title** SIU Specialist - Pharmacy Tech - Remote in the California...Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the… more
- CVS Health (Columbus, OH)
- …And we do it all with heart, each and every day. **Position Summary** Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims ; ... amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, complete… more
- Molina Healthcare (Akron, OH)
- …to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance ... standards set by the department. + Apply contract language, benefits, and review of covered services + Responsible for contacting the member/provider through written… more
- Walgreens (Madison, OH)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Veterans Affairs, Veterans Health Administration (Dayton, OH)
- Summary The Supervisory Health Systems Specialist , Credentialing and Privileging Manager oversees all functions related to healthcare providers' professional ... composes committee minutes, privileging requests and/or actions, malpractice payments, tort claims and adverse actions. Coordinates with Service Chiefs and service… more