- Molina Healthcare (Dayton, OH)
- …sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials. **KNOWLEDGE/SKILLS/ABILITIES** + Performs ... Condition Categories) Risk Adjustment Model + Background in supporting risk adjustment management activities and clinical informatics + Experience with… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …state and federal laws and regulations. Serves as Title IX coordinator. + **Legal Compliance and Risk Management ** : Work proactively with legal counsel ... Manager (CRCM) **Education** + Master's Degree in Law and Governance, Legal Studies, Risk Management , Compliance or related studies (required). + Juris… more
- Humana (Columbus, OH)
- …PCO is responsibility to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This team ensures that healthcare ... policies and internal controls, and communicating issues and recommendations to management . Coordinates implementation and compliance with corrective action… more
- IDEX (Mansfield, OH)
- …we have something special for you. PRIMARY FUNCTION: Responsible for maintaining compliance with the applicable laws and IDEX Corporate policies, and mitigating the ... risk that comes with global trade. Work with forwarders...ensure all international shipments leave on time and meet compliance requirements. PRIMARY DUTIES AND RESPONSIBILITIES: + Use Precision… more
- Sedgwick (Cincinnati, OH)
- …work dates appropriately in system(s). + Manages claims in close collaboration with Claims Management Team. + Supports other claims management staff ... status changes due to functional limitations/medical instability. + Documents communications and claims management appropriately in system(s). + Responds to all… more
- Sedgwick (Dublin, OH)
- … supervisory experience preferred. **Skills & Knowledge** + Thorough knowledge of claims management procedures and processes for disability + Excellent oral ... for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles, reviews, and analyzes management reports… more
- Sedgwick (Dublin, OH)
- …or college preferred. **Experience** Three (3) years of benefits or disability case/ claims management experience or equivalent combination of education and ... (SSDI), and other disability offsets. + Medically manages disability claims ensuring compliance with duration control guidelines...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps… more
- Sedgwick (New Albany, OH)
- …on state regulations. **Experience** Three (3) years of benefits or disability case/ claims management experience or equivalent combination of education and ... regarding return to work. + Medically manages complex disability claims ensuring compliance with duration control guidelines...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps… more
- Sedgwick (Dublin, OH)
- …on state regulations. **Experience** Three (3) years of benefits or disability case/ claims management experience or equivalent combination of education and ... regarding return to work. + Medically manages complex disability claims ensuring compliance with duration control guidelines...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps… more
- Sedgwick (Dublin, OH)
- …combination of education and experience required. One (1) year of benefits or claims management experience preferred. **Skills & Knowledge** + Excellent oral and ... on the ADA, state, and/or client requirements. Processes ADA claims ensuring compliance with duration control guidelines,...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps… more