- Molina Healthcare (Dayton, OH)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Hospital payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is… more
- Molina Healthcare (Dayton, OH)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of… more
- Elevance Health (Mason, OH)
- …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines...in good faith believes is the range of possible compensation for this role at the time of this… more
- Walmart (Wintersville, OH)
- …action plans to address audit findings Validates claim records work with workers compensation case managers for investigation of claims Asset Protection Security ... salary range for this position is $65,500.00 - $98,000.00 Additional compensation includes annual or quarterly performance bonuses. Additional compensation … more
- Zurich NA (Independence, OH)
- …work collaboratively across business units including but not limited to; claims , finance, risk engineering, actuary, and technical underwriting while gaining ... and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...+ Strong verbal and written communication skills At Zurich, compensation for roles is influenced by a variety of… more
- Sedgwick (Cincinnati, OH)
- …Adjuster - Mid Atlantic Region **PRIMARY PURPOSE** **:** To handle losses or claims regionally unassisted up to $10M, including having the ability to address most ... to determine insurance coverage. + Administers and reconciles complex catastrophic claims for property. + Interviews, telephones, or corresponds with claimant and… more
- Walmart (Gallipolis, OH)
- …Manages facilitylevel training and execution of asset protection safety and claims and receiving procedures by reviewing the application of policiesprocedures ... Determines training needs Develops and delivers training as needed Manages claims and receiving operations by ensuring proper policies and procedures are… more
- Sedgwick (Dublin, OH)
- …FMLA and other paid and unpaid state, military, and/or company-specific leave claims ; tracks and codes documentation in accordance with internal workflow processes. ... needs. + Analyzes FMLA and other complex paid and unpaid leave claims to determine eligibility, certification, payment calculations, payments and/or adjustments in… more
- Sedgwick (Dublin, OH)
- …Establishes FMLA and other unpaid state, military, and/or company-specific leave claims ; tracks and codes documentation in accordance with internal workflow ... processes. + Analyzes FMLA and other unpaid claims to determine eligibility and certification in compliance with...required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions… more
- Molina Healthcare (Cleveland, OH)
- …rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate ... for Monthly Governance and Operations Reviews + Performs root cause analysis of claims and encounter data and develops recommendations based on data and industry… more