• Senior Analyst, Technical Configuration…

    Molina Healthcare (Cincinnati, OH)
    …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... of new and existing health plans. + Executes retroactive claims reports + Runs fee schedule & MRDT update...job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer… more
    Molina Healthcare (11/01/25)
    - Related Jobs
  • AVP Client Services - Casualty | Northeast Region

    Sedgwick (Columbus, OH)
    …Services within the assigned area. **Account Management with a background in liability claims required** **PRIMARY PURPOSE OF THE ROLE:** We are looking for driven ... Executive on national accounts experience and five (5) years of claims /supervisory experience. The candidate must have experience with commercial liability (Auto… more
    Sedgwick (10/30/25)
    - Related Jobs
  • Associate Analyst, Provider Configuration (Remote)

    Molina Healthcare (OH)
    …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... that provider information is loaded accurately to allow for proper claims processing, outbound reporting and directory processes. **JOB QUALIFICATIONS** **Required… more
    Molina Healthcare (10/23/25)
    - Related Jobs
  • Investigator, Coding Special Investigative Unit…

    Molina Healthcare (Akron, OH)
    …enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims ... of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of Local, State… more
    Molina Healthcare (10/22/25)
    - Related Jobs
  • Manager, Appeals & Grievances…

    Molina Healthcare (South Charleston, OH)
    …**I** **E** **N** **C** **E:** + Min. 6 years' experience in healthcare claims review and/or member dispute resolution. + 2 years leadership experience + Experience ... reviewing all types of medical claims (eg HCFA 1500, Outpatient/Inpatient UB92, Universal Claims...job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer… more
    Molina Healthcare (10/18/25)
    - Related Jobs
  • Lead QNXT Analyst, Benefits Configuration

    Molina Healthcare (Cincinnati, OH)
    …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... as a QNXT SME. + Networx / Pricer and claims experience is highly preferred. + SQL is highly...job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer… more
    Molina Healthcare (10/17/25)
    - Related Jobs
  • Actuary, Medicaid Trend Analytics and Data…

    Humana (Columbus, OH)
    …community and help us put health first** Design and maintain Medicaid claims analytics dataset using Databricks. Conduct in-depth analysis of healthcare claims ... Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. Maintain dashboards to communicate key trends to stakeholders. The… more
    Humana (10/16/25)
    - Related Jobs
  • Director, Provider Data Management - Inventory…

    Molina Healthcare (Columbus, OH)
    …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... the development, implementation and maintenance of provider data in the claims payment system. * Supports critical business strategies by providing systematic… more
    Molina Healthcare (10/14/25)
    - Related Jobs
  • Care Team Representative, Weekend

    Sedgwick (Dublin, OH)
    …OF THE ROLE:** To provide excellent service displaying empathy to callers regarding claims for multiple lines of business, including but not limited to, expediting ... the claims process, and providing detailed claim notes on all...required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions… more
    Sedgwick (09/28/25)
    - Related Jobs
  • Specialist, Provider Network Administration (EST…

    Molina Healthcare (Columbus, OH)
    …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... care experience + Experience in one or more of the following: Claims , Provider Services, Provider Network Operations, Hospital or Physician Billing, or similar.… more
    Molina Healthcare (08/14/25)
    - Related Jobs