- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... needed. Follows established guidelines/procedures. + Medical necessity reviews for Medicaid claims and Provider disputes. + Must be passionate about contributing to… more
- Prime Therapeutics (Columbus, OH)
- …and documenting relevant information relating to the case in both the claims processing system and case management systems within pre-determined timelines + Act ... management cases, including entering, reviewing, and documenting requests in both the claims processing system and case management system + Handle phone, email, and… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …learning + Actively solicits feedback on performance As a Bon Secours Mercy Health associate , you're part of a Mission that matters. We support your ... self-insurance and commercial insurance plans through a partnership with the markets, claims management and pro-active risk management to include the minimization of… more
- Dayton Children's Hospital (Dayton, OH)
- …and functions of the department's billing services, which can include claims processing, claim edits, claim rejections, denials and insurance collections. This ... third-party regulations, and improving key revenue-cycle performance indicators. Under the general direction of the Director Patient Financial Services, the manager… more