- Sedgwick (Columbus, OH)
- …client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and… more
- Sedgwick (Columbus, OH)
- …growth, and inclusion. **ESSENTIAL RESPONSIBILITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate ... behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and… more
- Sedgwick (Columbus, OH)
- …exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner | Multi-Line | Public Entity | Remote...professional and timely manner. + Communicates claim activity and processing with the claimant, insured, client and agent or… more
- Sedgwick (Columbus, OH)
- …exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and ... as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner | General Liability BI | Captive | Remote As a Claims … more
- CVS Health (Columbus, OH)
- …Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, ... At CVS Health , we're building a world of health...**Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines.… more
- Sedgwick (Dayton, OH)
- …exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and ... Sedgwick Office - Hybrid **PRIMARY PURPOSE** : To analyze complex or technically difficult general liability claims to determine benefits due; to work with high… more
- Highmark Health (Columbus, OH)
- …+ High school diploma or GED + Experience in pharmacy prescription claims processing /submission/payment. **Preferred** + Associate degree + Pharmacy technician ... Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings. The incumbent… more
- Medical Mutual of Ohio (OH)
- …of integration of evidence-based medicine and managed care principles. + Knowledge of health plan claims adjudication and utilization review processes ... Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million… more
- Humana (Columbus, OH)
- …health first** **Requires a strong foundation in COBOL mainframe development ** The Claims Adjudication System (CAS) team at Humana is essential in delivering ... core services through effective claims processing and management solutions. This position...offers a variety of benefits to promote the best health and well-being of our employees and their families.… more
- Molina Healthcare (Columbus, OH)
- …in working with claims and claim configuration teams to streamline adjudication and resolve claim processing issues + Familiar with payment integrity ... requirement documentation, and Sponsor approvals. Works as the liaison between the health plan and IT to ensure requirements are interpreted correctly and the… more
Recent Jobs
-
Licensed Clinical Social Worker (LCSW)
- STG International (Savannah, TN)
-
Hvac Service Engineer
- Actalent (Indianapolis, IN)
-
Cardiovascular Invasive Specialist Internal Traveler
- Boulder Community Hospital (Boulder, CO)
-
Assistant Teacher, River Valley Montessori of
- Learning Care Group (Savage, MN)