- Sedgwick (Dublin, OH)
- …**_caring counts-and so do you._** **We're not just a global leader in claims management; we're a team driven by empathy, expertise, and impact. Right now, ... the go-to guide for individuals navigating the challenges of disability claims . Your role blends technical expertise with human connection-you'll interpret medical… more
- OhioHealth (Mansfield, OH)
- …Description Summary:** Given that the organization self-insures for professional liability claims , it is essential that the Sr Consultant Risk Management effectively ... patient outcomes that have the potential to progress to professional liability claims against the hospital; analyze, interpret, and generate reports regarding the… more
- KPH Healthcare Services, Inc. (Brecksville, OH)
- …the medication orders for various facilities. Ensuring that all Third-Party claims are billed properly. **Responsibilities** **Job Duties:** + Provides customer ... service and problem resolution to assigned facilities + Responsible for accurate data entry of patient profiles and medications + Maintaining accurate information for patients and facilities + Responsible for billing and crediting each facility appropriately… more
- KPH Healthcare Services, Inc. (Maumee, OH)
- …payersandobtainauthorizations as + Assist inthe preparationand submissionof claims for paymentfromthird party payers,andinvoices forpatientco-payments. + Support ... theresolutionofbilling issuessuch asclaim resubmissions toallpayers, changes incoverage,andclaims + Communicateasrequiredwithpatients about billing issues,including theresults ofapplications for financial hardshipassistanceand other responses… more
- Highmark Health (Columbus, OH)
- …CrewAI) and Generative AI techniques, assessing their applicability to core healthcare payer operations (eg, utilization management, claims processing, member ... cutting-edge applications of Generative AI (GenAI) and Agentic AI within the healthcare payer domain. The intern will work alongside AI Engineers, Data Scientists,… more
- Humana (Columbus, OH)
- …**Preferred Qualifications** + Bachelor's Degree + Prior experience working within the healthcare field + Previous experience with medical claims + Project ... benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also...our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions… more
- OhioHealth (Columbus, OH)
- …addressing concerns impacting OhioHealth's liability with respect to professional liability claims and incidents and the review and oversight of practitioner claim ... trends from the organization's claims /incidence database. In partnering with System Quality, this role...and want to be among the best in the healthcare industry Equal Employment Opportunity OhioHealth is an equal… 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...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …to better deliver on patient, caregiver and HCP needs in an evolving healthcare environment. This model is built around where patients get their care-locally, with ... the intent to better serve patients, caregivers, and healthcare providers, delivering a higher quality experience that ultimately...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- CVS Health (Columbus, OH)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more