• FNMA Claims Recovery & Loss Analysis…

    Carrington (Columbus, OH)
    …processes up to and including Loss Mitigation, Bankruptcy, Foreclosure, Conveyance and Claims in addition to mortgage servicing state, federal and agency guidelines ... within one or more default related areas such as Foreclosure, Bankruptcy, Default MI Claims , Loss Mitigation, Recovery, etc. + Previous FHA, VA, USDA and PMI … more
    Carrington (11/20/25)
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  • Senior Manager, Provider Claims Diagnostics

    CVS Health (Columbus, OH)
    …improvements across key provider journeys including self-service / digital transactions, claims management, dispute resolution, and more. They will directly support ... following areas: provider revenue cycle operations / optimization, payer relations, healthcare analytics. + Ability to work collaboratively in a cross-functional… more
    CVS Health (11/06/25)
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  • Senior RWD Analytic Consultant

    Norstella (Columbus, OH)
    …relational databases, ensuring data accuracy and quality. * Perform in-depth analyses on healthcare data sources, including claims , lab, EMR/EHR, and SDOH data, ... unified Real World Data asset, NorstellaLinQ, a combination of claims , lab, SDOH and EMR data. You will be...worked in and understands the dynamics of the US healthcare ecosystem. **Responsibilities:** * Lead the delivery of complex… more
    Norstella (10/25/25)
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  • Healthcare Regulatory Compliance Manager…

    Fujifilm (Columbus, OH)
    …on the Fujifilm Healthcare Code of Conduct, Interactions with Healthcare Professionals Policy, Anti-Kickback, False Claims Act, HIPAA, Anti-Corruption Policy ... **Minimum of 2 years of experience with Antitrust.** + Strong understanding of healthcare regulations (eg, Anti-Kickback Statute, False Claims Act) and global… more
    Fujifilm (11/05/25)
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  • Medical Director - OP Claims Mgmt

    Humana (Columbus, OH)
    …medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, ... management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilization management… more
    Humana (11/24/25)
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  • Pricing Analyst Senior - Remote

    Prime Therapeutics (Columbus, OH)
    …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare , and/or related field + Must be eligible to ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
    Prime Therapeutics (10/31/25)
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  • Medicaid State Technology Lead

    Humana (Columbus, OH)
    …operations, technology, communications, and processes + Solid understanding of healthcare operations, particularly around claims processing, enrollment, provider ... make an impact** **Required Qualifications** + Bachelor's degree in healthcare administration, public health, information systems, business, policy administration or… more
    Humana (11/20/25)
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  • Epic Systems Analyst - Resolute Hospital Billing

    Highmark Health (Columbus, OH)
    …experience within one or more Epic modules. **Preferred** + 2+ years of Healthcare Revenue Cycle experience ( Claims , Patient Access, Billing) + Epic ... **Preferred** + Bachelor's degree in Computer Science, Information Systems, Healthcare or relevant experience. **LICENSES or CERTIFICATIONS** **Required** + Epic… more
    Highmark Health (09/24/25)
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  • Specialist, Appeals & Grievances - Remote ( Must…

    Molina Healthcare (Cincinnati, OH)
    JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
    Molina Healthcare (11/23/25)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (Cincinnati, OH)
    JOB DESCRIPTION Provides support for claims activities including reviewing and resolving **Provider No Surprises Act** cases in accordance with the standards and ... ensure that internal and/or regulatory timelines are measured correctly. * Researches claims using support systems to determine **Provider No Surprise Act** cases… more
    Molina Healthcare (11/21/25)
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