- Zurich NA (Cleveland, OH)
- …experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate Degree and 5 or more years of experience ... We may, at the sole discretion of the Hiring Manager , be open to hiring remote talent This role...Zurich North America is a leading provider of commercial property -casualty insurance solutions and a wide range… more
- Elevance Health (Mason, OH)
- …Specialist Lead** is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to ... cash receipts, cash application, claims audits, collections, overpayment vendor validation, and ...submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health… 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...submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health… more
- Elevance Health (Mason, OH)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and...submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health… more
- Elevance Health (Mason, OH)
- …with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable ... and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize...submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health… more
- Elevance Health (Columbus, OH)
- … claims . Health insurance experience required with understanding of health insurance policies, health insurance claims handling and provider network ... and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying and developing enterprise-wide specific… more
- Elevance Health (Mason, OH)
- …decisions. **How You Will Make An Impact:** + Analyze and monitor weekly incurred claims , paid claims , pharmacy, lab results, and authorizations to identify cost ... and actuarial software tools. + Experience working with large administrative claims datasets and healthcare cost/utilization metrics. + Ability to apply actuarial… more
- Elevance Health (Mason, OH)
- …SPECIALIST II** is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to ... **How you will make an impact:** + Audits paid claims for overpayments using various techniques including systems-based queries,...submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health… more
- Elevance Health (Mason, OH)
- …with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities ... prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses...submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health… more
- Elevance Health (Mason, OH)
- …Analyst I** is responsible for auditing and facilitating the recovery of claims overpayments as identified by our business partners. Responsible for research, ... **How you will make an Impact:** + Audits paid claims for overpayments using various techniques including systems-based queries,...submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health… more