- Humana (Columbus, OH)
- …coding certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ... in healthcare or business-related field + Knowledge of internal Medical Coverage Policies and Claims Payment Policies...Policies and Claims Payment Policies + CAS claims processing experience + Experience in data… more
- CVS Health (Columbus, OH)
- …with key payers to discuss reimbursement issues and payer publication notices affecting claims processing changes + Ensure daily reconciliation of electronic ... representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances,… more
- Bon Secours Mercy Health (Warren, OH)
- …drug to a patient or patient representative and assisting with insurance claim processing . Performing diagnostic laboratory testing as defined in state ... Robotic Dispensing Systems Prioritization Performance Improvement Packaging Medications Insurance Claim Processing Compounding Medications Attention to Detail… more
- Open Mind Health (OH)
- …thrive in an environment of excitement, expansion, and innovation will likely find a home at Open Mind Health. This is an opportunity to join a fast-growing ... will also engage in timely follow-up to billing disputes, claim denials, and any other intervening issue that has...that has the potential to interrupt the flow of claims and subsequent payer remittances. This individual will also… more
- Evolent (Columbus, OH)
- …of Actuaries credentials with Group Health track **(Preferred)** + Familiarity with healthcare claim processing **(Preferred)** + 5+ years experience at payer or ... You'll Be Doing:** + Serve as the lead for medical cost and revenue projections for Performance Suite business...clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for… more
- Bon Secours Mercy Health (Youngstown, OH)
- …Prescriptions Robotic Dispensing Systems Performance Improvement Packaging Medications Insurance Claim Processing Compounding Medications Attention to Detail ... Exposure to moving mechanical parts Exposure to dust/fumes **Skills** Electronic Medical Records (EMR) Stocking Medications Mathematically Proficient Processing … more
- Humana (Columbus, OH)
- …Operations encompasses critical functions including care coordination, quality measurement, billing, claims processing , and customer service, each essential to ... operational knowledge of core functional areas (care coordination, quality, billing, claims , and customer service). + Collaborate with each Insurance Operations… more
- Humana (Dayton, OH)
- …best outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Adequately staff and manage the program ... skills to make an impact** **WORK STYLE:** Work at home /remote. While this is a remote position, occasional travel...CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and investigative process development +… more
- CenterWell (Columbus, OH)
- …scheduling, pre-appointment preparation, follow up tasks for medication reconciliation/education. + Processing of select medication claim updates (lists) as ... + Know and continually review medication brand and generic names, medical terminology, and pharmaceutical calculations. + Medication adherence outreach, auditing,… more
- Humana (Columbus, OH)
- …and processes + Solid understanding of healthcare operations, particularly around claims processing , enrollment, provider data management and clinical ... time that is best for your schedule. To ensure Home or Hybrid Home /Office employees' ability to...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more