- Sedgwick (Columbus, OH)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claim Examiner - Liability | Remote **PRIMARY PURPOSE** : To analyze complex or ... technically difficult general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure… more
- Sedgwick (Columbus, OH)
- …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
- Sedgwick (Columbus, OH)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Complex Claims Advisor | Commercial GL and Auto | Remote Are you looking for an ... needs. **ARE YOU AN IDEAL CANDIDATE?** Are you an experienced attorney or examiner with a strong background in insurance coverage analysis? We're seeking an… more
- Sedgwick (Cincinnati, OH)
- …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance General Liability Claims Team Lead | Premise Liability Experience | Blue Ash, OH (Hybrid… more
- Sedgwick (Columbus, OH)
- …accredited college or university preferred. **Experience** 2-3 years experience processing work comp claims as an examiner . Familiar with CPT, DRG and resources ... Best Workplaces in Financial Services & Insurance Work Comp Claims Negotiator **PRIMARY PURPOSE** **:** To negotiate Out of...a diverse and comprehensive benefits package including: + Three Medical , and two dental plans to choose from. +… more
- Sedgwick (Columbus, OH)
- …& Insurance OSS Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple office locations; and to ... within assigned group. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Completes examiner update reports, claim adjustments, provider requests and operational expense… more
- Molina Healthcare (OH)
- …to law enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of ... for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses information from a tip, member benefits, and… more
- Molina Healthcare (Cincinnati, OH)
- …fraud, abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of ... programs as well as Marketplace + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems + Understanding of datamining… more