- Manulife (OH)
- …been followed in accordance with established guidelines and policies. + Audit medical record summaries to ensure documentation is in accordance with our established ... research projects pertaining to risk assessment. + Process formal underwriting appeals and complaints. + Review underwriting fraud referrals for appropriateness and… more
- KPH Healthcare Services, Inc. (Maumee, OH)
- …outstanding balances. **Responsibilities** + Manage the collection process for outstanding claims , including contacting insurance companies, patients, and other ... written correspondence. + Investigate and resolve denied or partially paid claims , identifying root causes and implementing corrective actions. + Collaborate with… more
- Owens & Minor (Columbus, OH)
- …our success starts with our teammates. Owens & Minor teammate benefits include: + Medical , dental, and vision insurance , available on first working day + 401(k), ... plan + Tuition reimbursement **JOB SUMMARY** The collections representative follows-up with insurance companies to resolve unpaid claims . The anticipated hourly… more
- Highmark Health (Columbus, OH)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary ... through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical staff. +… more
- UIC Government Services and the Bowhead Family of Companies (Cleveland, OH)
- …of Defense and many federal agencies. Bowhead offers competitive benefits including medical , dental, vision, life insurance , accidental death and dismemberment, ... DHS in appellate proceedings before the Board of Immigration Appeals , and providing support and direction to the Department...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- Molina Healthcare (Dayton, OH)
- …PM (Team will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. JOB DESCRIPTION Job SummaryProvides ... services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes… more
- Cognizant (Columbus, OH)
- …following benefits for this position, subject to applicable eligibility requirements: . Medical /Dental/Vision/Life Insurance . Paid holidays plus Paid Time Off . ... teams. **In this role, you will:** . Perform comprehensive follow-up on hospital claims to resolve outstanding accounts receivable. . Analyze denial trends and root… more
- Elevance Health (Mason, OH)
- …management. + Respond to and resolve issues related to member/provider complaints, claims processing issues and appeals . **Minimum requirements:** + PharmD from ... and incentive bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits, 401(k) +match,… more