- Molina Healthcare (Akron, OH)
- …to reduce the likelihood of a formal appeal being submitted. * Reevaluates medical claims and associated records independently by applying advanced clinical ... in the specific programs supported by the plan such as utilization review, medical claims review, long-term services and supports (LTSS), or other specific… more
- Utilities Service, LLC (Middletown, OH)
- …: Competitive Hourly **Benefits:** + Company-sponsored Retirement Plan + Health Insurance ( Medical /Dental/Vision) + Employee Assistance Program + Life, ... long-term/short-term disability insurance **Essential Functions & Responsibilities:** + Plans, coordinates, and...be delegated the authority to investigate incident reports, damage claims , etc., and to settle minor damage claims… more
- Elevance Health (Mason, OH)
- …distance from an office._** The **Business Strategy Plan Director- MedEx ( Medical Expense) Management** is responsible for managing the development and ... implementation of medical expense management initiatives for assigned Carelon Health business...human capital resources, and partners with care management, network, claims & operational teams, IT, and business partners. +… more
- Elevance Health (Mason, OH)
- …fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Fraud Investigator II** is responsible for… more
- Humana (Columbus, OH)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... EAPG + 2+ years of experience with Optum Rate Manager + 2+ years of experience with Optum WebStrat...Optum WebStrat or PSI applications + Experience reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg… more
- Elevance Health (Cincinnati, OH)
- …technologies. + Trains associates on all upskilling of customer service and claims to include providing professional medical service facility correspondence, ... an equivalent background. **Preferred Skills, Capabilities and Experiences:** + FEP Claims or Customer Service experience highly preferred. + Strong written, verbal,… more
- ChenMed (Cincinnati, OH)
- …taking inventory, answering the phone, checking patient information for insurance co-pays, restocking and ordering necessary supplies, assisting with delivery ... position working directly with patients and their families, doctors and other medical personnel in a dynamic and professional environment to provide the highest… more
- Oracle (Columbus, OH)
- …Oracle US offers a comprehensive benefits package which includes the following: 1. Medical , dental, and vision insurance , including expert medical opinion ... benefits based on parity and consistency and support our people with flexible medical , life insurance , and retirement options. We also encourage employees to… more
- Medtronic (OH)
- …tenured field team + Leads coordination of new-hire training with accountability to hiring manager (CSM or RM) + Responsible for new hire sign-off + Delivers new ... Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through… more
- Packing Corp of America (Massillon, OH)
- …Program for PCA Filer under the direction of the Employee Health & Safety Manager . This includes medical examinations, health care, medical surveillance, ... or conditions. The Nurse is responsible for maintaining an adequate supply of medical supplies and the various pieces of occupational health equipment while working… more