- Cleveland Clinic (Cleveland, OH)
- …etc.). We are looking for some with pharmacy background, medication knowledge, and insurance claims familiarity. **A caregiver in this position works from 8:00AM ... most respected healthcare organizations in the world. As a Medical Access Pharmacy Technician, you will work with discharge,...many patients are admitted, check the status of patient's insurance and work through insurance issues with… more
- Elevance Health (Cincinnati, OH)
- …in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least ... are not limited to: Managing incoming calls or incoming post services claims work. + Determines contract and benefit eligibility; provides authorization for… more
- Elevance Health (Mason, OH)
- …predictive models, trend detection algorithms, and statistical analyses using weekly claims , pharmacy, lab, and authorization data to identify emerging cost drivers. ... business problems under the direction of team lead or manager . + Work with data-sets of moderate size and...bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits,… more
- The Cigna Group (Cleveland, OH)
- …channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, ... of the Provider Contracting Team and reports to the Provider Contracting Senior Manager . This role assists in developing the strategic direction and management of… more
- Elevance Health (Mason, OH)
- …Capabilities and Experiences** + Medical terminology training and experience in medical or insurance field preferred. Please be advised that Elevance Health ... make an impact:** + Managing incoming calls or incoming post services claims work. + Determines contract and benefit eligibility; provides authorization for… more
- Highmark Health (Columbus, OH)
- …related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, ... appropriate steps to effect resolution. (10%) + Reviews and interprets medical information, classifies that information into the appropriate payor specific groups… more
- CommonSpirit Health (Steubenville, OH)
- …days off), Professional Dues, and Certification Reimbursement + Malpractice and Tail Insurance (Modified Claims Made) + Full Benefits Eligibility with ... Expectation + Excellent support staff with a strong office manager and a mix of LPNs and MAs +...**Qualifications** + Must be a graduate of an approved medical school, completed an internship and/or residency in his/her… more
- Elevance Health (Mason, OH)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... satisfaction. Typically works with one provider type, eg physician, ancillary, or medical group. Provides advice and analytic support to Medical Directors,… more
- Elevance Health (Cincinnati, OH)
- …reporting and formulating recommendations. This position will value new medical cost initiatives, applying financial modeling expertise and using independent ... impact on existing programs. + Conduct comprehensive analysis of healthcare data, claims , and financial reports to identify trends, patterns, and opportunities for… more
- Elevance Health (Columbus, OH)
- …law. The **Group Underwriter, Senior** is responsible for determining acceptability of insurance risks and appropriate premium rates for large, complex renewal and ... or benefit change increments or decrement. + Communicates with sales, administration and claims to assess the rating and administrative impact or benefit and plan… more