- Molina Healthcare (Cincinnati, OH)
- …MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the ... + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management… more
- Humana (Columbus, OH)
- …+ Familiarity with compliance standards, HR data governance, and system audit -readiness. **Preferred Qualifications** + MBA or other Advanced Degree + Demonstrated ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Humana (Columbus, OH)
- …+ Familiarity with compliance standards, Finance data governance, and system audit -readiness. **Preferred Qualifications** + MBA or other Advanced Degree + ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Polaris Pharmacy Services, LLC (Columbus, OH)
- …payor verification * Verify insurance and Medicaid coverage * Handle Dual Coverage, Medicare Part D, and Commercial Plans related to Long-Term Care * Address ... professionally * Enter fees and charges in Framework LTC * Prepare and audit daily, weekly, and monthly billing reports * Generate statements and end-of-month… more
- Bon Secours Mercy Health (Sheffield Village, OH)
- …certifications, accreditations, legal), and third-party payer (managed care, HMO, Medicare , commercial insurance, etc.) agents.** **Provides at least two ... Performance measured by patient satisfaction, medical records, documentation, and audit /survey results.** **Provides scheduled work hours during clinic hours to… more
- Trinity Health (Columbus, OH)
- …, a college of nursing (https://www.mccn.edu/) , a Medicare Advantage plan (https://www.medigold.com/) , and extensive outreach and ... the standards, procedures and guidelines of the Organization. **Responsibilities** + Audit charts monthly to ensure Clinical Staff are correctly documenting on… more