• Specialist , Appeals & Grievances

    Molina Healthcare (Cleveland, OH)
    …and prepares written response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments or to requests from ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance… more
    Molina Healthcare (08/15/25)
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  • Revenue Cycle Management Specialist

    KPH Healthcare Services, Inc. (Maumee, OH)
    **Overview** The Revenue Cycle Management Specialist - Collections responsibility is to ensure timely collection of outstanding balances. **Responsibilities** + ... Manage the collection process for outstanding claims , including contacting insurance companies, patients, and other responsible parties via phone, email, and written… more
    KPH Healthcare Services, Inc. (08/16/25)
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  • Claim Benefit Specialist

    CVS Health (Columbus, OH)
    …of a member's illness or injury + Identify claim cost management opportunities and refer claims for follow up + Make claim payment decisions + Process claims ... with heart, each and every day. Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit...by providing accurate and timely resolution in processing medical claims . You will be a key link in providing… more
    CVS Health (08/08/25)
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  • FEMA - Program Delivery Specialist

    CDM Smith (Cincinnati, OH)
    …40509BR **Business Unit:** FSU **Job Description:** The Disaster Program Delivery Specialist : * Collects, coordinates and/or reviews applicant data to determine ... expertise may be needed throughout the program delivery process. * Supports the claims process by reviewing and validating damage details, scopes of work, and costs… more
    CDM Smith (07/19/25)
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  • Physician Office Specialist - Riverside…

    OhioHealth (Columbus, OH)
    …verification, providing support to staff members as assigned. The Office Specialist is well organized, highly motivated, customer service oriented, expresses good ... patient insurance co-payments, collects patient outstanding balances, establishes patient payment plans, ensuring accuracy of information placed in information… more
    OhioHealth (08/16/25)
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  • Provider Service Specialist Remote Seasonal…

    Trinity Health (Columbus, OH)
    …to Plan documentation policies + Review, investigate and advise providers regarding claims status and payment determinations + Maintain a comprehensive knowledge ... analysis, audit, provider relations and more. **About the job:** Provider Service Specialist responds in a timely and accurate manner to provider inquiries made… more
    Trinity Health (08/13/25)
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  • FEMA - Costing Specialist

    CDM Smith (Akron, OH)
    …ID:** 40481BR **Business Unit:** FSU **Job Description:** The FEMA Costing Specialist : * Conducts preliminary damage assessments (PDAs) in the field for ... structure damaged by a disaster. * Reviews, evaluates and analyzes applicant-provided cost claims for reasonableness and accuracy as related to the scope of work. *… more
    CDM Smith (07/18/25)
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  • FEMA - Construction Specialist

    CDM Smith (Cleveland, OH)
    …**Business Unit:** FSU **Job Description:** The FEMA Disaster Management Construction Specialist : * Schedules and conducts site inspections with applicants, performs ... projects and meets regularly on the status. * Evaluates applicant-provided cost claims for reasonableness to report to FEMA regarding claim eligibility. Participates… more
    CDM Smith (07/15/25)
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  • CBO Specialist II - PPG CBO - Full Time…

    ProMedica Health System (Toledo, OH)
    …timely input of billing information into the practice management system for payment . 6. Accurately reviews and updates demographic and insurance information in the ... to resolve. 17. Maintains current payor knowledge for effective claims management and follow up of unresolved claims... claims management and follow up of unresolved claims . 18. Routinely reviews workflows for process improvement and… more
    ProMedica Health System (08/15/25)
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  • Billing Specialist

    Open Mind Health (OH)
    POSITION DESCRIPTION BILLING SPECIALIST LOCATION: REMOTE REPORTS TO: CHIEF OPERATING OFFICER ABOUT OPEN MIND HEALTH We are a collaborative team of mind-body-spirit ... that has the potential to interrupt the flow of claims and subsequent payer remittances. This individual will also...Meet bi-weekly with representatives from RCM vendor to ascertain payment flow and address any issues. + Works with… more
    Open Mind Health (08/17/25)
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