- Molina Healthcare (Cincinnati, OH)
- …the credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. ... GED **Required Experience/Knowledge Skills & Abilities:** Certified Provider Credentialing Specialist (CPCS) or participation in a CPCS progression program.… more
- BlackBox (Bowling Green, OH)
- …and the freight applied to sales orders. Approves and/or recommend invoice payment . . Responsible for improving the routing of all shipments to achieve ... and store freight quote information for future order execution and invoice payment . . Create routing guides and shipping instructions for inbound and outbound… more
- ProMedica Health System (Toledo, OH)
- …practices, including regulatory changes or updates. Reviews medical record documentation and claims data to ensure compliance with CMS and payer guidelines and ... and medical terminology. In-depth knowledge of reimbursement systems and prospective payment methodologies. Must be detail orientated and have the ability to… more
- Sedgwick (Cincinnati, OH)
- …professional needs. **PRIMARY PURPOSE** **:** To provide excellent service to callers regarding claims for multiple lines of business; to expedite the claims ... specifications in assisting with questions and solving problems related to the claims application and servicing processes. + Educates and informs the customer via… more
- Elevance Health (Mason, OH)
- …or quality assurance environment preferred. + Broad knowledge of medical claims billing/ payment systems provider billing guidelines, payer reimbursement ... an accommodation is granted as required by law._ Carelon Payment Integrity is a proud member of the Elevance...auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all… more
- CDM Smith (Cincinnati, OH)
- …**Business Unit:** FSU **Job Description:** CDM Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical ... in evaluating and analyzing financial data related to disaster-related claims , including property damage, business interruption, and other loss categories. The … more
- Banner Health (OH)
- …for improvement of clinical documentation and accurate MS-DRG, Ambulatory Payment Classification (APC) or ICD-10 assignments on health records. Provides ... Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment Classification (APC) or utilized operational systems. Provides explanatory and… more
- Elevance Health (Mason, OH)
- …preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing guidelines, payer ... and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims … more
- Premier Health (Moraine, OH)
- …needed to insure accurate and timely processing of all third party billing ( claims ). The Coder/Medical Billing Specialist 's responsibilities may also include all ... to company billing and collection policies. **Natureand Scope** The Coder/Medical Billing Specialist is responsible to assign and report these more specified codes… more
- ProMedica Health System (Toledo, OH)
- …Lead is responsible for the accurate and timely submissions of facility claims to the third-party payors. In addition to claim submission, responsibilities include ... This position supports leadership staff in identifying and mitigating payment delays. The HB Billing and Follow-Up - Team...direct elbow support to the HB Billing and Follow-Up Specialist I's & II in resolving complex barriers. Keep… more