• Service Center Representative | Cincinnati, OH…

    Sedgwick (Cincinnati, OH)
    …Saturdays: 10am-6pm **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
    Sedgwick (09/11/25)
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  • Service Center Representative- Blue Ash|…

    Sedgwick (Blue Ash, 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
    Sedgwick (09/02/25)
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  • DRG Coding Auditor

    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
    Elevance Health (10/25/25)
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  • Investigator, Coding Special Investigative Unit…

    Molina Healthcare (OH)
    …a medical review to facilitate a referral to law enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding ... medical records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines,...+ AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional… more
    Molina Healthcare (11/20/25)
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