- Molina Healthcare (Columbus, OH)
- …& ABILITIES** : * 2 - 3 years customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed ... including but not limited to, fee-for service, capitation and various forms of risk , ASO, etc. **PREFERRED EDUCATION** : Bachelor's Degree in a related field or… more
- Capgemini (Cincinnati, OH)
- …Medicaid or Exchange program/ product build knowledge (Enrollment, Eligibility, Claims , Provider network, encounters etc) (Highly Recommended having exposure to ... an expedited fashion Partner with project team to monitor and manage schedule, risk , issues, actions, decisions and change requests Partner with project team to plan… more
- Rexel USA (Youngstown, OH)
- …orders stocked on shelves orderly and in designated area and reports freight damage claims + Prepare branch orders from the warehouse and ensure that the correct ... to heat and cold Constantly - at least 51% + Exposed to electrical hazards; risk of electrical shock Constantly - at least 51% + Handles or works with potentially… more
- Cleveland Clinic (Independence, OH)
- …regulations, and identifying revenue cycle compliance risks-such as potential False Claims Act exposures-to protect the organization. This role offers professional ... action plans. + Assist the Director with identifying and analyzing areas of risk . + Coordinate responses to monitoring and audit activities. + Distribute material… more
- Molina Healthcare (Dayton, OH)
- …**Required Experience** + 2 - 3 years customer service, provider service, or claims experience in a managed care setting. + Working familiarity with various managed ... but not limited to, fee-for service, capitation, and various forms of risk , ASO, etc. **Preferred Education** Bachelor's Degree. **Preferred Experience** + 5 years'… more
- Molina Healthcare (Cincinnati, OH)
- …setting. **Required Experience** + 3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5 years' experience in managed ... but not limited to; fee-for service, capitation, and various forms of risk , ASO, etc. **Preferred Education** Bachelor's or master's degree. **Preferred Experience**… more
- Molina Healthcare (OH)
- …Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to maximize ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. *… more
- Centene Corporation (Columbus, OH)
- …network spend. + Interprets and analyzes data from multiple sources including claims , provider, member, and encounters data. Identifies and assesses the business ... point of contact for all program related issues and escalations including risk management. + Communicate business objectives, program process as well as technical… more
- Elevance Health (Cincinnati, OH)
- …impact on existing programs. + Conduct comprehensive analysis of healthcare data, claims , and financial reports to identify trends, patterns, and opportunities for ... managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory… more
- Nestle (Solon, OH)
- …the organization, you are empowered to challenge the status quo, embrace risk -taking, and pioneer new ideas. Our supportive and collaborative environment encourages ... practical application of HACCP/Food Safety fundamentals, new material onboarding, allergen/ claims validation and process capability. 5. Continuous improvement of… more