- Highmark Health (Columbus, OH)
- …areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in ... and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong education/training background… more
- Meta (Columbus, OH)
- …4. Respond to counterparty inquires and manage contract amendments, collateral, force majeure claims , and other issues as needed 5. Surface and resolve issues in ... 8. Track project progress through development and construction milestones and lead risk reporting against schedule and forecast 9. Manage approval and signature… more
- HUB International (Cincinnati, OH)
- …full-service global insurance broker and financial services firm providing risk management, insurance, employee benefits, retirement and wealth management products ... to clients regarding Health Care Reform + Lead and develop strategy based on claims data analytics + Listen and counsel on key compliance impacts including Health… more
- Molina Healthcare (Dayton, OH)
- …advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain efficient ETL pipelines ... with **clinicians, nurses, or case management teams** + Familiarity with risk adjustment, value-based care models, or healthcare performance metrics + Understanding… more
- Kyndryl (Columbus, OH)
- …on engagements, while enduring profitability and understanding and containing risk **Client Engagement:** + Lead C-level client engagements and consultative ... Partner with CCaaS architects to build future-proof architectures with EHR, CRM, and claims system integrations. The compensation range for the position in the US is… more
- Ricoh Americas Corporation (Parma, OH)
- …capable and qualified. + Utilizes methods such as Lean, Six Sigma, and risk management tools to monitor and drive process improvement activities. + Works ... + Collaborates with other functional areas to resolve product quality claims ; administers the returned merchandise process and/or product rework activities; directs… more
- J&J Family of Companies (Cincinnati, OH)
- …reviews and providing expert regulatory feedback for specifications, device testing, risk management, and other relevant documentation in accordance with regulatory ... applicable regulations and guidance documents in product development, support of claims , content labeling, and promotional materials. + Assists in the development… more
- The Cigna Group (Cleveland, OH)
- …of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales ... and identifies and acts upon opportunities for greater value-orientation and risk arrangements. + Responsible for meeting unit cost targets, while preserving… more
- Molina Healthcare (Columbus, OH)
- …with AI Data Integration._** + **_Experience with Member, Enrollment, and Claims applications -_** **which underpin essential business functions such as HEDIS ... reporting, Risk Adjustment (RA), and Health Plan Reporting.** + **_Azure Databricks._** + **_Python._** + **_Spark._** + **_QNXT._** **Preferred License,… more
- IDEX (Mansfield, OH)
- …compliance with the applicable laws and IDEX Corporate policies, and mitigating the risk that comes with global trade. Work with forwarders and distributors to ... brokers and send all export and import documentation to file duty drawback claims . + Responsible for being knowledgeable on new regulations and relaying information… more