- Prime Therapeutics (Columbus, OH)
- …systems, particularly those that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.). + ... drives every decision we make. **Job Posting Title** Business Intelligence Specialist - Sacramento, California market **Job Description** Delivers against business… more
- Cleveland Clinic (Independence, OH)
- …healthcare organizations in the world. As a Corporate Compliance Coding/Billing Specialist , you will support the Office of Corporate Compliance by maintaining ... regulations, and identifying revenue cycle compliance risks-such as potential False Claims Act exposures-to protect the organization. This role offers professional… more
- Molina Healthcare (OH)
- …the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. Ongoing… more
- Molina Healthcare (OH)
- …the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. *… 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 ... comprehensive historical data; analyzing all data and communicating to management relative information and recommendations that could impact future planning.… more
- Sedgwick (Cincinnati, OH)
- …information that meets both the internal and external customer's requirements accurately into the claims management system. + Assigns new claims to the ... contact at multiple locations or escalates to Service Center Specialist / management as needed. + Attendance during scheduled...Knowledge** + Knowledge of medical terminology + Understanding of claims management + Excellent oral and written… more
- Banner Health (OH)
- …and billing codes. Works with clinical documentation improvement and quality management staff to: align diagnosis coding to documentation to improve the ... Assists in creating a department-wide focus of performance improvement and quality management . Assists and participates with management through committees to… more
- Parker Hannifin Corporation (Cleveland, OH)
- …Development Program (LDP/Program) with the general duties of a Parker Sourcing Specialist , Buyer/Planner and Logistics Analyst. The SCM LDA's primary duties will ... with the goal to develop skillsets in supervision, team leadership, and management . While in program, rotational assignments are structured to expose participants to… more
- Highmark Health (Columbus, OH)
- …analytical and communication skills Preferred + Associate's Degree + 3 years with claims processing and data management + Past auditing and strong ... areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in… more