- Humana (Dayton, OH)
- …work closely with internal and external auditors, financial investigators, and claims processing areas Adequately staff and manage the program integrity ... Clinical Certifications, CPC, CCS, CFE, AHFI) Understanding of healthcare industry, claims processing and investigative process development Experience in a corporate… more
- Citizens (Medford, MA)
- …gain the customer's consent on a resolution. Provide accurate complete claims processing, and records management using established procedures in moving/placing ... documents appropriately through software (eg, claims management system) or manual methods, to maintain claim records. Experience leadership that's invested in… more
- CVS Health (Columbus, OH)
- …or intricate healthcare fraud schemes. Investigates to prevent payment of fraudulent claims submitted to the Medicaid lines of business Researches and prepares cases ... skills. The ability to understand and analyze health care claims and coding Ability to travel up to 10%...or equivalent experience ( A bachelor's degree, or an associate 's degree with an additional four+ years working on… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …compliance with Federal, investor and Bancorp requirements. Review, approve or deny & pay claims for tax provider that result in 5/3 charge offs. Work closely with ... to correct improper escrow line set-up issues. Work w/ Title Agencies to file claims on incorrect legal descriptions they provided and to also get corrected legal… more
- Kohler Co. (Bristol, PA)
- …on-time delivery. Identify and resolve delivery issues and drive process improvements. Claims & Pricing Administration: Oversee resolution of claims , deductions, ... performance bonus/variable incentive compensation. Why Choose Kohler? We empower each associate to #BecomeMoreAtKohler with a competitive total rewards package to… more
- UnitedHealth Group (Philadelphia, PA)
- …prevention of healthcare fraud, waste and abuse. The Investigator will utilize claims data, applicable guidelines and other sources of information to identify ... roles you may be interested in. Required Qualifications: Bachelor's Degree OR Associate 's Degree 2+ years of equivalent work experience with healthcare related… more
- AmeriHealth Caritas (Newtown Square, PA)
- …performs research using the Internet, data analysis tools, etc., to analyze aberrant; claims billing and practice patterns. Analyzes data as part of the investigative ... field working in fraud, waste, and abuse investigations and audits OR An associate 's degree, with a minimum of four years of experience working in healthcare… more
- Dal-Tile Corporation (Cincinnati, OH)
- …a career with Dal-Tile. Dal-Tile is seeking an exceptional Customer Service/Warehouse Associate to join our TEAM! The Customer Service/Warehouse Associate will ... returns, and notifying management of damaged shipments for freight claims . Operates crane forklift equipment. Maintains clean and organized...employee may sit, climb, balance, talk, or hear. The associate must have the ability to regularly lift up… more
- UMB Bank (Kansas City, MO)
- …third-party administrators to ensure timely and accurate processing of leave claims . Maintain accurate records of leave status, documentation, and return-to-work ... assistance; an employee assistance program; fitness reimbursement; tuition reimbursement; an associate wellbeing program; an associate emergency fund; and… more
- Humana (Raleigh, NC)
- …There is a 5% shift differential for weekend work. Preferred Qualifications Associate or bachelor's degree. Previous inbound call center or related customer service ... 4 years of grievance and/or appeals experience. Previous experience processing medical claims . Additional Information Workstyle: remote, work from home or in office.… more
