• Claims Processing…

    Humana (Columbus, OH)
    **Become a part of our caring community and help us put health first** The Claims Processing Representative 1 reviews and adjudicates complex or ... specialty claims , submitted via paper. The Claims Processing Representative 1 performs basic administrative/clerical/operational/customer… more
    Humana (11/24/25)
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  • BILINGUAL Claims Research & Resolution Rep…

    Humana (Columbus, OH)
    …based on business needs. **Preferred Qualifications** + Bachelor's Degree + Prior claims processing experience + Overpayment experience + Financial recovery ... community and help us put health first** The Bilingual Claims Research & Resolution Representative 2 manages...(Spanish / English) (see Language Proficiency Testing below)** + ** 1 or more years of Call Center or Telephonic… more
    Humana (11/21/25)
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  • Grievances & Appeals Representative

    Humana (Columbus, OH)
    …Previous inbound call center or related customer service experience o Previous experience processing medical claims o Bilingual (English and Spanish); with the ... help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting...and speak English and Spanish o Experience with the Claims Administration System (CAS) o Experience working with MHK… more
    Humana (11/21/25)
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  • Representative , Pharmacy

    Molina Healthcare (Columbus, OH)
    …Medicare and Medicaid Services (CMS) standards. * Provides coordination and processing of pharmacy prior authorization requests and/or appeals. * Explains ... point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any...call center member relations. Required Qualifications * At least 1 year related experience, including call center or customer… more
    Molina Healthcare (11/21/25)
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  • Claim Supervisor - REMOTE

    Ryder System (Columbus, OH)
    …action plans if deficiencies are noted. Monitors staff's workflow to ensure accurate processing of claims , timely establishment of reserves, reviews and logs ... : **SUMMARY** This position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling… more
    Ryder System (10/30/25)
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  • Supervisor, Revenue Cycle

    CVS Health (Columbus, OH)
    …key payers to discuss reimbursement issues and payer publication notices affecting claims processing changes + Ensure daily reconciliation of electronic claim ... representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances,… more
    CVS Health (11/22/25)
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  • PFS Insurance Follow-Up Rep Ambulatory Denials

    Banner Health (OH)
    … 1 . May be assigned to process payments, adjustments, claims , correspondence, refunds, denials, financial/charity applications, and/or payment plans in an ... the best place to work and receive care. **The PFS Insurance Follow-Up Representative (Ambulatory Denials)** is responsible for following up with assigned payer for… more
    Banner Health (11/22/25)
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  • EH&S Coordinator

    ITW (Troy, OH)
    …refrigeration equipment, including refrigerators, freezers, and prep tables; food processing equipment, including slicers, mixers, and scales; and kitchen exhaust, ... appropriate actions with a third-party administrator for all Worker's Compensation claims , assist in preparing training materials and communications, and support… more
    ITW (11/19/25)
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