- Molina Healthcare (Cincinnati, OH)
- …**Job Summary** Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines, ... and provider compliance. Interacts with health plans and vendors regarding recovery outstanding overpayments. **Job Duties** + Prepares written provider overpayment… more
- Zurich NA (Cleveland, OH)
- Claims Recovery Specialist -...Designed with our employees' needs in mind, the ZNA Claims Remote work model emphasizes flexibility, allowing ... records, invoices and other required material during the investigation and recovery effort and notifies appropriate parties of outstanding issues as needed.… more
- Western Digital (Columbus, OH)
- …**Job Description** **Position Summary** We are looking for a **Retail Compliance Specialist ** to join the Western Digital Fulfillment Operations Team to be ... chargebacks, late deliveries, labeling errors, incorrect shipments. Review and validate claims received from retail partners to determine legitimacy and compliance… more
- Molina Healthcare (OH)
- …Qualifications * At least 3 years clinical nursing experience in claims auditing, quality assurance, recovery auditing, DRG/clinical validation, utilization ... Information Technician (RHIT) or Registered Health Information Administrator (RHIA). * Claims auditing, quality assurance, or recovery auditing, ideally in… more
- Molina Healthcare (Dayton, OH)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... and State regulatory requirements are met for Pre-pay Edits, Overpayment Recovery which improves encounter submissions, reduces General and Administrative expenses… more
- Molina Healthcare (Akron, OH)
- …review to facilitate a referral to law enforcement or for payment recovery . **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical ... records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines,...+ AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional… more
- Morley (Columbus, OH)
- **About the Role** **_Role: Full time | Remote - Ohio residents_** Looking for a work-from-home opportunity that will help you make the move from a job to a ... managers and clients + Initiate status reports or service recovery letters to the inquirer + Route inquiries when...Apply?_** Live chat with a Morley Talent Acquisition (TA) Specialist : careers.morleycompanies.com | chat hours: 8 am - 5… more
Recent Jobs
-
Mid Market Account Executive
- ADP (San Diego, CA)
-
Housing Management Officer, Intermediate - Housing Development Officer, Intermediate
- State of Minnesota (St. Paul, MN)
-
Truck Driver on-the-job CDL Training
- Roehl Transport (New Baltimore, MI)
-
Senior Electrician ($5K Sign On Bonus)
- Caris Life Sciences (Phoenix, AZ)