- Molina Healthcare (Columbus, OH)
- …of knowledge although they may have technical team members. **Expanded Scope:** The Senior Project Manager for Claims Operations drives complex, ... & Regulatory Acumen (Healthcare/ Claims )** + Deep understanding of claims lifecycle, EDI transactions, payment integrity, provider data, appeals/grievances,… more
- CVS Health (Columbus, OH)
- …strategic initiatives, and partnering to elevate insights that can positively impact provider experience. The Senior Manager , accounts receivable ... to help review, understand, and identify process improvements across key provider journeys including self-service / digital transactions, claims management,… more
- Zurich NA (Columbus, OH)
- …**This role will be filled at either the** ** Senior or AVP Claims Professional** **Level.** **The hiring manager will determine the appropriate level based ... + Microsoft Office experience + Knowledge of insurance regulations, markets, and products OR Senior Claims Professional: + Bachelor's Degree and 6 or more years… more
- CVS Health (Columbus, OH)
- …to solution design and architecture discussions, collaborating with architects and senior engineers. + Provide input on technical feasibility, performance ... project work that crosses many Aetna Technology domains/applications. A Release Manager in this area requires substantial business and systems knowledge along… more
- CVS Health (Columbus, OH)
- …providers in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, compliance, quality, and ... financial goals and cost initiatives. Collaborates cross-functionally to develop provider compensation and pricing strategies and manages contracts through language… more
- WelbeHealth (Columbus, OH)
- … claims with errors back to the claims team for corrections + Provide feedback to the Oversight & Monitoring Manager on claims processing errors, ... senior care by providing an all-inclusive healthcare option (PACE) to the most vulnerable senior population while serving as a care provider and care plan to… more
- WelbeHealth (Columbus, OH)
- … senior care by providing an all-inclusive healthcare option to the most vulnerable senior population, while serving as a care provider and care plan to those ... pivotal role in ensuring timely and efficient processing of claims for our contracted specialty provider partners....procedures, or other established quality standards + Work alongside manager to establish and maintain claims processing… more
- RxBenefits (Columbus, OH)
- In this multi-disciplinary, cross functional role, the Senior Manager , Pharmacy Pricing will report to the Director, Pharmacy Pricing & Analytics. The Senior ... file requests, current account RFPs, and competing PBM comparisons. The Manager also assists with resolving client issues involving performance discrepancies and… more
- Turner & Townsend (Columbus, OH)
- …markets around the world. **Job Description** **Turner & Townsend** is looking for a ** Senior Risk Manager ** to join our growing team. The ideal individual will ... claims management. + Carry out assessment of contractual claims in accordance with the contract. + Provide... claims in accordance with the contract. + Provide strategic and contractual advice on disputes and related… more
- Turner & Townsend (Columbus, OH)
- …around the world. **Job Description** **Turner & Townsend** are seeking an experienced ** Senior ** **Project Controls Manager ** to join our team. The ideal ... a significant minority interest. Turner & Townsend and CBRE work together to provide clients with the premier programme, project and cost management offering in… more
- ABM Industries (Columbus, OH)
- …is damaged in any way and that the accident is promptly reported to the District Manager , Safety, Claims and Customer. + Looks for root causes of accidents and ... **Overview** Sr. Project Manager operates rental cars in a safe manner...when the sun's glare or direct blasts of sunlight provide additional challenges to safe vehicle operation. **Physical Demands:**… more
- Molina Healthcare (Columbus, OH)
- …cost recovery processes + Direct PM experience in Managed Care Operations ( claims , system configuration, provider data management preferred) + Demonstrated ... system development lifecycle methodologies **Knowledge:** + Experienced in working with claims and claim configuration teams to streamline adjudication and resolve… more
- OhioHealth (Columbus, OH)
- …meetings & trial activities as delegated. 4. Liability & Casualty Insurance claims manager - 10% Reviews, investigates, & analyzes general liability incidents ... with the Risk Manager , Systems Director, and/or the General Counsel, for claims within the self-insured retention, is given authority to negotiate & settle … more
- Walgreens (Columbus, OH)
- …Co. Pharmacy Code of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems to ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more
- Walgreens (Canal Winchester, OH)
- …Co. Pharmacy Code of Conduct. + Performs duties as assigned by Pharmacy Manager , Staff Pharmacist and Store Manager including utilizing pharmacy systems to ... pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient… more
- Cardinal Health (Columbus, OH)
- …billing questions and set up payment arrangements if needed. + Analyze claims , process payments and complete adjustments + Analyze explanation of benefits (EOBs) ... Flag trends or recurring issues for team Supervisor or Manager . + Meet daily/weekly productivity goals (eg, number of.... + Meet daily/weekly productivity goals (eg, number of claims worked, follow-ups completed). + Assist with special projects,… more
- Fujifilm (Columbus, OH)
- **Position Overview** The Regulatory Compliance Manager (Corporate) is a member of the FUJIFILM Holdings America Corporation ("HLUS") Department reporting to the ... Corporate Compliance Director. The Compliance Manager will be responsible for managing the day-to-day operations...you're shaping tomorrow's tech or redefining today's processes, we'll provide a flexible work environment and dynamic culture where… more
- Cardinal Health (Columbus, OH)
- **Job Summary:** The Manager , Revenue Cycle Management, is responsible for overseeing the insurance collection follow-up team to ensure timely and accurate ... resolution of outstanding insurance claims . This role leads strategy development, performance monitoring, and process improvement initiatives to optimize cash flow,… more
- Molina Healthcare (Columbus, OH)
- …Supporting the OH Plan, the candidate will act as the Ohio Operation lead on Claims and Encounters as well as the liaison to our state regulator in these areas. ... developer role but the candidate must be technically inclined and interface with IT, Claims , and Encounter Teams. Must be a self-starter willing to learn. Must be a… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …plan. This position provides guidance, coaching, and oversight to the Manager , Medical Core Content, ensuring all materials are developed with scientific ... consistency, and compliance. This position reports directly to the Senior Director, CNS Medical Communications Lead. **Job Description** **Key Responsibilities… more