- Sedgwick (Cleveland, OH)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Director Complex Claims **PRIMARY PURPOSE** **:** To be responsible for ... managing SIU investigations of complex fraud schemes involving providers, vendors, attorneys and others;...degree from an accredited college or university preferred. Fraud Claims Law Associate (FCLA), Certified Insurance Fraud Investigator (CIFI),… more
- CommuniCare Health Services Corporate (Akron, OH)
- …leader in post-acute care for those that are chronically ill or have complex conditions. Our more than 150 skilled nursing, assisted living, independent living, ... growth, CommuniCare Health Services is currently recruiting for a Claims Validator / Biller to support our Central Billing...team, CBO cash posting team, Business Office Manager, Regional Director of Finance, MDS, Case Management, and others. The… more
- The Cigna Group (Independence, OH)
- …Providers. Must reside in the Cleveland or Independence, OH area.** The ** Director ** **,** **Provider Contracting Network Management** serves as an integral member ... for a local given territory. **DUTIES AND RESPONSIBILITIES** + Manages complex contracting and negotiations for fee for service and value-based reimbursements… more
- Sedgwick (Cleveland, OH)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer IT Director PRIMARY PURPOSE: To lead the selection, enhancement and support of IT ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Sedgwick (Cleveland, OH)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director Finance **PRIMARY PURPOSE** **:** To direct all aspects associated with ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Molina Healthcare (Akron, OH)
- …with federal and state laws. Negotiates and services larger and more complex market/national/group-based providers in accordance with company standards in order to ... expectations * Evaluates, negotiates and supports larger and more complex market/national/group-based providers in compliance with company standards while meeting… more
- Molina Healthcare (Akron, OH)
- …contracting negotiations and understanding of alternative arrangements. Maintains critical Complex provider information on claims and provider databases. ... federal, state and local regulations. Responsible for contracting/re-contracting of Complex contracts with Alternative Payment Methods including but not limited… more