• Liability Litigation Claims Examiner

    Sedgwick (Cincinnati, OH)
    …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Liability Litigation Claims Examiner | Litigation Experience Required Are you looking for an ... some of the world's best brands? + Apply your examiner knowledge and experience to adjudicate complex customer ...examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +… more
    Sedgwick (04/19/25)
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  • Claims Examiner - Bodily Injury

    Sedgwick (Seven Hills, OH)
    …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Bodily Injury **PRIMARY PURPOSE** : To analyze and process ... complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.… more
    Sedgwick (05/09/25)
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  • Claims Examiner - Bodily Injury

    Sedgwick (Seven Hills, OH)
    …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Examiner - Bodily Injury **PRIMARY PURPOSE** : To analyze and ... process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of… more
    Sedgwick (05/07/25)
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  • Claims Examiner

    Intermountain Health (Columbus, OH)
    **Job Description:** The Claims Examiner I is responsible for inbound calls from providers and health plans and adjudicates physician claims , in a timely and ... to and supports the corporation's quality improvement efforts. Processes medical claims (CPT, ICD, and Revenue Coding) at production standards, including timely… more
    Intermountain Health (05/08/25)
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  • Specialist, Claims Recovery

    Molina Healthcare (Cleveland, OH)
    …or GED **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + 1-3 years' experience in claims adjudication, Claims Examiner II, or other relevant work ... **Job Summary** Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines,… more
    Molina Healthcare (05/10/25)
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  • Claims Team Lead - Liability (GL, Lit, BI…

    Sedgwick (Dayton, OH)
    …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles reviews and… more
    Sedgwick (04/26/25)
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  • Absence Management Team Lead

    Sedgwick (Dublin, OH)
    …training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a ... with management projects for the office. + Provides technical/jurisdictional direction to examiner reports on claims adjudication. + Compiles, reviews, and… more
    Sedgwick (03/27/25)
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  • Director Complex Claims

    Sedgwick (Toledo, OH)
    …Work(R) Fortune Best Workplaces in Financial Services & Insurance Director Complex Claims **PRIMARY PURPOSE** **:** To be responsible for managing SIU investigations ... Bachelor's degree from an accredited college or university preferred. Fraud Claims Law Associate (FCLA), Certified Insurance Fraud Investigator (CIFI), or Certified… more
    Sedgwick (05/08/25)
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  • Intern - Risk Management - Full Time - Days

    ProMedica Health System (Toledo, OH)
    …RELATIONSHIPS/SUPERVISORY RESPONSIBILITIES This position reports to the Lead Workers' Compensation Examiner and does not have any direct reports. POSITION SUMMARY ... Assists in the management of workers' compensation claims by providing support to the Claims ...compensation claims by providing support to the Claims Administrators; Responsible for bill review, repricing, check processing,… more
    ProMedica Health System (05/13/25)
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  • OSS Coordinator

    Sedgwick (Dayton, OH)
    …Suite 100, Austin, TX 78758.** **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple office locations; and to ... within assigned group. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Completes examiner update reports, claim adjustments, provider requests and operational expense… more
    Sedgwick (04/04/25)
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  • Estimate Review Specialist Sr. (Repair Solutions)

    Sedgwick (Toledo, OH)
    …Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. + Deliver innovative customer-facing ... to advance to the next round, a recruiter will be in touch. \#claimsexaminer # claims _As required by law, Sedgwick provides a reasonable range of compensation for… more
    Sedgwick (04/24/25)
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  • Investigator

    Highmark Health (Columbus, OH)
    …**Required** + None **Preferred** (any of the following) + Certified Fraud Examiner (CFE) + Certified Professional Coder (CPC) + Certified Outpatient Coder (COC) ... (AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must have… more
    Highmark Health (05/08/25)
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  • Investigator, SIU (Remote)

    Molina Healthcare (Dayton, OH)
    …Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims ) to gather documentation pertinent to investigations. + Detects ... Associate (HCAFA). + Accredited Health Care Fraud Investigator (AHFI). + Certified Fraud Examiner (CFE). To all current Molina employees: If you are interested in… more
    Molina Healthcare (03/21/25)
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