- PharmaCord (Cincinnati, OH)
- …PharmaCord Lynk system, maintaining detailed records of reimbursement activities, including claims status, payments, and appeals . Generate reports and analysis ... includes completing benefit investigations, tracking prior authorizations / denial appeals , and assisting patients or other callers/stakeholders through resolution… more
- Lincoln Financial (Columbus, OH)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter ... multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and...lieu of Bachelor's) + 1 - 3+ Years of Short -Term and/or Long-Term Disability. (Required) + Ability to communicate… more
- Cognizant (Columbus, OH)
- **Provider Appeals & Grievances Specialist ** (remote) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** We ... are seeking a dedicated Provider Appeals & Grievance Specialist with 1 to...and state Medicaid policies. **Qualifications/Skills Needed:** 1-2 years of Appeals and Grievance 1 yr. medical claims … more
- Cognizant (Columbus, OH)
- …assigned accounts. . Maintain working knowledge of applicable health insurers' internal claims , appeals , and retro-authorization as well as timely filing ... with Medicare, Medicaid, and third-party guidelines. . Effectively document and log claims / appeals information on relevant tracking systems . Utilize critical… more
- CVS Health (OH)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
