- Molina Healthcare (Columbus, OH)
- …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
- The Hartford (Columbus, OH)
- Sr Data Scientist - GD07AE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working ... Step into the future with The Hartford as a Data Scientist / Sr Data ...Join a team that's pioneering AI-driven solutions in underwriting, claims processing, and customer service, transforming how we operate… more
- The Hartford (Columbus, OH)
- Sr Data Scientist - GD07AEData Scientist - GD08AE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages ... Step into the future with The Hartford as a Data Scientist / Sr Data ...Join a team that's pioneering AI-driven solutions in underwriting, claims processing, and customer service, transforming how we operate… more
- The Hartford (Columbus, OH)
- …The Customer Operations Data Science & Analytics team is seeking a Senior Analyst to support analytics across the Contact Center Operations (CCO) Portfolio for ... Sr Consultant Perf Analytics - GB07AE We're determined...as we help shape the future. The Customer Operations Data Science & Analytics team engineers end-to-end analytic and… more
- Evolent (Columbus, OH)
- …Familiarity with value-based care and utilization management is preferred + Understanding of data systems and the critical thinking skills to solve new problems ... interactions fostering expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. **Qualifications… more
- Molina Healthcare (Columbus, OH)
- … claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component… more
- Evolent (Columbus, OH)
- …skills + Microsoft Office experience (Excel, Visio) + Understanding of healthcare data formats (eg, eligibility, claims , configuration, authorizations, clinical ... You'll Be Doing:** Evolent Health is looking for a Senior Product Owner to be a key member of...key member of the Product team, focused on client data integrations. This individual will play a critical role… more
- JPMorgan Chase (Columbus, OH)
- …Conducted security assessments and implemented best practices to protect sensitive data in financial systems . **Preferred qualifications, capabilities, and ... Chase within the Consumer and Community Banking - Fraud. Claims & Disputes Tech team, you lead and manage...the form of cash and/or forfeitable equity, awarded in recognition of individual achievements and contributions. We also offer… more
- Humana (Columbus, OH)
- …community and help us put health first** Humana's Gulf South Region is seeking a Senior Data and Reporting Professional that generates ad hoc reports and regular ... or data warehouse queries and scripts. The Senior Data and Reporting Professional: + Integrates...insurance industry or health care sector with authorization or claims data + Ability to see trends… more
- Cardinal Health (Columbus, OH)
- …and enhance the overall healthcare experience. We are seeking a highly motivated and experienced Senior Data Scientist to join our team as a thought leader and ... data to solve complex business problems on large data sets, integrating multiple systems . At Cardinal...Extensive knowledge of healthcare data , including clinical data , patient demographics, and claims data… more
- Turner & Townsend (Columbus, OH)
- … data center design and construction processes, including MEP systems , and structural elements. + Excellent communication, negotiation, and interpersonal skills. ... **Job Description** **Turner & Townsend is** seeking an experienced ** Senior Cost Manager / Quantity Surveyor** to join our...join our team, leading cost management for a high-profile data center campus project for a major technology client.… more
- Datavant (Columbus, OH)
- …designing, developing, and maintaining robust data pipelines for healthcare data including prescriptions, medical claims , MAO4, patient demographics, and ... with the other engineering teams to troubleshoot issues with API's and data exchanges between multiple systems . **What You Need to Succeed** + 5+ years Data … more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- **Position Summary** The Senior Manager of Field Technology will lead the design, optimization, and delivery of field sales reporting platforms and tools. This role ... in ensuring that our field teams have seamless access to accurate, actionable data to drive performance. The role focuses on managing field-facing technology … more
- Trinity Health (Columbus, OH)
- …+ Under general supervision, performs research and analysis of complex health care claims , pharmacy, and lab data regarding network utilization and cost ... candidates will have knowledge of Health Plans in decision support, data analytics, or governmental or managed care reimbursement. **Why MediGold?** MediGold… more
- Elevance Health (Columbus, OH)
- … data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health… more
- Evolent (Columbus, OH)
- …SAS, SQL, or similar analytical software to analyze clinical authorization and healthcare claims data * Using analytical tools to integrate various data ... care data including medical, pharmacy and ancillary claims data , membership data , clinical...feasible given data limitations * Understanding of data systems and the critical thinking skills… more
- Walgreens (Westerville, OH)
- …by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- Highmark Health (Columbus, OH)
- …overall business targets or assigned volume of new applications or RFP's.Utilize various systems and tools to obtain necessary data and accurately complete and ... quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …- Interacts effectively with internal/external functional business units to gather data and develop documentation required for on-time submissions. - Works closely ... (Word, Excel, PowerPoint, Outlook) and familiarity with electronic document management systems (EDMS). **Competencies** See OPDC Competencies Chart (Level X) **P**… more
- Highmark Health (Columbus, OH)
- …years with coding languages, analytical software, systems , tools and processes using claims , clinical, enrollment and provider data + 3 years of project ... office periodically for scheduled business meetings.** This job creates data -driven insights which identify actionable opportunities and/or create analytics and… more