- Molina Healthcare (Covington, KY)
- …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
- Molina Healthcare (Covington, KY)
- … 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
- City of Cincinnati (Cincinnati, OH)
- SENIOR ENGINEER (NON-COMPETITIVE) Print (https://www.governmentjobs.com/careers/cincinnati/jobs/newprint/4970454) Apply SENIOR ENGINEER (NON-COMPETITIVE) ... and construction of engineering projects including streets, bridges, mechanical systems , utility plants, buildings and other projects, varying with assigned… more
- Elevance Health (Cincinnati, OH)
- …May require strong knowledge of products as well as our internal business models and data systems . + May coordinate with external audits as appropriate. + Acts ... **Business Information Consultant Senior - Provider Economics** The **Business Information Consultant...on existing programs. + Conduct comprehensive analysis of healthcare data , claims , and financial reports to identify… more
- Elevance Health (Mason, OH)
- ** Senior Test Lead - Pharmacy Benefit Manager (PBM)** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... a strong, clinical-first lens to deliver member-centered, lasting pharmacy care. The ** Senior Test Lead (Business Change Manager Senior )** will be responsible… more
- Elevance Health (Cincinnati, OH)
- … data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy ... healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding,… more
- GE Aerospace (Evendale, OH)
- …business units and engineering technology groups. The IP Counsel will report to a more senior IP Counsel or deputy who reports up to the Chief IP Counsel & General ... principles to standardize work and leveraging resources efficiently + Advising on data rights issues in US government contracts and proposals + Supporting pursuit… more
- J&J Family of Companies (Cincinnati, OH)
- …Market Access for the Endomechanical and Energy platforms, reporting to the Senior Director, HEMA for Energy/Endomech/Robotics, will work in close collaboration with ... value of products and therapies with clinical and quality of life outcomes data from clinical trials and/or epidemiology studies. + Support the development and… more