- Molina Healthcare (Cincinnati, OH)
- JOB DESCRIPTION Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and ... Standard Operating Procedures (SOPs). * Responds to provider correspondence related to claims recovery requests and provider remittances where recovery … more
- Molina Healthcare (Cincinnati, OH)
- …review to facilitate a referral to law enforcement or for payment recovery . **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical ... records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines,...+ AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional… more