- 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)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… 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
- Elevance Health (Mason, OH)
- **Business Consultant Senior - Commercial Claims Data Mining** **Hybrid 1:** This role requires associates to be in-office 1-2 days per week, fostering ... and adaptable workplace. Alternate locations may be considered. The **BUSINESS CONSULTANT SENIOR ** is responsible for translating the most highly complex and varied… 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
- Cushman & Wakefield (Florence, KY)
- **Job Title** Senior Facility Manager **Job Description Summary** The Senior FM is responsible for the day-to-day operations of regional sites. Direct oversight ... cross-functional partners to effectively maintain each site. **Job Description** The Senior Facilities Manager has the overall responsibility for overseeing the… more
- Elevance Health (Mason, 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
- 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
- Citigroup (Florence, KY)
- …based on data and process observations. + Ensure recovery and claims processes comply with regulatory standards and internal policy requirements. + Support audit ... results to the business and Fraud Prevention peers and senior management. + Ability to learn and understand the...Ability to learn and understand the internal and external systems and networks that interact with and/or drive authorization… 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