- Elevance Health (Cincinnati, OH)
- **Title: Plan to Plan Service Specialist III** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles ... of our PulsePoint locations. The **Plan to Plan Service Specialist III** will be responsible for serving as a...of contact in responding to all Plan to Plan claims inquiries and resolving related issues. Plan to Plan… more
- Robert Half Accountemps (Cincinnati, OH)
- …long term contract employment opportunity for a Medical Biller/Medical Accounts Receivable Specialist in Cincinnati, Ohio. This role is situated in the medical ... on conducting medical AR clean up projects and managing claims . Responsibilities: * Handle medical accounts receivable clean up...up projects * Monitor, review and re-bill 4000+ medical claims as necessary * Carry out insurance follow-ups to… more
- Deloitte (Cincinnati, OH)
- Operations & Technology Transformation Specialist Master, Guidewire Data Migration - ETL Developer What we do Operations and Technology Transformation delivers ... on July 31, 2024 Work you'll do As an OTT Insurance Transformation Specialist Master, you will bring considerable technical expertise to deliver effective solutions… more
- GE Aerospace (Evendale, OH)
- …Aerospace Litigation and Investigations Team is looking for a mid-career Litigation Support Specialist to join our growing team. The successful candidate will be a ... key member of the team managing incoming claims and legal matters at a programmatic level, including...Serve as a program manager evaluating and administering incoming claims and legal process + Synthesize data and assess… more
- Walgreens (Mason, OH)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Air National Guard Units (Blue Ash, OH)
- …5 EXCEPTED SERVICE POSITION. This National Guard position is for a IT SPECIALIST (SYSADMIN/NETWORK), Position Description Number T5826600 and is part of the OH 123 ... in interconnection/integration of tactical radar sites. Responsibilities As a IT SPECIALIST (SYSADMIN/NETWORK), GS-2210-11, you will perform the following duties: 1.… more
- Elevance Health (Mason, OH)
- **Pharmacy Quality Improvement Specialist ** _This position will work a hybrid model (remote and office), 1-2 times per week. The Ideal candidate will live within 50 ... to deliver member-centered, lasting pharmacy care. The Pharmacy Quality Improvement Specialist is responsible for generating process improvements that bring about… more
- Molina Healthcare (Covington, KY)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. 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 adherence to business and system requirements of… more
- Republic Finance, LLC (Springdale, OH)
- …in the financial services industry for you, apply today! As a Consumer Loan Specialist , you will be a key team member in the branch. Your primary responsibility ... to quickly and efficiently resolve any customer issues. Processes insurance claims , follow-ups and payments daily and maintains insurance log. Provides excellent… more
- Republic Finance, LLC (Springdale, OH)
- …in the financial services industry for you, apply today! As a Sr. Consumer Loan Specialist , you will be a key team member in the branch. Your primary responsibility ... core values, company policies, operational procedures and compliance. Processes insurance claims , follow-ups and payments daily and maintains insurance log. Provides… more
- Robert Half Finance & Accounting (Cincinnati, OH)
- Description We are searching for a Medical Billing Specialist to join our team in CINCINNATI, Ohio. In this role, you will handle all aspects of our medical billing ... ensure its accuracy. * Handle the preparation, review, and submission of patient claims . * Process payments received from insurance companies and carry out account… more
- Sedgwick (Cincinnati, OH)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer ADA Accommodation Specialist **PRIMARY PURPOSE OF THE ROLE:** To enhance the ADA process for ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more… more
- Gentiva (Cincinnati, OH)
- …difference in people's lives every day. **Overview** We're looking for a **Revenue Cycle Specialist ** to join our team. You will report directly to the Revenue Cycle ... Manager.You will be responsible for processing Government and/or Commercial claims and payments as assigned and maintain required medical records. + Track… more
- GE Aerospace (Evendale, OH)
- …Negotiate terms and conditions and transmit information to Procurement + Manage claims , and provide sourcing management, data analysis and negotiations support + ... Define and improve Sourcing strategies at business or plant level + Knowledge of current market conditions, pricing and sources of supply + Adhere to GE Aviation compliance, quality, cost, and delivery requirements + Collaborate with team members and various… more
- Molina Healthcare (Covington, KY)
- …credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. * ... Completes follow-up for provider files on 'watch' status, as necessary, following department guidelines and production goals. * Reviews and processes daily alerts for federal/state and license sanctions and exclusions reports to determine if providers have… more
- Insight Global (Cincinnati, OH)
- …develop and support various projects, coordinate and design studies to support product claims , and ensure all product claims comply with global regulations. ... to consumer data focus groups to gather insights. The specialist will also conduct update meetings to ensure team...to ensure team alignment and write defensives about product claims . Preferred candidates will have the ability to assess… more
- Elevance Health (Cincinnati, OH)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... HS diploma or equivalent and a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Molina Healthcare (Covington, KY)
- …enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of claims ... of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of Local, State… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …in lieu of a degree.** **Licensure/Certification** **Preferred:** SHRM-CP, SHRM-SP /Labor Relations Specialist **Minimum Years and Type of Experience:** + 5 years in ... detailed documentation and maintaining files in preparation for potential future claims . Reasoning ability that includes strong problem solving and conflict… more
- ASRC Industrial Services (Cincinnati, OH)
- …Regional Corporation (ASRC), an Alaska Native Corporation (ANC) established under the Alaska Native Claims Settlement Act of 1971. As part of an ANC, EQM is a ... may also perform as a waste Transportation & Disposal Coordinator or Regulatory Specialist in support of other PMs from time to time. Responsibilities: + Manage,… more