- Molina Healthcare (Akron, OH)
- …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... clinical/ medical reviews of retrospective medical claim reviews, medical claims and...Claims Auditing, Medical Necessity Review and Coding experience +… more
- Elevance Health (Independence, OH)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… more
- CommuniCare Health Services (Akron, OH)
- …and ensuring coding and documentation are accurate, appropriate, and demonstrate medical necessity. Submission of claims , pre-certifications, processing of ... and compliant billing and coding. + Prepare and submit claims via electronic billing system. + Ensure medical...EOB's, electronic EDI reports, electronic remits. + Work with nurse practitioners and other medical personnel to… more
- Sedgwick (Cleveland, OH)
- …the ADA process for claimants requesting accommodations under the ADAAA; to review complex medical information for temporary and permanent accommodation ... are driven to deliver great work. + Apply your medical /clinical or rehabilitation knowledge and experience to assist in...the next round, a recruiter will be in touch. \# nurse Sedgwick is an Equal Opportunity Employer and a… more