- Molina Healthcare (Covington, KY)
- …**Job Summary** Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines, ... overpayment notification and supporting documentation such as explanation of benefits, claims and attachments. + Maintains and reconciles department reports for… more
- AAA Mid Atlantic (Cincinnati, OH)
- …+ Annual bonus eligibility + No weekends required - great work/life balance + Dedicated Claims Specialist We are looking for someone who will: + Hires, trains ... and manages the Account Management/Client Services staff. + Develops workflows and processes for delivery of client services at consistently high levels. + Establish and communicate service metrics, monitor and analyze results and implement appropriate… more
- Elevance Health (Cincinnati, OH)
- **Title: Plan to Plan Service Specialist I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... of our PulsePoint locations. The **Plan to Plan Service Specialist I** 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
- First Student (Cincinnati, OH)
- …transportation industry has to offer.** About the Position Submission of warranty claims to vehicle manufactures on behalf of First Student company maintenance ... in accordance with company policy and within the parameters established by the manufacturers. Claims need to be filed in a timely manner. + Performs periodic audits… more
- Molina Healthcare (Covington, KY)
- **Molina Healthcare** is hiring for a remote **Pharmacy Operations Specialist ** This role can be worked remotely anywhere within the US. This role will be the ... (National) + Excellent observation and communication skills + Comfortable monitoring pharmacy claims and reporting to the Healthplan + Solid understanding of how… more
- Deloitte (Cincinnati, OH)
- Manager/ Specialist Master, Operations & Technology Transformation, Insurance, Guidewire Integration & Configuration What we do Operations and Technology ... contributing to the development of junior staff. Your role As a Manager/ Specialist Master you will bring considerable technical expertise to deliver effective… more
- Deloitte (Cincinnati, OH)
- Manager/ Specialist Master, Operations and Technology Transformation, Guidewire Data Architect What we doOur Operations and Technology Transformation team (OTT) ... on January 31, 2025 Work you'll do As an OTT Insurance Transformation Manager/ Specialist Master, you will bring technical expertise to deliver effective solutions to… more
- J&J Family of Companies (Cincinnati, OH)
- Senior Regulatory Affairs Specialist (Robotics & Digital Solutions) - MedTech Surgery - 2406219400W **Description** Robotics & Digital Solutions, part of the Johnson ... & Johnson Medtech Surgery, is recruiting for a **Senior Regulatory Affairs Specialist ** _. The preferred location for this role is within a commutable distance of… more
- Walgreens (Cincinnati, 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
- Carmeuse Americas (Butler, KY)
- Job Summary: The Health & Safety (H&S) Specialist is responsible for effectively leading the implementation and execution of the company's H&S Strategy placing a ... including, but not limited to, assist with managing workers compensation claims , property damage, business interruption, and unexpected costs. Basic Requirements: +… more
- Molina Healthcare (Florence, KY)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER,… more
- HUB International (Cincinnati, OH)
- …the answer is yes, we have the perfect opportunity for you._ _Our Client Specialist position a great starting point within our benefits consulting team, where you ... and vendor partners to resolve problems and troubleshoot client issues with invoices, claims and delivery of service. + Collaborate with HUB | HORAN Benefit… 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
- Sedgwick (Cincinnati, OH)
- …- 11p Shift **PRIMARY PURPOSE** **:** To provide excellent service to callers regarding claims for multiple lines of business; to expedite the claims application ... specifications in assisting with questions and solving problems related to the claims application and servicing processes. + Educates and informs the customer via… 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
- 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
- Sedgwick (Cincinnati, OH)
- …to develop labor market surveys. + Maintains professional communication with the claims examiners to provide timely updates and promote the necessary plan for ... university preferred. Certified Rehabilitation Counselor (CRC) and/or Certified Disability Management Specialist (CDMS), COHN, CCM , Registered Nurse (RN), CRRN or… more