- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Claims Review Representative makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer… more
- Sedgwick (Columbus, OH)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to ... YOU AN IDEAL CANDIDATE?** Join our team as a Claims Representative focused on Property Damage and...and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations,… more
- Ryder System (Columbus, OH)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Director Claims directs...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Sedgwick (Dublin, OH)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Disability Representative Sr. **Senior Disability Representative - Make a Meaningful ... do you._** **We're not just a global leader in claims management; we're a team driven by empathy, expertise,...your moment.** **WHAT YOU'LL DO** **As a Senior Disability Representative , you'll be the go-to guide for individuals navigating… more
- Sedgwick (Dublin, OH)
- … system. + Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims . + Evaluates and arranges appropriate ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Disability Representative Sr. **PRIMARY PURPOSE** : Provides disability case management and complex… more
- Highmark Health (Columbus, OH)
- …position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist distribution. Interpret ... added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance. + Perform effective on-site visits… more
- Ryder System (Columbus, OH)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- OhioHealth (Columbus, OH)
- …OGC addressing concerns impacting OhioHealth's liability with respect to professional liability claims and incidents and the review and oversight of practitioner ... claim trends from the organization's claims /incidence database. In partnering with System Quality, this role...expertise to the Quality and Patient Safety and Peer Review staff and leadership to help manage risk and… more
- Highmark Health (Columbus, OH)
- …for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more
- CVS Health (Columbus, OH)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- Otsuka America Pharmaceutical Inc. (Columbus, OH)
- …maintain the effectiveness of Quality Systems for managing the batch record review and release process Quality Management Activities supporting all phases of ... compliance. + Manages reports and trends to the Management Representative to help in the preparation of Management reviews...above. + Improves supplier quality performance for batch record review and release process for OAPI GMP release of… more
- Prime Therapeutics (Columbus, OH)
- …with various levels of leadership within the organization, acting as a representative of the broader Financial Systems team + Provide consulting services to ... experience, preferably leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in… more
- CVS Health (Columbus, OH)
- …program offered by the health plan. This includes benefit set-up, claims processing, contractual oversight, formulary management and updates, medication utilization ... review , prior authorization processes in alignment with contract, and...attend and lead discussions as the delegated health plan representative in all state meetings regarding pharmacy program initiatives,… more
- Ryder System (Etna, OH)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **We are ... times, product cuts, loads not picked up by carrier and damage claims . **Essential Functions** + Routing customer's freight through portals, email, and manual… more
- Ryder System (Lockbourne, OH)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **We are ... transactions including leave of absence administration and responding to unemployment claims and payroll. + Prepare accurate month-end financial closing reports,… more
- RxBenefits (Columbus, OH)
- …team also assists with resolving client issues involving performance discrepancies, claims issues, and reporting. The successful Pharmacy Pricing Senior Manager will ... across internal stakeholders to foster collaborative and efficient work products + Review for accuracy and finalize all current account pricing comparisons for… more