- Bon Secours Mercy Health (Cincinnati, OH)
- …Regulatory and Property/ADP, to protect the assets of the ministry by resolving those claims within the parameters of the available insurance coverages. Is the ... named in a lawsuit + Works closely with the Risk management related to claim management + Manages closely...and obtain necessary discovery information + Utilize knowledge of insurance contracts, claims investigations, and vendor management… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …clinical and operational excellence. **Summary** Works collaboratively with the Compliance Manager on creating auditing protocols which align with Bon Secours Mercy ... review of Bon Secours Mercy Health coding, billing and claims processing policies and procedures for the development of...monitors and audit protocols specific to hospital revenue cycle risk areas highlighted by the OIG, Medicare, State Medicaid,… more
- Sedgwick (Cincinnati, OH)
- …telemarketing, social media and local marketing events. + Calling on residential/commercial insurance claims adjusters & managers, attending various claims ... telemarketing, social media, local marketing events, and direct contact with property claims adjusters and manager level professionals. To engage potential… more
- Republic Finance, LLC (Springdale, OH)
- … risk analysis, making credit decisions, administering loan closings, and processing insurance claims . Your management abilities shine as you assist the ... amazing benefits and perks, including health, dental, and vision insurance with employer contribution as well as paid time...industry for you, apply to be an Assistant Branch Manager today! *Please note that this position is 100%… more
- Triversity Construction (Cincinnati, OH)
- The Project Manager for our Craft Force division provides overall administrative and technical direction, enforces company and project policies, main client ... most aspects of SPA type assignments + Demonstrates strong understanding of risk management and safety + Demonstrates understanding and execution of safety planning… more
- The Salvation Army (Cincinnati, OH)
- …the Finance Secretary. + Coordinate the sharing of information and the processing of insurance claims for SWONEKY Division including: + Property + Auto + General ... clerical work as needed, as well as administration of various risk management functions. Responsibilities Duties: + Handle information for SWONEKY mini-Council,… more
- CVS Health (Cincinnati, OH)
- …flexibility as you coordinate the care of your members. + Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing ... + Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which… more
- Elevance Health (Mason, OH)
- …Auditor II** is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. **How you will make an impact:** + ... Examines claims for compliance with relevant billing and processing guidelines...concern. + Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.… more
- Elevance Health (Mason, OH)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new...concern. + Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.… more
- Elevance Health (Mason, OH)
- …a designated virtual-eligible role and specified as primarily virtual by the hiring manager , associates are required to work at an Elevance Health location at least ... formulae and creating and/or reviewing alternative settlement formulate and risk sharing models. + Responsible for recommendations on pricing, marketing,… more
- Elevance Health (Mason, OH)
- …appeals, manages inventory and production levels, and operational and plan risk , ensures quality, and regulatory compliance.** PRIMARY DUTIES: + Coordinates ... + Serves as a resource for complex issues and interpretation of claims , provider contracts and data, eligibility, member contracts, benefits, clinical decisions,… more