- Molina Healthcare (Cleveland, OH)
- …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... more
- Elevance Health (Independence, OH)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... more
- Molina Healthcare (Cleveland, OH)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... 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 ... more
- Molina Healthcare (Cleveland, OH)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... more
- Molina Healthcare (Cleveland, OH)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... more