- Insight Global (Cincinnati, OH)
- Job Description Insight Global is seeking a Claims Specialist for one of our clients who is in health insurance industry. This role would require to be onsite in ... aimed at helping small businesses save on their health insurance plans The claims specialist manages a queue of claims that will involve messaging, calling,… 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 (Mason, OH)
- **LOA/Disability Case Manager Specialist ** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of ... of our Elevance Health PulsePoint locations. The **LOA/Disability Case Manager Specialist ** will be responsible for coordinating the administration of Short-term… more
- Elevance Health (Cincinnati, OH)
- **Title: Plan to Plan Service Specialist III** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles ... of our PulsePoint locations. The **Plan to Plan Service Specialist III** 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
- Sedgwick (Cincinnati, OH)
- …Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Disability Clinical Specialist **PRIMARY PURPOSE** : To perform clinical evaluations, consult providers ... work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims ; documents decision rationale; and completes medical review of all … 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
- Walgreens (Mason, 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
- Molina Healthcare (Covington, KY)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of… 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
- 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
- Robert Half Finance & Accounting (Cincinnati, OH)
- Description We are searching for a Medical Billing Specialist to join our team in CINCINNATI, Ohio. In this role, you will handle all aspects of our medical billing ... ensure its accuracy. * Handle the preparation, review, and submission of patient claims . * Process payments received from insurance companies and carry out account… more
- Gentiva (Cincinnati, OH)
- …difference in people's lives every day. **Overview** We're looking for a **Revenue Cycle Specialist ** to join our team. You will report directly to the Revenue Cycle ... Manager.You will be responsible for processing Government and/or Commercial claims and payments as assigned and maintain required medical records. + Track… more
- Acosta Group (Cincinnati, OH)
- …Excel, and Outlook). * Proficient in document management software. * Proficient in claims management software. * Type a minimum of 60 wpm. Physical Abilities * ... Seeing * Ability to Travel Distances * Listening **ABOUT US** Acosta and Mosaic are the sales and marketing powerhouses behind the most recognized and proven brands with top retailers in the United States and Canada. We offer flexible services that maximize… more
- Molina Healthcare (Covington, KY)
- …processes, provider and contract configuration, provider information management, claims processing and other related functions. **Preferred Education** Bachelor's ... Degree **Preferred Experience** * Six years proven analytical experience within an operations or process-focused environment. * Previous audit and/or oversight experience. To all current Molina employees: If you are interested in applying for this position,… more
- Molina Healthcare (Covington, KY)
- …credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. * ... Completes follow-up for provider files on 'watch' status, as necessary, following department guidelines and production goals. * Reviews and processes daily alerts for federal/state and license sanctions and exclusions reports to determine if providers have… 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
- Molina Healthcare (Covington, KY)
- …activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors + Maintains professional and technical ... Association** + Certified Professional Coder (CPC) + Certified Coding Specialist (CCS) **Preferred Education** Bachelor's Degree in related field **Preferred… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …in lieu of a degree.** **Licensure/Certification** **Preferred:** SHRM-CP, SHRM-SP /Labor Relations Specialist **Minimum Years and Type of Experience:** + 5 years in ... detailed documentation and maintaining files in preparation for potential future claims . Reasoning ability that includes strong problem solving and conflict… more