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20

Claims Process Policy Professional 2 Jobs in Cincinnati






Job info
 
Company
**********
Location
Cincinnati, OH
Posted Date
Nov 28, 2020
Info Source
Employer  - Full-Time  90  

Description The Senior Business Intelligence Engineer solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Engineer work assignments ..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Dec 09, 2020
Info Source
Employer  - Full-Time  90  

Description The Senior Claims Research & Resolution Professional works with operational teams, vendors, ... members in the processing of claims. Strong analytical skills focusing on ... knowledge and experience with..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Feb 09, 2021
Info Source
Employer  - Full-Time  90  

... Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing ... reporting. The Consumer Service Operations Professional 2 evaluates metrics for early identification ... of..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Mar 22, 2021
Info Source
Employer  - Full-Time  90  

... to enhance the clinical delivery process. The Associate Director, Compliance Nursing ... multiple managers or highly specialized professional associates. The Associate Director, Compliance ... Responsibilities include: Leads Medicaid operational..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Jun 11, 2021
Info Source
Employer  - Full-Time  90  

Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical ... the Autism Care Demonstration (ACD) policy, TRICARE Operations Manual (TOM) Chapter ... session notes to the provider's claims..

 
Company
Location
Cincinnati, OH
Posted Date
Sep 02, 2021
Info Source
Employer  - Full-Time  90  

... tools, care coordination tools, and claims systems to identify issues, mitigate ... be certified as a Certified Professional in Health Care Quality by ... public health, health administration, health..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Apr 07, 2021
Info Source
Employer  - Full-Time  90  

... Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, ... Care Manager, Telephonic Behavioral Health 2 work assignments are varied and ... Care Manager, Telephonic Behavioral Health..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Mar 22, 2021
Info Source
Employer  - Full-Time  90  

... to enhance the clinical delivery process. The Associate Director, Utilization Management ... multiple managers or highly specialized professional associates. Detailed Responsibilities include: Leads ... Leads National Medicaid Utilization Management..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Apr 09, 2021
Info Source
Employer  - Full-Time  90  

... related issues which may include claims inquiries, enrollment issues, travel attestations, ... Manual (TRM), and the TRICARE Policy Manual (TPM). Assist with questions ... with qualifying ASD diagnoses. Provide..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Mar 26, 2021
Info Source
Employer  - Full-Time  90  

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

 
Company
**********
Location
Cincinnati, OH
Posted Date
May 26, 2021
Info Source
Employer  - Full-Time  90  

Description The Director, Provider Reimbursement is responsible for the leadership, strategy development and execution of Humana Military's provider reimbursement methodologies. This leader is responsible for timely and accurate implementation of Government ..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Sep 12, 2021
Info Source
Employer  - Full-Time  90  

... Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, ... Senior Clinical Strategy and Practice Professional work assignments involve moderately complex ... Responsibilities The Senior Behavioral Health..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Mar 21, 2021
Info Source
Employer  - Full-Time  90  

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

 
Company
Location
Cincinnati, OH
Posted Date
Oct 07, 2021
Info Source
Employer  - Full-Time  90  

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Jun 26, 2023
Info Source
Employer  - Full-Time  90  

... Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing ... reporting. The Consumer Service Operations Professional 2 evaluates metrics for early identification ... of..

 
Company
Location
Cincinnati, OH
Posted Date
Sep 06, 2021
Info Source
Employer  - Full-Time  90  

... and delivering on initiatives and process capabilities that enable improved effectiveness, ... identify, advise, lead and facilitate process improvement opportunities. KEY ACCOUNTABILITIES Process Improvement and Project Management Contributes .....

 
Company
**********
Location
Cincinnati, OH
Posted Date
Jun 29, 2021
Info Source
Employer  - Full-Time  90  

Description The Medical Coding Coordinator 2 extracts clinical information from a ... records. The Medical Coding Coordinator 2 performs varied activities and moderately ... Responsibilities The Medical Coding Coordinator 2..

 
Company
Location
Cincinnati, OH
Posted Date
Sep 02, 2021
Info Source
Employer  - Full-Time  90  

Description Humana's Claims Cost Management (CCM) organization is ... support our efforts for ensuring claims payment accuracy, so that our ... to day work of reviewing claims payments for clinical/coding..

 
Company
**********
Location
Cincinnati, OH
Posted Date
May 13, 2021
Info Source
Employer  - Full-Time  90  

Description The Pharmacy Claims Lead operationalizes and monitors Coordination ... Cultural Competency Enable personal & professional growth Develop analytics and reporting ... business Actively identifies and owns process improvements and..

 
Company
**********
Location
Cincinnati, OH
Posted Date
Aug 07, 2021
Info Source
Employer  - Full-Time  90  

... tools, care coordination tools, and claims systems to identify issues, mitigate ... be certified as a Certified Professional in Health Care Quality by ... public health, health administration, health..

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