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Appeals jobs in Columbus, OH, 43215

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Administrative Officer, OA

Franklin County, OH  –  Columbus, OH, 43216
... be point of contact for client case consults, complaints forwarded from BOC, and client appeals. Work closely with Workforce Administrator on employee hiring, resignation, FMLA and orientation. Supervise and work with case managers in the absence of ... - May 22

Administrative Officer,OA

Franklin County, OH  –  Columbus, OH, 43216
... be point of contact for client case consults, complaints forwarded from BOC, and client appeals. Work closely with Workforce Administrator on employee hiring, resignation, FMLA and orientation. Supervise and work with case managers in the absence of ... - May 21

Workers' Compensation Claims Specialist (Employee Benefits Analyst II)

City of Columbus, OH  –  Columbus, OH, 43215
... files waivers and/or appeals when necessary; Gathers information and reviews medical documentation and other details of claims in order to process and certify claims and to determine the appropriateness of treatment; schedules independent medical ... - May 21

Medical AR Specialist

Columbus Oncology & Hematology  –  Dublin, OH, 43016
... Essential Duties: Proven experience in reviewing, researching and following up on insurance denials Proven experience in submitting customized appeals using precise arguments based on clinical documentations, third-party payer medical policies, and ... - May 05

Attorney 2, CSEA

Franklin County, OH  –  Columbus, OH, 43216
... Attend court hearings in the Court of Appeals. Attend court hearings in the United States Bankruptcy Court concerning child support matters. Prepare documents. Perform legal research. Review files in preparation for court hearings. Meet with clients ... - May 07

Attorney 2, CSEA

Franklin County, OH  –  Columbus, OH, 43216
... Attend court hearings in the Court of Appeals. Attend court hearings in the United States Bankruptcy Court concerning child support matters. Prepare documents. Perform legal research. Review files in preparation for court hearings. Meet with clients ... - May 07

Medical Director - North Central Region - Medicaid

Humana  –  Columbus, OH, 43224
... Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician ... - May 27

Manager 2, Clinical Finance Case Manager- The James

Ohio State University  –  Columbus, OH, 43201
... for daily operational management of Revenue Cycle Clinical Support Staff primarily involving the oversite of Clinical Pre-Certification Peer to Peer Clinical Appeals Denial Analysis and Prevention for The Ohio State University Health System. ... - May 24

Senior Medical Director

CVS Health  –  Columbus, OH, 43224
... Understand UM and participate in UM front line work and appeals as needed in OH and other markets as needed• Confer directly with providers regarding the care of patients with severe, complex, and/or treatment resistant illnesses through peer review ... - May 16

Medical Director Aetna Duals Center of Excellence

CVS Health  –  Columbus, OH, 43224
... • Appeals – The medical director will perform appeals in their “base plan” and in the round robin based on “same or similar specialty” needs. • Pharmacy coverage – The medical director will perform pharmacy reviews. • The medical director will ... - May 16
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