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Clinical or Claims or Review or Boulder jobs in Columbus, OH, 43215

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Clinical Authorization Review Nurse (Medicaid Health Systems

Ohio Department of Commerce  –  Clinton Township, OH, 43224
What You Will Do At ODM: Working Title: Clinical Authorization Review Nurse Classification : Medicaid Health Systems ... health and safety process improvements Reviewing and approving claims for payment Working collaboratively with internal and ... - Jun 17

Clinical Authorization Review Nurse (Medicaid Health Systems

ohio.gov  –  Franklin County, OH
Schedule: Full-time What You Will Do At ODM: Working Title: Clinical Authorization Review Nurse Classification: Medicaid ... health and safety process improvements Reviewing and approving claims for payment Working collaboratively with internal and ... - Jun 12

Clinical Review Clinician - Appeals

Spectraforce Technologies  –  Clinton Township, OH, 43224
Position Title: Clinical Review Clinician - Appeals Work Location: Remote in Ohio - Columbus area preferred Assignment ... Review medical code data and records to determine whether a denial is warranted. Utilizing multiple appeals/claims systems ... - Jun 19

Clinical Authorization Review Nurse (Medicaid Health Systems

Medicaid  –  Columbus, OH, 43215
... What You Will Do At ODM: Working Title: Clinical Authorization Review Nurse Classification\: Medicaid Health Systems ... health and safety process improvements Reviewing and approving claims for payment Working collaboratively with internal and ... - Jun 20

Failed Claims Specialist

Ohio State University Wexner Medical Center  –  Clinton Township, OH, 43224
... Conduct thorough review of the medical record to ensure that the clinical documentation supports all billed charges. Take an active role in identifying the discrepancies in nursing documentation and report findings to nurse managers. Follow up on ... - Jun 07

Legal Secretary- Court of Claims

State of Ohio  –  Columbus, OH, 43216
... a motivated and hard-working individual for a Legal Secretary position in our Court of Claims Section, Columbus office. ... applications * Proofreads and corrects all materials prior to review by attorneys * Composes or independently answers ... - Jun 17

Legal Secretary- Court of Claims

ohio.gov  –  Franklin County, OH
... a motivated and hard-working individual for a Legal Secretary position in our Court of Claims Section, Columbus office. ... software applications -Proofreads and corrects all materials prior to review by attorneys -Composes or independently answers ... - Jun 12

Clinical Review Nurse - Prior Authorization

Actalent  –  Clinton Township, OH, 43224
... and clinical reviews of authorization requests in accordance with regulatory guidelines and clinical criteria. The role involves collaboration with healthcare providers and the authorization team to ensure timely review and approval of services. ... - Jun 20

Utilization Review Specialist-PRN

Acadia External  –  Franklin Township, OH, 43223
Act as liaison between managed care organizations and the facility professional clinical staff. Conduct reviews, in ... Facilitate peer review calls between facility and external organizations. Initiate and complete the formal appeal process ... - Jun 14

Disability Clinical Specialist

Sedgwick  –  Clinton Township, OH, 43224
... clinical evaluations, consult providers and employees; to provide case direction; and to ensure medical information substantiates the need for absence from work. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Performs clinical review of referred claims; ... - Jun 19
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