Medical Claims Coordinator/Processor AVA ConsultingMedical Claims Coordinator/ProcessorMason, OHMedical Billing, cash application and collection (collection is not calling demanding payment; it's researching why a claim didn't get paid and taking steps necessary to correct the info). Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action.
Office/Administration - Medical Claims Coordinator/Processor MindlanceOffice/Administration - Medical Claims Coordinator/ProcessorMASON, OHUtilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action. " Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistCincinnati, OH$110,700–$218,300 / yearOther skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.
Medical Claims Coordinator/Processor Tailored ManagementMedical Claims Coordinator/ProcessorMASON, OH$22.55 / hourUtilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action. Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
Financial Operations Analyst Lead - Payment Integrity Datamining Elevance Health IncFinancial Operations Analyst Lead - Payment Integrity DataminingMason, OHMinimum Requirements: Requires a BA/BS in accounting or finance and a minimum of 5 years' experience in a finance/health insurance field capacity and experience with relational databases and mainframe and client server report writers; or any combination of education and experience, which would provide an equivalent background. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
NewPrior Authorization Specialist Riverhills NeurosciencePrior Authorization SpecialistCincinnati, OH$18–$22 / hourFull timeYour responsibilities include:Streamline pre-certification, authorization, and referral processes, ensuring compliance with insurance requirementsCoordinate with insurance entities, review organizations, and clinical contacts for effective communication and benefit determinationFacilitate peer-to-peer reviews for escalated encounters and address inquiries from providers, staff, and patientsEnsure timely and accurate insurance authorizations, conduct medical benefits investigations, and manage authorizations for botulinum toxin proceduresMonitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheetInitiate patient education on available assistance programsBackground and Experience:1-2 years of relevant experience in medical billing and/or prior authorization within a healthcare practicePain Management experience is a plusExperience with an Electronic Medical Record (EMR) and practice management systemKnowledge of Medicare/Medicaid and major insurance carrier's guidelinesWorking knowledge of ICD-9-10 medical coding and billing and medical terminologySuperior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendorsIf you're eager to contribute to a world-class healthcare team, apply today. Our commitment to excellence extends across diagnosis, education, and treatment for those facing nervous system diseases and injuries.
DRG Clinical Auditor Principal Elevance HealthDRG Clinical Auditor PrincipalMason, Ohio$122,240–$183,360 / yearSpecializes in review of DRG coding via medical record and attending physician’s statement provided by acute care hospitals on paid DRG, especially on very complex coding cases that are paid using APS-DRG, APR-DRG, AP-DRG, MS-DRG or TRICARE methodology and findings may be so complex and advanced that disputes or appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). The DRG Clinical Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients.
Medical Claims Biller Onsite GlobalchannelmanagementMedical Claims Biller OnsiteMason, OhioPartner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system. The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of medical claims for one or more doctor practices.
MEDICAL BILLER Belcan LLCMEDICAL BILLERMason, OHUtilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action. Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
MEDICAL BILLER BelcanMEDICAL BILLERMason, OhUtilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action. * Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
Medical Biller The Kemtah Group, Inc.Medical BillerMason, OHUtilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unpaid claim balances and take required action. Partner with the clearing house to distribute patient billing statements and monitor the patient portal to post payments in the EHR system.
NewPrior Authorization Specialist Riverhills Healthcare IncPrior Authorization SpecialistCincinnati, OH$18–$22 / hourSuperior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendors. Monitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheet.
Patient Financial Advocate Firstsource Solutions LtdPatient Financial AdvocateCincinnati, OHThe Patient Financial Advocate is responsible for screening patients on-site at hospitals for eligibility assistance programs either bedside or in the ER. Essential Duties and Responsibilities: Review the hospital census or utilize established referral method to identify self-pay patients consistently throughout the day.
Executive Case Manager (Remote) ValerisExecutive Case Manager (Remote)Cincinnati, OhioRemoteBacked by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Personalized Case Management Provides personalized case management to patients and HCPs including outbound communication to HCPs, specialty pharmacies and patients to communicate benefit coverage and/or appropriately help drive next steps in obtaining coverage and/or access to prescribed medicine.
Traveling Optometric Technician West Point OpticalTraveling Optometric TechnicianCincinnati, OhioThe position will interact with patients/customers by delivering an exceptional patient/customer experience, foster patient/customer retention, and promotes outstanding associate/doctor satisfaction. An Optometric Office Technician role may combine skills of a medical office administrator, medical billing and collections, appointment scheduler or medical records clerk and direct patient care.
Optometric Technician West Point OpticalOptometric TechnicianFlorence, KentuckyThe position will interact with patients/customers by delivering an exceptional patient/customer experience, foster patient/customer retention, and promotes outstanding associate/doctor satisfaction. An Optometric Office Technician role may combine skills of a medical office administrator, medical billing and collections, appointment scheduler or medical records clerk and direct patient care.
Facility Clinical Documentation Specialist TriHealth IncFacility Clinical Documentation SpecialistCincinnati, OHRegistered Nurse or Licensed Practical Nurse, or Registered Health Information Administrator, or Registered Health Information Technician, ACDIS - Association of Clinical Documentation Integrity Specialists credential, or Certified Professional Coder, Certified Outpatient Coder, Or Certified Documentation Expert Outpatient. Job Overview: The Facility Outpatient Clinical Documentation Specialist (CDS) is responsible for activities which assist the organization with processes for complete and accurate capture of documentation and charges in a compliant manner for the outpatient services rendered.
Medical Assistant - Certified TriHealth IncMedical Assistant - CertifiedCincinnati, OHProvides accurate/complete documentation of clinical calls and patient rooming info as well as order entry, pending prescriptions, noting current pharmacy, and enter edit workflows to result orders. Job Overview: This position provides both direct patient care in a primary care office and works with care delivery providers to identify gaps in care, contacts patients to schedule required care, and provides referral follow up.
MEDICAL ASSISTANT/MEDICAL HOME COORDINATOR TriHealth IncMEDICAL ASSISTANT/MEDICAL HOME COORDINATORMason, OHJob Overview: This position provides both direct patient care in a primary care office and works with care delivery providers to identify gaps in care, contacts patients to schedule required care, and provides referral follow up. Provides accurate/complete documentation of clinical calls and patient rooming info as well as order entry, pending prescriptions, noting current pharmacy, and enter edit workflows to result orders.
Prior Authorization and Medical Records Coordinator- Outpatient Behavioral Health TriHealth IncPrior Authorization and Medical Records Coordinator- Outpatient Behavioral HealthCincinnati, OHThe Prior Authorization and Medical Records Specialist is responsible for obtaining and managing insurance authorizations to support timely patient access to services within various Behavioral Health programs, including partial hospitalization (PHP), intensive outpatient program for addiction (IOP), neuropsychology, and psychiatric medication management practices. Job Overview: This position provides both direct patient care in a primary care office and works with care delivery providers to identify gaps in care, contacts patients to schedule required care, and provides referral follow up.