Claims Specialist Jobs in Grove City, OH

Drive the success of inpatient Payment Integrity programs by overseeing audits, ensuring compliance, and enhancing quality across teams and vendors. Collaborate with stakeholders to optimize processes...

Help us architect a robust regulatory framework that empowers GPs to thrive in complex financial markets. You will lead compliance initiatives, ensuring operational integrity and strategic alignment w...

Lead collections strategy for complex U.S. Enterprise accounts, ensuring timely payments while maintaining strong customer relationships. Collaborate with cross-functional teams to resolve issues and...

Engineer data-driven solutions to enhance business strategies and competitive positioning. Collaborate with teams to analyze complex data, develop insights, and communicate findings effectively to dri...

Oversee and manage claims investigations, ensuring compliance with policies while leading a team to achieve optimal performance and cost management. Foster communication and training to align with bus...

Drive transformation in Payment Integrity by leading cross-functional initiatives, enhancing processes, and delivering innovative solutions that improve member and provider experiences while ensuring...

Analyze clinical documentation and risk adjustment for healthcare providers, ensuring accurate representation of patient acuity. Collaborate with physicians to identify documentation opportunities and...

Drive statutory financial reporting and audits, ensuring compliance and accuracy. Collaborate with cross-functional teams to enhance financial transparency and support leadership in understanding perf...

Transform compliance oversight in the DME order-to-payment lifecycle. Lead audits, analyze data, and coordinate payer audits while developing practical controls and reporting to enhance revenue integr...

Unlock your potential by leading business and functional requirements for Medicaid financial management. Collaborate with diverse teams to enhance payment operations and ensure compliance while drivin...

Drive team performance and enhance customer experience by overseeing policy administration and contact center operations. Collaborate on goals, manage staffing, and ensure compliance with regulations...

Lead the charge in operational excellence by overseeing performance across client accounts, ensuring effective communication and high-quality execution in revenue cycle management, while mentoring tea...

Lead the charge in building and scaling AI Data Operations, transforming emerging opportunities into commercially viable solutions. Drive strategy, partnerships, and operational excellence to support...

Lead the charge in developing and maintaining insurance policy forms and endorsements. Ensure compliance and quality assurance across multiple states while collaborating with cross-functional teams to...

Drive patient access by leveraging your expertise in reimbursement and market access. Collaborate with healthcare providers to navigate complex payer landscapes, ensuring timely access to therapies wh...

Elevate your career by providing strategic consultation and advanced case design support for Life Insurance distribution channels, enhancing sales effectiveness and driving growth through collaboratio...

Take ownership of regulatory support for pharmaceutical programs, managing IND and NDA submissions, health authority interactions, and lifecycle maintenance. Collaborate with cross-functional teams to...

Champion compliance excellence by leading innovative technology integration and regulatory strategies across Medicare Advantage and Part D channels, ensuring seamless operations and enhanced agent eff...

Shape innovative pricing strategies for P&C insurance products. Lead a dynamic team, ensuring compliance and driving profitability while collaborating with senior leadership to meet financial goals an...

Join a team that inspires growth and excellence in Life Underwriting, leading a high-performing group to deliver exceptional service, elegant risk assessment, and superior client experiences while nav...

Accelerate progress at the forefront of healthcare by driving commercial performance, building relationships with providers, and ensuring patient access to innovative therapies across a defined territ...

Lead the charge in ensuring compliance and integrity within federal healthcare programs through rigorous investigations, data analysis, and collaboration with key stakeholders to produce actionable fi...

Transform regulatory insights into actionable strategies by analyzing national and state legislative activities. Collaborate with legal and business teams to ensure compliance and support effective de...

Transform the future of Life & Annuity services by driving complex business and technology transformations. Collaborate with clients to analyze challenges, design solutions, and deliver impactful resu...

Elevate business insights by analyzing complex data and delivering actionable recommendations. Collaborate with teams to enhance competitive intelligence and drive strategic decisions, ensuring data a...