Caresource jobs in Dayton, OH

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Urgent Required for ::::::: OnBase Developer_Dayton, OH_4357
- Dayton, OH 45490
Assist and contribute to the Architectural Council on all software solutions designed or purchased at CareSource 9....

Fraud Examiner

- Dayton, OH 45402 (Downtown area)
Role and Responsibility: Responsible for investigating and resolving all assigned allegations of healthcare FWA by medical professional, facilities, and...

Knowledge Specialist-Claims

- Dayton, OH 45402 (Downtown area)
Role and Responsibility: Responsible for the coordination, development and maintenance of the Claims Department knowledge repository that houses policies,...

Provider Claims Specialist

- Dayton, OH 45402 (Downtown area)
Role and Responsibility: Research and resolve claims issues that have been escalated by providers Research and resolution may include coding/billing issues,...

Member Engagement Specialist

- Dayton, OH 45402 (Downtown area)
Role and Responsibility: § Verify member eligibility, previous enrollment history, demographics and current health status § Engage with members with...

COB Claims Specialist

- Dayton, OH 45402 (Downtown area)
Perform all verification requests received from providers on the CareSource Provider Web Portal. Role and Responsibility:....

Prior Authorization Specialist

- Dayton, OH 45402 (Downtown area)
Role and Responsibility: § Assists with Medical Management processes § Convert information obtained from providers/members, (received via fax, phone or mail...

Claims Specialist

- Dayton, OH 45402 (Downtown area)
Role and Responsibility: § Coordinate with a core group of priority provider offices to identify claim problems and resolve them in a timely manner § Adjust...

Grievance & Appeals Specialist

- Dayton, OH 45402 (Downtown area)
Attempt to save members from disenrolling from CareSource by identifying reason and recommending appropriate resolution. Role and Responsibility:....

Provider Resolution Speci

- Dayton, OH 45402 (Downtown area)
Role and Responsibility: § Responsible for capturing, resolving/facilitating resolution, and reporting on escalated complaints regarding claims processing,...

Escalation Mitigation Specialist

- Dayton, OH 45402 (Downtown area)
Role and Responsibility: Lead and execute the Corporate Escalation Process, ensuring that all customer escalations are tracked while utilizing problem...
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