Claims Specialist SummaCare IncClaims SpecialistAkron, OH$22.61–$27.14 / hourSummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2026 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships.
Casualty Claims Specialist First Chicago Insurance CompanyCasualty Claims SpecialistCleveland, OHThey will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. The Casualty Claims Specialist will have the following duties and responsibilities: Review & determine course of action on each file assigned, utilizing technical knowledge & experience for the purpose of supporting final disposition of a loss.
Casualty Claims Specialist First Chicago Insurance Company (FCIC)Casualty Claims SpecialistCleveland, OHFull timeThey will settle complex liability claims which require greater investigation and verification, as well as casualty claims including severe injuries which may result in extended disability or bodily injury as well as coverage related litigation. Conduct thorough investigations and keep accurate and relevant documentation of file activity on each claim assigned including coverage, liability status, and damages that are applicable for each claim.
NewClaims Specialist - Professional Liability Philadelphia Insurance CompaniesClaims Specialist - Professional LiabilityBeachwood, OH$95,000–$105,000 / yearEvaluates each claim in light of facts; Affirm or deny coverage; investigate to establish proper reserves; and settles or denies claims in a fair and expeditious manner. Marketing Statement: Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional liability insurance products for select industries.
Property Claims Specialist Field Western Reserve GroupProperty Claims Specialist FieldAvon, OhioEstimates losses directly or working with consultants, independent adjusters and other experts to assess building, personal property, business income, heavy equipment, and other damages that can include losses which may range from moderate to large loss levels. The position requires the individual to apply common sense, understanding, reasoning and sound educated judgement coupled with sound Claims training and experience to properly evaluate and analyze claims for recommended action within assigned authority levels.
Cleveland - WC Claims Specialist - PN: 20068905, 20068930, 20068979 & 20069000 Highland County Joint Township District HospitalCleveland - WC Claims Specialist - PN: 20068905, 20068930, 20068979 & 20069000Cleveland, OHFor applicant support and additional information about employment with the State of Ohio, return to Careers. Ohio.
Senior Claims Benefit Specialist CVS Health CorpSenior Claims Benefit SpecialistOH$18.50–$42.35 / hourp>In this role, you will: Perform adjustments across all dollar amount levels on customer service platforms, specifically by using technical and claims processing expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Claims Administrative Support Specialist The Progressive CorpClaims Administrative Support SpecialistHighland Heights, OH$19–$21 / hourFor ideas about how you might be able to protect yourself from job scams, visit our scam-awareness page at https://careers.progressive.com/pages/how-we-hire-faq-job-scams/. In addition to ensuring essential administrative functions run smoothly, you may also interact with customers and medical providers by phone or in person when applicable.
Cleveland - Workers'''' Compensation Claims Supervisor- PN: 20069011 State of OhioCleveland - Workers'''' Compensation Claims Supervisor- PN: 20069011Cleveland, OHAbility to deal with problems involving few variables within familiar context; define problems, collect data, establish facts & draw valid conclusions; calculate fractions, decimals & percentages; use proper research methods in gathering data & make impartial decisions; check data against records for accuracy; operate VDT & PC; read & understand medical reference manuals; prepare meaningful, concise & accurate reports; gather collate & classify information about data, people or things; proofread technical materials & make corrections; handle sensitive inquiries from & contacts with officials & general public; comprehend computer generated reports, oral & written business communications. ''142288'',''true'',''142288'',''false'',''Submission for the position: Cleveland - Workers'' Compensation Claims Supervisor- PN: 20069011 - (Job Number: 2600046T)'',''false'',''142288'',''false'',''true'',''Cleveland - Workers'' Compensation Claims Supervisor- PN: 20069011'',''2600046T'',''Workers'' Compensation'',''Workers'' Compensation'',''Ohio Bureau of Workers'' Compensation Human Resources, Sierra.
Claim Benefit Specialist CVS Health CorpClaim Benefit SpecialistWork At Home, OH$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing.
Technical Specialist, Construction Claim The Travelers Companies IncTechnical Specialist, Construction ClaimIndependence, OH$85,600–$141,200 / yearDirectly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.
Appeals Specialist EverStaffAppeals SpecialistMiddleburg Heights, OH$19.50–$21 / hourStrong knowledge of the managed care industry, including payer structures, administrative processes, and government payers (e.g., Medicare/Medicaid). The ideal candidate is highly organized, knowledgeable in medical billing and payer requirements, and skilled in analyzing claims and preparing effective appeals.
Litigation Specialist First Chicago Insurance Company (FCIC)Litigation SpecialistCleveland, OHFull timeConduct prompt investigations by securing statements from the involved parties/witnesses and obtaining all necessary documents, including but not limited to, police reports, medical specials, photographs, and/or appraisals. We realize the strength of teamwork and its ability to join individuals together and push and pull each other, with a synergy that can only be found in groups of good people sharing ideas.
NewMedical Biller/Software Support Specialist Area TempsMedical Biller/Software Support SpecialistHudson, OHRather than processing claims all day, you'll help clients successfully navigate and utilize industry-leading billing software while solving problems and providing exceptional customer support. This is an exciting opportunity to join a growing company that develops, sells, and supports innovative medical billing software used by healthcare organizations nationwide.
SNF/LTC - Medicare Billing Specialist RichterSNF/LTC - Medicare Billing SpecialistTwinsburg, OHFull timeEffectively communicates and responds to inquiries by client staff, co-workers, and other party representatives • Analyzes and problem-solves when faced with obstacles . The Billing Specialist facilitates the Richter policies and procedures to ensure accurate and timey billing of the collection process of client revenue.
NewPharmacy Prior Authorization Specialist Onco360Pharmacy Prior Authorization SpecialistCleveland, OhioWhat You’ll Do The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests. Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds.
NewBenefit Verification Specialist Kellis Eye & Laser Center (KELC)Benefit Verification SpecialistChardon, OhioFull timeVerifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program specific SOPs. Team player that develops strong collaborative working relationships with internal partners and can effectively engage and ability to build consensus among cross-functional teams.
NewMedical Billing Specialist - Westlake Achievement Centers for ChildrenMedical Billing Specialist - WestlakeWestlake, OHThis role is ideal for someone who enjoys detail-oriented work, understands healthcare billing processes, and can balance professionalism with empathy when addressing billing questions. Achievement Centers for Children is a Cleveland, Ohio based nonprofit that is nationally recognized for helping children with disabilities and their families achieve and thrive.
HR Benefits and Leave Management Specialist Quadax Careers & CultureHR Benefits and Leave Management SpecialistMiddleburg Heights, OhioThis role supports employees by providing guidance on benefit eligibility, enrollment, claims, and leave processes, ensuring compliance with applicable laws and internal policies. Purpose: The HR Benefits & Leave Management Specialist is responsible for administering the company’s benefit plans and managing all employee leaves of absence.
Litigation Specialist First Chicago Insurance CompanyLitigation SpecialistCleveland, OHConduct prompt investigations by securing statements from the involved parties/witnesses and obtaining all necessary documents, including but not limited to, police reports, medical specials, photographs, and/or appraisals. We realize the strength of teamwork and its ability to join individuals together and push and pull each other, with a synergy that can only be found in groups of good people sharing ideas.
Billing Specialist- Insurance payment poster Midwest Vision PartnersBilling Specialist- Insurance payment posterBrecksville, OHFull timeAs a Billing Specialist- Insurance Payment Poster , you will be responsible for overseeing the billing process for customers, patients, and Midwest Vision Partners platforms. This role performs a variety of accounting, customer service, and organizational tasks to support the overall financial health of the organization.
Medical Coding Specialist Ensemble Health PartnersMedical Coding SpecialistOHRemote$20.45–$24.70 / hourRemain abreast of current requirements of the Centers for Medicare & Medicaid Services, (CMS) to include National Coverage Determinations, (NCD) and Local Coverage Determinations, (LCD) guidelines, related to the assignment of modifiers, to ensure the submission of a clean claim the first time through. We are seeking candidates with experience in multiple pro-fee specialties: Hem/Onc, Interventional Radiology, CVTS, Ortho, Podiatry, Wound Care, Rad/ONC, General Surgery, Allergy and ENT, OBGYN, Radiology and Urology.
Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare IncSpecialist, Appeals & Grievances (Must live in TX and Medicaid experience)Cleveland, OHli>Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.
Product Development Specialist Philadelphia Insurance CompaniesProduct Development SpecialistBeachwood, OH$76,700–$85,700 / yearYou'll develop new products and strengthen existing offerings by drafting and updating coverage forms, endorsements, and rate/rule pages - making sure our products are clear, competitive, and compliant. Superior interpersonal, communication, and time management skills and ability to develop and foster relationships with key internal and external stakeholders and contribute in a dynamic, fast-paced environment and effectively deliver on multiple priority matters.
Insurance Specialist - Prior Authorization (Remote) - Eastern Time zone MeduitInsurance Specialist - Prior Authorization (Remote) - Eastern Time zoneOhioRemoteboth in-person and by telephone to register patients, gather or update information, obtain referrals and pre-authorizations, complete appropriate forms, conduct evaluations, determine benefits and eligibility (insurance, public programs, etc.), determine financial responsibility and/or to identify sources of payment for servicesâ¯. You will utilize your expertise in patient billing, claims submission, and payer guidelines (Medicare, Medicaid, &, commercial insurers) to effectively work with insurance companies, resolve issues, and ensure accurate and timely payments.
Senior Quality Specialist CVS Health CorpSenior Quality SpecialistWork At Home-Ohio, OH$18.50–$38.82 / hourActs as an advocate and subject matter expert guiding the business by serving as a quality champion through measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service that impact customer satisfaction, medical cost management, and operational efficiency. Acts as a subject matter expert on Quality Specialist workflows, policies, systems requirements, and enhancements as well as daily operations and programs to consistently drive optimal results.
Workers Compensation Specialist The Goodyear Tire & Rubber CoWorkers Compensation SpecialistAkron, OHProtects the organization from audit and regulatory risk through ownership of SOX compliance, coordination with internal and external auditors, and completion of critical filings such as self-insured renewals, letters of credit, and bonds. Ensures financial accuracy and compliance by serving as the single point of contact for Supplemental Workers' Compensation (SWC), overseeing timely payments, accurate accounting, and adherence to self-insurance and state regulatory requirements.
NewSr. Total Rewards Specialist (Benefits Focus) Transtar IndustriesSr. Total Rewards Specialist (Benefits Focus)Bedford, OHHigh level of proficiency in Microsoft Office products, especially Excel Efficiently perform commonly used formulas (e.g., vlookup, IF statements, True/False, TRIM, SUM,) as well as Pivot Tables, charts, drop down lists, etc. Proactively identify and drive benefits cost-savings and cost-management opportunities, partnering with brokers and carriers to optimize plan design, contain spend, and maximize the value delivered to team members and the business.
Coding Denial Specialist Akron Children's HospitalCoding Denial SpecialistAkron, OHWorking closely alongside the Physician Advisor, the Denial Coding Specialist liaises between the Revenue Recovery team and providers, resolving queries for missing documentation and promoting departmental awareness of coding best practices. Summary: The Denial Coding Specialist supports the Revenue Recovery team by reviewing claims for coding accuracy and root causes for coding-related denials, as well as proposing process improvements to mitigate future denials.
SNF/LTC - Commercial Billing Specialist RichterSNF/LTC - Commercial Billing SpecialistTwinsburg, OHFull timeCompletes billing and collection efforts for all assigned payer types, including but not limited to generating clean claims, document billing, and collection activity, performing account analysis and problem-solving, and denials management. Identifies and escalates issues regarding tracking worksheets, at-risk accounts, incorrect database errors, communication, and payers to direct supervisor.
Billing Specialist- Insurance payment poster Midwest Vision Partners LLCBilling Specialist- Insurance payment posterBrecksville, OHAs a Billing Specialist- Insurance Payment Poster , you will be responsible for overseeing the billing process for customers, patients, and Midwest Vision Partners platforms. This role performs a variety of accounting, customer service, and organizational tasks to support the overall financial health of the organization.
Billing Specialist 838031 StiversBilling Specialist 838031Mayfield Heights, OHAs a Medical Billing Specialist, youll be responsible for managing insurance verification, submitting claims, following up on unpaid accounts, and handling denial appeals. If you're ready to start a rewarding career as a Medical Billing Specialist in Mayfield Heights, apply today or contact our recruiting team to learn more.
Senior Physician Billing Specialist Ensemble Health PartnersSenior Physician Billing SpecialistOHRemote$18.65–$20.50 / hourCompensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups.
Senior Billing Specialist Ensemble Health PartnersSenior Billing SpecialistOHRemote$18.65–$20.50 / hourCompensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups.
Pharmacy Benefits Specialist III SummaCare IncPharmacy Benefits Specialist IIIAkron, OH$25.54–$38.32 / hourSupports new benefit design, benefit build, testing, and implementation of market competitive, cost effective, quality-based drug benefits which meet applicable federal and state regulatory requirements. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2026 by the Centers for Medicare and Medicaid Services (CMS).
Pharmacy Benefits Specialist II - Medicare SummaCare IncPharmacy Benefits Specialist II - MedicareAkron, OH$21.11–$31.66 / hourp>Basic Life and Accidental Death & Dismemberment (AD&D) Supplemental Life and AD&D Dependent Life Insurance Short-Term and Long-Term Disability Accident Insurance, Hospital Indemnity, and Critical Illness Retirement Savings Plan Flexible Spending Accounts - Healthcare and Dependent Care Employee Assistance Program (EAP) Identity Theft Protection Pet Insurance Education Assistance Daily Pay. SummaCare is a part of Summa Health, an integrated healthcare delivery system that includes Summa Health System hospitals, its community-based health centers, dedicated clinicians and SummaCare.
Appeals and Grievances Clinical Specialist HealthfirstAppeals and Grievances Clinical SpecialistOH$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. Prepare cases for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case.
Senior Acquisition Specialist (Remote) GCC Technologies LLCSenior Acquisition Specialist (Remote)Cleveland, OHRemoteLeasing and Specialized experience requirements: Be familiar with Real Property Leasing, utilities contracts, sharing of space and other non-medical agreements (selling/sharing agreements, revokable licenses, interagency agreements), and hotel services for Veterans using procedures outlined in the FAR, VAAR, General Services Acquisition Manual (GSAM), General Services Acquisition Regulation (GSAR), public laws, and agency policy. Unless otherwise approved by the VA any SCS (who meets the 5 years' general experience requirement) who will be specializing in construction/AE requirements must also have the following experience: (1) 3 years of experience in developing AE solicitations and administrating AE contracts and modifications; (2) 3 years of experience developing construction solicitations and administering construction contracts and modifications.
HR Benefits and Leave Management Specialist Quadax, Inc.HR Benefits and Leave Management SpecialistMiddleburg Heights, OH$70,000–$80,000 / yearPart timep>Purpose: The HR Benefits & Leave Management Specialist is responsible for administering the company’s benefit plans and managing all employee leaves of absence. This role supports employees by providing guidance on benefit eligibility, enrollment, claims, and leave processes, ensuring compliance with applicable laws and internal policies.
NewInsurance Authorization and Reimbursement Support Specialist Saber Healthcare GroupInsurance Authorization and Reimbursement Support SpecialistBeachwood, OH$22–$26 / hourp>Position Summary: This job is a split position which assists the Rehab Services Insurance Authorization Coordinator with verifying treatment and referral authorization requests, member plan eligibility, research requests, handling complex provider inquiries, and providing analysis of denial of claims. Various discount programs offered, including discounted childcare programs through KinderCare .
Safety Specialist Towne Park LtdSafety SpecialistCleveland, OH$70,000–$80,000 / yearli>Supports and tracks district lot audit programs to ensure operational compliance and safe vehicle handling practices, including verification that vehicles are parked correctly, secured appropriately, and keys are handled according to company procedures. Coordinates new hire safety onboarding and field training in partnership with operations and training leaders by assigning, monitoring, documenting, and validating all required training activities prior to associates working independently.
NewLogistics Specialist FormerraLogistics SpecialistCleveland, OhioFormerra leads in the market with the following key capabilities: Problem-solving mindset, based on ingenuity and backed by a skilled and experienced commercial team that brings differentiated insights across markets including healthcare, consumer, industrial and mobility. The Logistics Specialist will be responsible for tracking performance of KPI metrics versus targeted service levels, reporting on any gaps to plan, and highlighting opportunities for improvement.
HEALTH SYSTEM SPECIALIST United States ArmyHEALTH SYSTEM SPECIALISTCleveland, OH$69,373–$90,190 / yearli>If you are a male applicant who was born after 12/31/1959 and are required to register under the Military Selective Service Act, the Defense Authorization Act of 1986 requires that you be registered or you are not eligible for appointment in this agency (https://www.sss.gov/RegVer/wfRegistration.aspx). Knowledge of the mission, organization, programs, and requirements of AGR Medical Department (AMEDD) to provide guidance and assistance on a variety of health care policies/programs, such as military treatment facility, admission policies and facility resources/programs, medical evaluation/physical profile board procedures, alcohol and drug rehabilitation policies/programs, line of duty investigation procedures, TRICARE, etc.
Patient Registration Specialist - Hybrid Cleveland Option Care Health IncPatient Registration Specialist - Hybrid ClevelandCleveland, OH$17.02–$28.38 / hourJob Description Summary: The Specialist, Patient Registration is responsible for facilitating new patient's transition to Option Care Health services with the goal of delivering a consistent onboarding experience where patients and referral partners feel Option Care Health makes it easy to transition care. Secures patient's upfront payment including assisting patients to find avenues for payment where needed (identifies opportunities and directs patient to financial assistance program).
Estate Specialist Weltman Weinberg & Reis Co LPAEstate SpecialistOH$18.29–$22.04 / hourResponsibilities/Duties/Functions/Tasks: Mails letters to consumers' representatives to notify and encourage payment of outstanding balances. Under general supervision, the Estate Specialist attempts to locate consumers' representatives, and/or consumers assets.
Hybrid Intake Specialist (Berea, OH or Fairlawn, OH) OhioGuidestoneHybrid Intake Specialist (Berea, OH or Fairlawn, OH)Fairlawn, OH1+ years' experience working with children, youth and families in a healthcare setting performing similar responsibilities preferred. Effective interpersonal skills; able to interact professionally and courteously with clients, agency personnel, vendors, authorities and other organizations.
Quality Specialist - Medicare D Quality CVS Health CorpQuality Specialist - Medicare D QualityWork At Home, OH$18.50–$42.35 / hourOur teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Quality Specialist- Medicare D Quality role administers the quality management system to manage the review of clinical processes, documentation, and patient records.
Collections Specialist- Evernorth- Remote The Cigna GroupCollections Specialist- Evernorth- RemoteOHRemote$17.75–$26 / hourThese states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
Warranty Pre-Authorization Specialist (Remote - Michigan) Morley Companies, IncWarranty Pre-Authorization Specialist (Remote - Michigan)OHRemoteOffer timely and accurate solutions through inbound and outbound conversations (including phone calls, chats, emails and other communications as needed) while keeping a positive and upbeat attitude. We do this by leading with humility, embracing everyone, sweating the details and moving mountains (making the impossible possible) - for our associates and for the world-leading companies that partner with us.
Customer Service Specialist Allstate Insurance Agency - Scott TatroCustomer Service SpecialistAkron, OHAllstate Insurance Agency - Scott Tatro has been serving the Akron, Ohio community for over 30 years, providing reliable insurance solutions tailored to our clients' needs. Our customers love us for our personalized service and commitment to their peace of mind, while our employees appreciate the supportive environment and opportunities for professional growth.