- UNUM (Harrisburg, PA)
- …Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The ... efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal workflow standards… more
- Evolent (Harrisburg, PA)
- …for the culture. **What You'll Be Doing:** **Senior Analyst, Healthcare Analytics Consultant ** The Client Analytics team provides a unique opportunity to collaborate ... You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population… more
- Manulife (PA)
- …further advance our underwriting expertise. We are seeking a Senior Underwriting consultant , Research & Development, with a history of making sound underwriting ... for targeted initiatives. + Analyze underwriting data through various studies and claims experience if applicable. + Prioritize project work, focusing on generating… more
- Exl Service (Scranton, PA)
- Overview Commercial Insurance Risk Control Consultant - Independent Contractor Overview EXL Risk Control is a leading provider of risk assessments and loss control ... Control + Commercial Lines Property/Casualty Underwriting + Commercial Lines Property/Casualty Claims Adjuster + Commercial insurance inspections + Fire and Life… more
- Highmark Health (Pittsburgh, PA)
- …recover identified overpayments, performing a follow-up review to ensure that the claims were adjusted correctly, resulting in expected recovery/savings. + Perform ... claims system extracts and create reports, graphs, and charts...+ Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency +… more
- Lincoln Financial (Harrisburg, PA)
- …key liaison with benefits vendors and brokers in Bermuda, overseeing renewals, claims and service delivery. * Ensure benefits programs meet statutory requirements ... while remaining competitive and cost effective. * Conduct periodic benchmarking of Bermuda Total Rewards offerings and recommend strategic adjustments to support retention and attraction. Other * Partner with external vendors and internal stakeholders to… more
- UPMC (Pittsburgh, PA)
- …provides the following services to various in-house clients. **Responsibilities:** + Consultant within UPMC Health System; Act as an Actuarial Consultant ... the financial reporting department to develop reserve amounts for IBNR claims , active claims and premium deficiency reserves on a regular or as-needed basis.… more
- UPMC (Pittsburgh, PA)
- …Risk Management, the role involves systematically managing potential and actual claims . Analyzing clinical data is crucial for identifying liability areas, with ... appropriate management and staff. Review and evaluate potential and current claims with relevant internal departments and make appropriate recommendations to Senior… more
- J&J Family of Companies (Horsham, PA)
- …brand within Janssen NA. This position will serve as an internal consultant to marketing and sales, and broader business partners: delivering business building ... **Preferred:** + Expertise in domain specific data sets for Immunology (medical claims , pharmacy claims , and sales data -- data sources such as IQVIA, SHS) +… more
- Prime Therapeutics (Harrisburg, PA)
- …meeting established financial targets. The Underwriter will serve as a consultant on matters pertaining to both financial and operational performance guarantees, ... Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing analyses of moderately complex external claims data +… more