• Payment Integrity Clinician

    Highmark Health (Richmond, VA)
    …SUMMARY** This job requires the ability to identify issues related to professional and facility provider claims data including determining appropriateness of ... of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review of medical documentation,… more
    Highmark Health (11/14/25)
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  • Senior Payment Integrity Professional

    Humana (Richmond, VA)
    …caring community and help us put health first** The Senior Payment Integrity Professional uses technology and data mining, detects anomalies in data to identify and ... collect overpayment of claims . Contributes to the investigations of fraud waste and...waste and our financial recovery. The Senior Payment Integrity Professional work assignments involve moderately complex to complex issues… more
    Humana (11/15/25)
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  • Sr. Provider Reimbursement Professional…

    Humana (Richmond, VA)
    …and help us put health first** The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and ... an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where… more
    Humana (11/21/25)
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  • Pharmacy Contracting Professional 2

    Humana (Richmond, VA)
    …caring community and help us put health first** The Pharmacy Contracting Professional 2 ensures contract compliance and performs analysis regarding pharmacy ... claims . Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding… more
    Humana (11/21/25)
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  • Qualified Intellectual Disabilities…

    BrightSpring Health Services (Forest, VA)
    Our Company ResCare Community Living Overview The Qualified Intellectual Disabilities Professional (QIDP) Manager oversees delivery of consumer support services for ... expenses, personnel costs, consultant services* Monitors worker's compensation and unemployment claims for assigned service site(s). Is proactive in efforts to… more
    BrightSpring Health Services (11/21/25)
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  • Senior Data and Reporting Professional

    Humana (Richmond, VA)
    …timely and accurate submission of mandated reports, leveraging their understanding of claims data and Medicaid program requirements to drive accurate and timely ... submissions. The Senior Data and Reporting Professional integrates data from multiple sources to produce requested...data into reports and dashboards + Experience working with claims data + Experience working with big and complex… more
    Humana (11/20/25)
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  • AVP- Complex Claim Specialist

    Travelers Insurance Company (Richmond, VA)
    …reserve, negotiate and resolve the company's most severe and/or complex claims , in multiple jurisdictions, in accordance with Best Practices. Provide quality ... claim handling and superior customer service on assigned claims , while engaging in indemnity & expense management. Promptly manage claims by completing essential… more
    Travelers Insurance Company (11/12/25)
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  • Producer - Financial Institutions…

    WTW (Arlington, VA)
    …phone and face to face with clients. + Champion the proper advocacy of claims . + Participate in stewardship meetings. + Support Client Management team in identifying ... + Participate and take leadership roles in targeted community and professional associations. **People Management:** + Provide annual input for the performance… more
    WTW (11/05/25)
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  • Business Insurance Underwriting…

    Travelers Insurance Company (Chantilly, VA)
    …appropriate pricing for insurance products. The Business Insurance Underwriting Professional Development Internship Program provides students with the amazing ... industry professionals. It is a potential pathway to our 12-month Underwriting Professional Development Program (UPDP). Applicants must be authorized to work for ANY… more
    Travelers Insurance Company (10/09/25)
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  • Property Adjuster Specialist - Field CAT Team

    USAA (Chesapeake, VA)
    …framework, investigate, evaluate, negotiate, and settle complex property insurance claims . You will confirm/analyze coverage, recognize liability exposure and ... technology and desk adjusting for a virtual first approach to inspections and claims handling. USAA also provides a company vehicle to physically inspect losses… more
    USAA (12/02/25)
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