- GuideOne Insurance (West Des Moines, IA)
- …you will be responsible for the full adjustment of first party commercial lines claims . In this role, you will be primarily accountable for overseeing large loss ... claims within the non-profit, church, education centers and niche...damages, making coverage recommendations and total value determinations, negotiating claim settlements and analyzing all necessary investigative documentation. +… more
- Idaho Division of Human Resources (Boise, ID)
- …employees must apply through their internal Luma account. Summary: The Benefits Administration Senior Claims Data Specialist (TRS2) will work in the Claims ... will become an expert in Electronic Data Interchange (EDI) Claims , capable of assisting claim reporters in proper filing, report sequencing, and editing of… more
- Festival Foods (WI)
- …tasks and plans to meet department objectives. Provides direct leadership to the Senior Claims Specialist and Workplace Safety Specialist. Prepares and delivers ... our culture of safety and care across our organization. Reporting to the Senior Director of Asset Protection, you'll lead strategic initiatives that protect both… more
- GE HealthCare (Memphis, TN)
- …Negotiate terms and conditions and transmit information to Procurement. Manage claims . Includes commercial sourcing management such as data analysis, negotiations ... support, etc. This may also include purchasing activities. + Developing specialized depth and/or breadth of expertise in own job discipline or field. Serves as best practice/quality resource. Has awareness of latest functional developments in own area.… more
- Pfizer (New York, NY)
- …care gaps analyses, including strategic planning, identifying data input required (eg, claims data for unmet need analysis), and effective visualization / insight ... generation for users. + Plan, generate and perform asset-specific care gap analyses to guide Medical Affairs activities using advanced techniques such as predictive models, machine learning, probabilistic causal models, and unsupervised algorithms. + Create… more
- CVS Health (Frankfort, KY)
- …a liaison to internal colleagues to interpret contracts, drive cost savings, resolve claims and other service issues. **Required Qualifications** + A minimum of 3 ... years work experience in a provider contracting or provider relations role, Medicaid and/or behavioral health experience preferred. + Proven working knowledge of physician reimbursement methodologies and contracting strategies. + Strong communication, critical… more
- REI (Seattle, WA)
- …labor activities, ERGs, and other related topics. + Manage employment-related claims and demands, including investigating, responding, and resolving demand letters ... and agency complaints and audits (eg, EEOC, DFEH, DOL, OFCCP, DLSE, etc.). + Manage employment litigation with outside counsel. + Advise on REI's compliance with applicable federal, state, and local labor and employment laws (eg, Title VII, ADA, ADEA, NLRA,… more
- BD (Becton, Dickinson and Company) (Durham, NC)
- …enterprise-wide medical policies and procedures, and ensures medical and clinical claims accuracy. Includes: serving as the Medical Affairs clinical delegate, ... attending Risk Management Board (RMB) meetings for the assigned product line; provide clinical input for RMB risk assessments: designation of hazardous situation severity; description of clinical workflow and assessment of situation and outcome probability;… more
- Marathon Petroleum Corporation (Findlay, OH)
- …development of commercial resolutions impacting supply trading desk (eg, disputes, claims , etc.) + Supports communications and position management with the Martinez ... Renewables JV. + Develops expertise around feedstock logistics. Lead justification for proposed logistics solutions working with scheduling for execution. Education and Experience + Bachelor's Degree required. + Five (5) or more years of experience in Trading… more
- Stryker (Portage, MI)
- …trials, research grants, and cost-benefit analysis papers to support clinical claims strategy **Minimum Qualifications (Required):** + Bachelor's degree required + ... 10+ years of work experience required + Medical device or marketing experience **Preferred Qualifications (Strongly desired):** + MBA preferred + 2+ years of people management experience preferred Health benefits include: Medical and prescription drug… more
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