- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more
- Highmark Health (Blue Bell, PA)
- …management, peers and other areas within the organization. Work with external PPOs and claims staff to resolve PPO repricing issues. (40%) + Perform other duties as ... **Education/Experience/Skills Requirements** **Required Education:** HS/GED **Required Experience:** Knowledge of claims terminology is preferred. **Required Knowledge/Skills:** 1. Knowledge of… more
- Insight Global (Robinson, PA)
- …hire a Pharmacy Benefits Specialist. This role will include processing pharmacy claims , triaging rejected claims , and verifying benefits. Prior Pharmacy benefits ... Skills and Requirements 1+ year of Pharmacy Benefits experience - processing claims , triaging denials, verifying benefits 1+ year of Insurance experience Ability to… more
- Applied Technical Services, Inc. (Metairie, LA)
- …insurance industry to provide technical experts to assist with resolving insurance claims . From the time we receive assignments until the final invoice, Forte's ... organized to manage all the client requirements and the volume of appraisal claims we receive daily. Key Responsibilities: + Project Management: Enter and verify new… more
- State of Colorado (CO)
- …while ensuring requirements trace ability for quality results for large scale medical claims processing systems or medical information systems. + Working in a large ... claims processing system, including State Medicaid and/or Pharmacy benefits...improvement in a professional setting for a large data, claims and integration system. 09 List any additional relevant… more
- Zurich NA (Schaumburg, IL)
- …of assumed reinsurance transactions and partnering across finance, actuarial, underwriting, claims and global reinsurance teams. This position is based in ... basic reinsurance contracts, identifies, and codes reinsurance, handles reinsurance claims of low complexity, performs basic to intermediate reinsurance accounting… more
- Justice, Bureau of Prisons/Federal Prison System (Florence, CO)
- …performs similar functions. Evaluates and prepares proposed disposition letters for more complex claims submitted under the Federal Tort Claims Act, the Civilian ... Employee's Claims Act, and Section 3722 of Title 31, United States Code. Research and analyze legal issues involved, conduct a supplemental investigation if the initial investigation of the claim so warrants. Prepares difficult interrogatory responses,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …data-driven solutions. This position requires expertise in healthcare data-including claims , membership, and provider information-along with hands-on experience in ... reports. * Experience with managed care and health care claims * Experience creating and maintaining reporting in Power...degree. * Knowledge of managed care and health care claims preferred. Compensation and Benefits: Pay Range: $88,600.00 -… more
- Samsung SDS America (Cerritos, CA)
- …and customs. You'll draft, negotiate, and review complex commercial contracts; resolve claims ; and ensure compliance with evolving regulations to mitigate risks and ... compliance and best practices across the organization Risk Management & Claims Resolution + Identify potential risks, recommend mitigation strategies, and provide… more
- MetLife (Oriskany, NY)
- …complaint outcomes. Collaboration * Collaborate with internal partner areas such as Claims Operations, Legal, Compliance, Network Development, and SIU. * Refer cases ... time service standards and regulatory requirements. Required Qualifications: * Knowledge of claims process * High School Diploma or equivalent. * Strong verbal and… more