- Humana (St. Paul, MN)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... requires an in-depth evaluation of variable factors. **Job Profile** The Medical Director actively uses their medical background, experience, and judgement to make… more
- HCA Healthcare (Nashville, TN)
- … Claims Department and in the larger Risk & Insurance Department reporting to a Director of Claims . As the Division Claims Administrator, you will have ... that invests in you as a East Florida Division Claims Administrator? At HCA Healthcare, you come first. HCA...We are looking for a dedicated East Florida Division Claims Administrator like you to be a part of… more
- MTA (Brooklyn, NY)
- …TA/OA Department: Law Division/Unit: Torts Reports to: Assistant General Counsel / Director of Claims Work Location: 130 Livingston Street, Brooklyn Hours ... Claims Manager Job ID: 11803 Business Unit: MABSTOA...Date Posted: May 21, 2025 Description Job Information Title: Claims Manager Last Date of Posting: Open Until Filled… more
- Humana (Raleigh, NC)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- HCA Healthcare (Nashville, TN)
- …within HCA Healthcare's Risk & Insurance department reporting directly to the Managing Director of Property Claims . You will support the Insurance programs ... and vendor selection process. + Assist the VP Insurance, AVP Insurance and Manager/ Director of Property Claims with other responsibilities as needed. **What… more
- Humana (Springfield, IL)
- …education and training. The Claim Research and Resolution Professional reports to the Claims Research and Resolution Associate Director and is responsible for ... Dually Eligible (HMO D-SNP) in IL, is seeking a Claims Research & Resolution Professional claims educator, who will be responsible for carrying out Humana's… more
- CVS Health (Blue Bell, PA)
- …it all with heart, each and every day. **Position Summary:** The Lead Director of Software Engineering is responsible for leading engineering teams that support the ... modernization of legacy systems-primarily IBM Mainframe platforms-used for commercial claims routing, adjudication, and operational reporting. This role ensures the… more
- University of Miami (Miami, FL)
- …and documentation of potentially compensable events to Chief Medical Risk Officer, Director of Medical Claims and Assistant General Counsel. Conduct additional ... Risk Management has an exciting opportunity for a full-time Director , Risk Management to work on the UHealth campus....practices. + Coordinates and develops organization-wide programs to mitigate claims and losses. + Acts as the liaison to… more
- Zurich NA (Parsippany, NJ)
- …The Legal Claims Professionals will under limited supervision handle public company Director 's and Officer's (D&O) claims of moderate to high value and ... Legal Claims Professional- Public D&O 127297 Zurich is currently looking for multiple Legal Claims Professionals to join our growing Management Solutions team to… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... 011250 CCA- Claims Hiring for One Year Term **_This position...Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and… more