• CASE Analyst

    MVP Health Care (Schenectady, NY)
    …our Talent team at ###@mvphealthcare.com . **Job Details** **Job Family** ** Claims / Operations ** **Pay Type** **Salary** **Hiring Min Rate** **54,200 USD** ... to work full-time, virtual in Schenectady or Rochester + 2+ years claims processing or system configuration experience required + FACETS experience required +… more
    MVP Health Care (09/29/25)
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  • Claim Field Analyst (Tampa/Orlando, Florida)

    CVS Health (Tallahassee, FL)
    …and payments. The **Claim Field Analyst** works with the grievance and appeal and claims operations department to trend provider claim issues or concerns that ... assist in creating bulletins, newsletters, and claim trainings to improve provider claims issues. as well as billing practices, while collaborating with internal… more
    CVS Health (09/24/25)
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  • Business Change Director- Payment Integrity

    Elevance Health (Atlanta, GA)
    …that support business needs, including those unique to payment integrity and claims operations . + Designs methods for integrating functions and processes, ... and scope data, with a focus on payment accuracy, claims validation, and audit readiness. + Leads efforts to...especially where claims adjudication, provider billing, and fraud/waste/abuse prevention intersect. +… more
    Elevance Health (09/19/25)
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  • Senior Investigator / Human Servies Program…

    State of Minnesota (St. Paul, MN)
    …through the Medicaid claims processing system. + An understanding of claims processing operations , claims forms, edits, and coding structures ... to understand the procedures followed and decisions made by claims processing staff. + Ability to adapt to changes...staff. + Ability to adapt to changes in priorities, operations practices, policies, procedures, laws, rules, and coding systems… more
    State of Minnesota (09/18/25)
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  • Actuary & AVP - Retail and Canada Property Pricing

    AIG (Chicago, IL)
    …for AIG's major insurance operating companies, globally. We collaborate with Finance, Claims , Operations , Marketing and Risk Management, among other functions. ... portfolio risk, and reserving actuaries in assessing the impact of loss trends and claims emergence. + Responsible for the success of the Retail and Canada Property… more
    AIG (09/11/25)
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  • Program Manager

    AIG (Philadelphia, PA)
    …will gain knowledge and have the opportunity to lead in other functional areas like operations , compliance, claims , etc. What you need to know: + Developing and ... UQR Audits and Stewardship meetings.. + Collaborating with Actuarial, Accounting, Claims , Operations , Program Development, Risk Management and Underwriting as… more
    AIG (09/02/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Columbia, SC)
    …They will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and other business teams involved in the ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
    Humana (09/09/25)
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  • Head Pricing Actuary - Management Liability

    AIG (Chicago, IL)
    …for AIG's major insurance operating companies, globally. We collaborate with Finance, Claims , Operations , Marketing and Risk Management, among other functions. ... trusted business partner, working closely with the underwriting and claims departments to ensure profitable performance and growth. +...an exciting time to join us - across our operations , we are thinking in new and innovative ways… more
    AIG (08/23/25)
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  • Provider Network Account Executive II

    AmeriHealth Caritas (Baton Rouge, LA)
    …channels with internal stakeholders, including but not limited to Claims Operations , Medical Management, Credentialing, Legal, Analytics departments, ... delivering timely reports, and fostering strong internal partnerships to support network operations . **Work Arrangement:** + Remote - Associate must be located in… more
    AmeriHealth Caritas (08/16/25)
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  • Application Development Project Manager/Lead

    Robert Half Technology (Burlington, VT)
    …enterprise application and data-focused projects. + Strong understanding of insurance operations , claims processing, and data warehousing. + Experience with ... instrumental in driving projects that enhance our data warehouse, modernize claims management systems, and optimize enterprise applications to support business… more
    Robert Half Technology (09/27/25)
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