- BeOne Medicines (Emeryville, CA)
- …using large-scale healthcare data sources (eg, electronic health records, claims , registries). This role will collaborate with cross-functional teams, including ... and RWE studies derived from diverse real-world data sources, including claims , electronic health records (EHRs) and registry data. + Conduct exploratory… more
- Highmark Health (Providence, RI)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... and industry regulatory changes and assess their potential impact on Claims Operations, Customer Service and other operational areas processes and collaborate… more
- Molina Healthcare (Iowa City, IA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …areas, its products, and general functions. + Assists with the monitoring of claims . + Supports colleagues with gathering the data collection and analysis associated ... Standard Office skills. . Fundamental concepts of insurance policy renewals and claims handling. + Insurance industry and terminology. . Fundamental concepts of… more
- CVS Health (MN)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- AbbVie (Mettawa, IL)
- …analytical methods, and technical programming skills to analyze clinical, survey, claims , and electronic medical record databases. Role supports the department as ... (SAS, SQL, R, Python) required and experience in observational study analysis ( claims , survey, clinical and EMR analysis) required. Candidates with Python and… more
- Molina Healthcare (GA)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER,… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …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
- Otsuka America Pharmaceutical Inc. (Atlanta, GA)
- …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
- The Hartford (Chicago, IL)
- …shareholders that we will lead the insurance industry in AI. The AI Accelerator - Claims & Operations is at the heart of that commitment, serving as the company's ... Our current focus is developing agentic AI workflows to automate and transform claims processing, while also advancing other strategic AI projects across Claims … more