- IQVIA (Durham, NC)
- …execution of the RWE strategy + Construct cohorts using RWD sources (eg, claims , EHR) and evaluate key variables, including diagnosis and procedures codes, and plan ... with secondary data analysis, including electronic medical record and/or medical claims databases + **Specifically, experience working with commercially available US… more
- Kemper (San Diego, CA)
- …and state requirements. + Works directly with strategic partners like Product, Claims , and Operations on issues impacting the account. + Performs other duties ... sales/marketing management experience + Extensive knowledge of insurance operations: claims , coverages, products and underwriting is preferable to effectively… more
- Truist (Greensboro, NC)
- …guidelines. 2. Independently analyze, research, and support electronic payment cases/ claims /inquiries escalated by internal departments and client service centers to ... resolution. Claims /inquiries related to Regulation E are met in accordance with the CFPB (Consumer Finance Protection Board). 3. Adhere to department standards… more
- CRC Insurance Services, Inc. (Phoenix, AZ)
- …(RFP) activities. Collaborate with internal teams, including sales, underwriting, and claims team to develop renewal strategies and ensure client retention. Serve ... recommendations. + Collaborate with internal teams, including sales, underwriting, and claims teams, to develop renewal strategies and ensure client retention. +… more
- CareFirst (Baltimore, MD)
- …integration, configuration, and performance of core payer functions like enrollment, claims , billing, and customer service. Focuses on building robust custom ... PL/SQL, Angular. + Experience working with core Facets modules such as claims , membership, provider, and billing. + Proficiency with Facets batch jobs, schedules,… more
- UCLA Health (Los Angeles, CA)
- …Compensation Analyst and department manager, you will manage workers' compensation claims by supporting employees who have experienced work-related injuries or ... treatment progress, recommending medical treatment interventions to the third-party claims examiner, and ensuring compliance with applicable workers' compensation… more
- Publix (Lakeland, FL)
- …and refine internal litigation processes and policies for attorney-represented and litigated claims . + Provide strategic legal counsel to senior leadership and ... Business, Finance, or related field. + 5-7 years of experience managing tort claims in a corporate legal or insurance setting. + In-house experience-preferably in a… more
- CVS Health (Columbus, OH)
- …care, and end of life. + 2+ years experienced working with clinical and claims data + Ability to manage multiple customers and competing priorities that drive ... positive outcomes + Experience in the following: + 5+ years experience introducing and implementing programs + Outstanding verbal and written communication skills, including formal presentations for all levels of management combined with strong… more
- CVS Health (Austin, TX)
- …Qualifications** + Healthcare Insurance and PBM knowledge including Prior Authorizations, Claims , Rebates, Network contracting, Sales, Call Center Ops and Pharmacy ... Ops + Business process design and development experience using SSMS (Sql Server Management Studio) Agent + SQL job monitoring, troubleshooting and issue resolution with the potential of off hour support + SQL programming, MS PowerShell, Open Query integration… more
- World Insurance Associates, LLC. (Seattle, WA)
- …collaborating with the team to resolve issues (eligibility, carrier coverage and claims issues, compliance; health care reform, HIPAA). + Lead the delivery of ... enrollment, benchmarking, financial and utilization data based on financial review standards and make recommendations as appropriate. + Support the renewal process, including marketing activities, underwriting and renewal development, and negotiating on behalf… more