• Pharmacy Clinical Review Specialist, Rx Partners

    UPMC (Bridgeville, PA)
    …dedicated team! This position provides prescription data entry and adjudication of claims under the supervision of a licensed pharmacist. This position provides ... Interface with other departments and identify medical documentation in support of prior authorization requests. + Act as a...diploma or equivalent required + 2 years of pharmacy claims , pharmacy tech, and/or other related experience in a… more
    UPMC (12/08/25)
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  • Counsel Litigation and Risk Management

    Atlantic Health System (Morristown, NJ)
    …with the ability to handle a variety of matters related to claims , policy development, and professional review activities. Responsibilities + Review professional ... liability claims and...review to ensure operational effectiveness and regulatory compliance + Support risk management team members with managing issues to… more
    Atlantic Health System (12/06/25)
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  • Associate Director, Medical Omnichannel Data…

    Otsuka America Pharmaceutical Inc. (Jefferson City, MO)
    …**Data Integration & Management** + Explore and analyze common pharmaceuticals data (eg, claims ) as well as novel data sets based on lab and EHR systems. ... and integration of omnichannel strategies. Provide technical guidance and support to cross-functional teams on data-related projects. + Stay...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
    Otsuka America Pharmaceutical Inc. (12/03/25)
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  • Leave of Absence Coordinator

    Sedgwick (Southfield, MI)
    …and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Establishes FMLA claims ; tracks and codes documentation in accordance with internal workflow ... processes. + Analyzes FMLA and other paid leave claims to determine eligibility, certification, payment calculations, payments and/or...curriculum + An assigned mentor and manager that will support and guide you on your career journey +… more
    Sedgwick (12/03/25)
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  • Medical/Cast Specialist Assistant - Ortho Cl…

    University of Southern California (Los Angeles, CA)
    …by the physician as needed. Reviews and codes charge slips, submits insurance claims . Returns patient phone calls. Performs various office and clerical duties. Must ... by the physician as needed. Reviews and codes charge slips, submits insurance claims . Returns patient phone calls. Performs various office and clerical duties. Must… more
    University of Southern California (12/03/25)
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  • Senior AS/400 (IBMi) Synon Developer

    Cognizant (Phoenix, AZ)
    …of experience to join our dynamic team. Your expertise in Medicare and Medicaid Claims will be crucial in ensuring efficient processing and management of claims . ... * Provide technical expertise in the Medicare and Medicaid Claims , Claims , and Payer domains. - Collaborate...Regardless of your working arrangement, we are here to support a healthy work-life balance though our various wellbeing… more
    Cognizant (12/02/25)
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  • Absence Leave Solutions PFML Unit Leader

    MetLife (Clarks Summit, PA)
    …goals and objectives. * Identify, remove, and challenge barriers related to claims management. Escalate to senior leaders in the organization as appropriate along ... external interactions. * Drives Claim Management Accuracy and customer experience through support of the quality program utilizing claim file reviews and call… more
    MetLife (11/28/25)
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  • Accounts Receivable Clerk

    Robert Half Accountemps (Minneapolis, MN)
    …your home. Responsibilities: * Contact insurance companies to follow up on outstanding claims and obtain payment status updates. * Utilize payer portals to gather ... * Prepare and submit appeals for denied or underpaid claims to ensure accurate reimbursement. * Maintain accurate records...technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in… more
    Robert Half Accountemps (11/26/25)
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  • Medical Assistant/Cast Specialist - PMOB Ortho…

    University of Southern California (Pasadena, CA)
    …by the physician as needed. Reviews and codes charge slips, submits insurance claims . Returns patient phone calls. Performs various office and clerical duties. Must ... by the physician as needed. Reviews and codes charge slips, submits insurance claims . Returns patient phone calls. Performs various office and clerical duties. Must… more
    University of Southern California (11/19/25)
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  • Provider Network Operations Analyst CPC

    AmeriHealth Caritas (Charleston, SC)
    …+ Requests/runs queries to identify root causes of claim denials, incorrect payments and claims that are not correctly submitted for payment. + Act as the resource ... education and experience preferred. + Required ability to focus on technical claims processing and Provider data maintenance knowledge. + Required understanding of… more
    AmeriHealth Caritas (11/19/25)
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