- Lundbeck (Deerfield, IL)
- …Do you want to join a team where the mission is meaningful, the challenges are complex , and you can directly see the results of your hard work? Lundbeck is a global ... United States** **Summary:** The Manager, Field Compliance will support the Director , Field Compliance and Investigations with driving and implementing all elements… more
- MyFlorida (Tallahassee, FL)
- …will be given to candidates with at least two years of experience in complex litigation, including but not limited to the prosecution or defense of cases involving ... investigates and enforces cases under state and federal antitrust laws, Florida False Claims Act, Florida securities law, Civil Racketeering and as needed civil … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address ... and refers potential quality of care and utilization issues to Medical Director . + Utilizes appropriate communication techniques with members and providers to obtain… more
- New York State Civil Service (Albany, NY)
- …Code 12210 Duties Description The Public Health Physician 3 will function as the Director of the Division of Medical and Dental Director , reporting directly to ... including Medical Directors, Dental Directors, and program staff; Overseeing medical director reviews of prior approval requests and denials related to durable… more
- CHS Inc. (Inver Grove Heights, MN)
- …risk management, or risk financing roles including: + Experience with complex global insurance programs, broker/carrier management, and claims oversight ... Heights, MN._ **Responsibilities** Strategic Program Management + Support the Senior Director in developing and executing CHS's global insurance and risk financing… more
- Otsuka America Pharmaceutical Inc. (Montpelier, VT)
- …Contracts and Management Lead who reports into the Executive Director , Medical Excellence and Operations. **Job Description** **Key Responsibilities Include:** ... and Competencies:** + Exceptional ability to draft and review complex contracts, with high attention to detail + Strong...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Port Authority of New York and New Jersey (New York, NY)
- …Department is seeking a motivated and detail-oriented intern to support the Director 's Office and the Risk Financing Division. This internship offers a professional ... and change-management initiatives, Certificates of Insurance review, data analysis, claims support, and risk-transfer activities. This role provides meaningful… more
- City of New York (New York, NY)
- …The Bureau of Engineering (BOE) investigates construction and construction related disputes and claims for and against the City of New York, and in collaboration ... of its oversight of City Agencies. Reporting to a Director , the Managing Engineers will be responsible for the...responsible for the investigation and analysis of construction contract claims and disputes and for the oversight of the… more
- Zurich NA (Queens County, NY)
- …Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... including an Associate Degree and 8 or more years of experience in the Claims or Underwriting Support areaAND + Experience with Microsoft Office OR AVP, Middle… more
- Addiction Recovery Care (Lexington, KY)
- …supervision the Denials Resolution Specialist is responsible for resolving outstanding claims with government and commercial health insurance payers submitted on ... Key Responsibilities + Conducts root cause analysis of all assigned insurance payer claims and denials to determine appropriate actions required to resolve the claim… more