- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …healthcare? Bring your true colors to blue. Reporting to the Director of Professional Reimbursement Strategy, the Payment Integrity Consultant uses industry ... drug fee schedules, including assessing and pricing new codes + Analyze claims data in conjunction with provider reimbursement methodologies and external benchmarks… more
- Commonwealth Care Alliance (Boston, MA)
- …satisfaction and member access to care. Reporting to the Senior , Director of Delegation Partnerships., the Senior Provider Relations Account Manager will: + ... + **Operational Excellence:** + Collaborate with cross-functional teams (eg, Claims , Credentialing, Clinical Care Management, Member Services, Provider Services,… more
- Zurich NA (Lansing, MI)
- …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, Underwriting… more
- Access Dubuque (Dubuque, IA)
- …to our clients, including resource consulting, safety and loss control management, claims management, and more. At Kunkel, we take pride in exceeding customer ... Prepare renewal proposals and client service materials + Gain exposure to claims , marketing applications, and carrier communications + Contribute to special projects… more
- US Tech Solutions (Columbia, SC)
- …provides health management program interventions. + Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to ... determinations. Identifies and makes referrals to appropriate staff (Medical Director , Case Manager, Preventive Services, Subrogation, Quality of care Referrals,… more
- Lockheed Martin (Bethesda, MD)
- …pathways\. This position will report to the recently established position of Director of Labor and Employment Litigation, Enterprise Operations\. We are seeking an ... paralegals\. The substance of cases will vary from individual labor and employment claims , to class actions, across the full range of labor employment issues, such… more
- Humana (Oklahoma City, OK)
- …investigations into allegations of fraud, waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As the Senior Fraud ... Medicaid program transparency and accountability. You will report to the SIU Director and work closely with Humana's Oklahoma Market. **Key Role Functions** +… more
- BD (Becton, Dickinson and Company) (Sandy, UT)
- …personas, insights, brand positioning statements, benefit ladders, and differentiated claims , to support launches, drive adoption, and accelerate growth across ... and lifecycle management + Lead development and validation of differentiated product claims in collaboration with legal, regulatory, and medical teams to ensure… more
- Veterans Affairs, Veterans Health Administration (Palo Alto, CA)
- …for the evaluation of Veterans and Service Members who have filed VA Disability claims . The incumbent will be located at VA Palo Alto Health Care System (VAPAHCS). ... Clinical: Evaluates Veterans and Service Members who have filed VA Disability claims with the Veterans Benefits Administration (VBA) and/or Service Members being… more
- Transdev (Lombard, IL)
- …staff position within North American headquarters responsible to support FP&A Manager and Director of Accounting on a variety key projects. We offer a competitive ... support for key internal topic of insurance and insured claims estimates + Work with actuary and risk department...to support valuation of significant estimates related to insured claims + Create and maintain pricing model related to… more