• Pharmacy Claims Auditor CPhT

    Conduent (Dallas, TX)
    … Auditor CPhT** **Do you have a CPhT certification?** **Would you like to audit pharmacy claims for accuracy?** **About the Role** Conduent Payment Integrity ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety...and pharmacy practices. + Responding to pharmacy calls regarding audit results and dealing with clients periodically to report… more
    Conduent (05/31/25)
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  • Manager, Claims Operations & Research

    Molina Healthcare (Sterling Heights, MI)
    **JOB DESCRIPTION** **Job Summary** Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage ... amount and benefit interpretation. Monitors and controls backlog and workflow of claims \. Oversees analysis of complex claim inquiries and reimbursement issues using… more
    Molina Healthcare (06/07/25)
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  • Liability Claims Representative PD

    Old Dominion Freight Line (Thomasville, NC)
    …pay as needed + Review financial information and determining settlement of downtime claims + Audit and process independent adjuster invoices + Write settlement, ... keep OD the premier transportation solutions provider. Effectively handle property damage claims due to OD vehicle accidents and incidents. Perform other duties… more
    Old Dominion Freight Line (05/29/25)
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  • Claims Implementation Analyst

    Healthfirst (NY)
    …and results verification before sign-off and Production. + Assist in the on-going audit of configurations for new and existing claims business rules within ... terms, prepare fee schedules and accurately document file changes into the claims processing system + Research and identify published updates to payment… more
    Healthfirst (05/29/25)
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  • Senior Employment Claims Manager

    Marriott (Bethesda, MD)
    …Investigations, Legal and Internal Audit , in the resolution of EPLI and Fidelity claims . + Advise the Director of Specialty Claims of any high exposure ... Remotely?** N **Position Type** Management **JOB SUMMARY** The Senior Manager, Specialty Claims is primarily responsible for overseeing and managing claims more
    Marriott (03/27/25)
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  • Workers Compensation Claims Team Lead | New…

    Sedgwick (Rochester, NY)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Team Lead | New York Jurisdiction Job Description We are seeking a… more
    Sedgwick (06/06/25)
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  • Claims Team Lead - Workers Compensation

    Sedgwick (Ontario, CA)
    …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead - Workers Compensation **PRIMARY PURPOSE:** To supervise the operation… more
    Sedgwick (06/06/25)
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  • Complex Claims Director, Severity

    AIG (Atlanta, GA)
    …point for colleagues . + You will also contribute to continuous improvement in Claims by supporting Quality Assurance / Regional Audit processes , ensuring ... Join us as a Senior Claims Adjuster to take on key responsibilities within...spent at work to offer benefits focused on your health , wellbeing and financial security-as well as your professional… more
    AIG (05/30/25)
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  • Medical Claims Examiner

    International Medical Group (Indianapolis, IN)
    …for employment visa status (eg, H-1B or TN status) for this position. JOB SUMMARY Claims Examiners provide a service to our policyholders by reviewing claims to ... the need for further investigations. Examiners resolve medical/dental/life/trip cancellation claims ; documenting actions; maintaining their imaging queues; maintaining quality… more
    International Medical Group (05/23/25)
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  • Card Fraud Claims Analyst Sr

    UMB Bank (Kansas City, MO)
    …appropriate timing, proper resolution, and weekly reporting. Assisting with ongoing monthly audit and reporting of vendor claims processing to ensure compliance ... hybrid or remote working schedule The Sr Card Fraud Claims Analyst will be a member of the UMB...plan including medical, dental, vision, and other insurance coverage; health savings, flexible spending, and dependent care accounts; adoption… more
    UMB Bank (05/13/25)
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