- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …the corporate philosophy: "Otsuka-people creating new products for better health worldwide." Otsuka researches, develops, manufactures, and markets innovative ... to meet unmet medical needs and nutraceutical products for the maintenance of everyday health . As the Associate Director of Commercial Data Science, you will play a… more
- The Hartford (Hartford, CT)
- …- CG08OE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every ... and operations teams to co-design scalable, production-ready solutions. + Claims Domain Expertise: Apply a deep understanding of ...business context. This role can have a Hybrid or Remote work schedule. Candidates who live near one of… more
- PSKW LLC dba ConnectiveRx LLC (Pittsburgh, PA)
- …disability insurance . The company regularly reviews and updates its health , welfare, and fringe benefit policies to ensure competitive offerings. Employees may ... in a quality assurance or quality auditing role, preferably in a call center, claim operations, pharmacy hub, or similar environment Knowledge + Serves as a Quality… more
- Actalent (Maple Grove, MN)
- …crucial support for cardiovascular trials. Leverage your programming skills and expertise in claims and electronic health record (EHR) data to conduct insightful ... data. + Strong coding experience, particularly with SAS. + Experience working with claims databases and real-world data sources, primarily using SAS. + Ability to… more
- BrightSpring Health Services (Clarksburg, WV)
- …living, adult host homes for adults regardless of disability, behavioral/mental health support, in-home pharmacy solutions, telecare and remote support, ... and ensures staff follows agency procedures to promote optimum health care and behavior supports + Monitors and ensures...service site injuries and assist with the management of claims + Monitors service site expenses relative to budgets… more
- Humana (Oklahoma City, OK)
- **Become a part of our caring community and help us put health first** Humana's Special Investigations Unit is seeking a Senior Fraud & Waste Investigator to join ... of fraud, waste, and abuse involving providers who submit claims to Humana's Oklahoma Medicaid line of business. As...provider fraud, and member abuse cases to the Oklahoma Health Care Authority (OHCA) and other duly authorized enforcement… more
- The Hartford (Sunrise, FL)
- …- KR08DE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every ... and risk management solutions. This role will have a Remote work arrangement, with the expectation of coming into...process - meeting with insured's, making presentations, working with claims and underwriting, etc. + Work with Risk Engineering… more
- Northern Light Health (South Portland, ME)
- …. Generous compensation and comprehensive benefits including CME allowance . Malpractice insurance on claims -made basis with tail coverage provided . Educational ... staff who perform community-based home visits. While this position is primarily remote , there may be occasional opportunities for face-to-face visits and some… more
- Actalent (Elk Grove Village, IL)
- …to find insurance coverage information for new enrollments. Troubleshooting pharmacy claims and resolving rejections for both new and refill patients is also ... claims and resolving rejections + Knowledge of medical insurance + National Technician Certification preferred + Ability to...in Elk Grove Village and 3 days working remotely. Remote work is a privilege that may be revoked… more
- CommonSpirit Health (Centennial, CO)
- …for reimbursement. Demonstrates dynamic ability to adapt to ongoing changes within the health insurance industry in order to effect and implement positive ... for all care sites with external third-party payers to appeal denied claims and retrospectively identifies appeals determination as indicated through research and… more