- Cognizant (Harrisburg, PA)
- ** Claims Quality Review ** ( remote ) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** Our ... quality standards, processes and procedures and policies + Ensures the claims processing reps adhere to predetermined quality assurance standards and the… more
- Cognizant (Harrisburg, PA)
- ** Claims Process Executive ( remote )** **JOB PURPOSE:** Claim Processors will review claim submissions, verify information, adjudicate the claim as per claim ... the business requirements. **ESSENTIAL FUNCTIONS** : + Examining and entering basic claims for appropriateness of care and completeness of information in accordance… more
- TEKsystems (Harrisburg, PA)
- TekSystems is currently hiring for a FULLY REMOTE Claims examiner contract position! THIS POSITION CAN START ASAP! MUST HAVE: 1-3 years of recent medical ... complex or high-risk cases for further investigation or legal review . Skills customer service, healthcare industry, claims ...on business needs. - Must be able to meet quality , productivity, and behavior expectations. - Must possess basic… more
- Cognizant (Harrisburg, PA)
- …and coverage guidelines and regulations + Experience in the analysis and processing of claims , utilization review / quality assurance procedures + Must be able ... to transform a variety of business operations. We are seeking **Fully Remote US Based** Claims Processors to join our growing team. The **Medical** ** Claims … more
- Cognizant (Malvern, PA)
- …* 1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review / quality assurance procedures. * Must be ... Based on this role's business requirements, this is a remote position open to qualified applicants in the United...is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist, you will be responsible for timely… more
- UPMC (Pittsburgh, PA)
- UPMC is hiring a Systems Analyst-Senior (Epic PB Claims and Remittance) who has healthcare experience. If you are looking to join a highly accomplished team with ... great chemistry, APPLY NOW! Hybrid work environment, but predominately remote . One week per month we have mandatory meetings...meet client IT and business needs. Responsibilities: + PB claims IT analyst. Ability to quickly diagnose claims… more
- Otsuka America Pharmaceutical Inc. (Harrisburg, PA)
- …Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for leading a ... global team focused on R&D Quality . This global role includes direct reports in the...be reported periodically to Senior Management through the Management Review process to ensure alignment with Company policy and… more
- Sedgwick (Harrisburg, PA)
- …+ Compiles reviews and analyzes management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, ... Financial Services & Insurance Team Leader - Liability | Remote **PRIMARY PURPOSE** : To supervise the operation of...authority of the individual examiner. + Monitors third party claims ; maintains periodical review of litigated … more
- Sedgwick (Harrisburg, PA)
- …various specialized services such as subrogation, fraud evaluation or case management review to resolve claims . + Establishes and maintains effective ... Fortune Best Workplaces in Financial Services & Insurance Account Consultant- Remote Opportunity- Flood Experience Required **PRIMARY PURPOSE** **:** To manage claim… more
- Prime Therapeutics (Harrisburg, PA)
- …requestors to resolve questions regarding requested software changes, and participate with Quality Assurance and UAT resources to review related test cases ... drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with an AI background?… more