- Cambia Health Solutions, Inc (Portland, OR)
- …recommendations for medications subject to prior authorization, appeals, retrospective claim reviews, and audits based on applicable medication coverage policies, ... recommendations for medications subject to prior authorization, appeals, retrospective claim reviews, and audits based on applicable medication coverage policies,… more
- Northeast Georgia Health System, Inc (Oakwood, GA)
- …of improving the health of our communities. About the Role:Job SummaryThe Employee Relations Consultant (ERC) is as a member of the HR Business Partner (HRBP) Team ... to five (5) years of investigative management experience. Other: Preferred Job QualificationsPreferred Licensure or other certifications: Preferred Educational… more
- Cambia Health Solutions, Inc (Boise, ID)
- …service. These pharmacy issues include formulary drug coverage, appeal and reconsideration claim status, and pricing for drug claims .Completes daily formulary ... reconsiderations, and appeals. Prepares reconsideration requests for Clinical Pharmacy Consultant review by obtaining and organizing appropriate documentation, including,… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …projects with time sensitive deadlines. Good understanding of existing market and claim data sources preferred ; strong ability to condense complicated data ... improving the quality of all information. Serve as an internal consultant for Marketing, Sales, Finance, Supply Chain, Business Development, and Investor… more
- Medline Industries LP (Northfield, IL)
- …Gross to Net Systems (Vistex, Model N, Integrichain) as an Application consultant , Lead, and/or Solution Architect. Web based ordering systems, SAP Based APIs, ... execution, billing, pricing agreements, commissions, rebates, incentives and distributor claims . Expertise in configuring order management, delivery / shipping and… more
- OSI Group (Riverside, CA)
- …counsel regarding human resource aspects of plant operations. Act as an internal consultant to local management to ensure the efficient and effective delivery of ... for supporting documentation and represent company at hearings for unemployment claims .Works closely with the corporate training specialist to support corporate and… more
- Creative Financial Staffing (Cambridge, MA)
- …Health and Benefits Program including 403B Plan with outside consultant Payroll reconciliations DOL/OSHA Reporting Process Workers Comp incidents, reports, ... and claims Qualifications for the HR Generalist position: 2+ years...payroll experience Knowledge of ADP Understanding of state and federal HR compliance preferred Strong organizational and problem-solving skills… more
- Sedgwick (Columbus, OH)
- …or university preferred . Current valid RN license required. Legal Nurse Consultant (LNC) Certification or training highly preferred . **Experience** 6 (Six) ... consultant experience. General or Professional Liability investigation related training preferred with specialty experiencing with bodily injuries claims ,… more
- The Hartford (Lake Mary, FL)
- …team as we help shape the future. The General Liability Litigation Senior Claim Representative or Consultant is accountable for delivering superior customer ... and successfully investigating, reserving, recommending and implementing strategies to resolve claims consistent with corporate claim standards, policies and… more
- The Hartford (New York, NY)
- Claims Consultant FL - CV07GE We're determined... Group currently has an open Cyber and Technology claim position. As a Cyber and Technology claims ... liability and damages based upon the facts of each claim . + On first party cyber claims :...topics. Qualifications: + Knowledge of both first- and third-party claims a plus + Juris Doctorate degree preferred… more
- The Hartford (Hartford, CT)
- Consultant Claims - CH08CEConsultant Claims CA - CH08BN We're determined to make a difference and are proud to be an insurance company that goes well beyond ... Claims Unit (CCU) Hartford Global Specialty (HGS) Claims Division. As a Claims Consultant...trials and mediations as necessary. + Contributing to broader claim and enterprise goals by participating in audits, projects,… more
- The Coca-Cola Company (Atlanta, GA)
- The Risk Claims Consultant is an integral part of the Risk Management Claims Team participating in management and resolution of claims for all lines of ... other RIMS/data systems knowledge helpful + 1-3 years' experience working with insurance claims preferred + Proficiency in Microsoft Office and strong Excel… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …Industry, its financial components, and any relevant issues and trends is preferred . #LI-BP1 Senior Development Consultant LOCATION -- Cincinnati, Ohio 45202 ... to work collaboratively on executive team development efforts. Serve as a consultant and trusted advisor to HRBPs, executives and leadership teams by leveraging… more
- Travelers Insurance Company (Rancho Cordova, CA)
- …claim and/or legal experience and technical expertise to evaluate severe and complex claims preferred . + Able to make independent decisions on most assigned ... and resolving, assigned Auto and Homeowner related Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life… more
- Sedgwick (New York, NY)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim ...limited to Bachelor of Science in Nursing, Legal Nurse Consultant , Associate in Claims (AIC), Chartered Property… more
- Sedgwick (Richfield, MN)
- …timely resolution by investigating and gathering information to determine the exposure on the claim . + Reporting claims to the excess carrier and responding to ... + Managing claim recoveries if applicable. + Negotiating settlement of claims within designated authority. + Referring cases as appropriate to supervisor and… more
- Montana State University (Bozeman, MT)
- …Statistics or a related field + 2 years of experience as a statistical consultant Preferred Qualifications - Experience, Education, Knowledge & Skills + Ph.D. ... related field + 4 or more years of experience as a statistical consultant + Experience working in MSU's statistical resource environment The Successful Candidate… more
- HUB International (Lewisville, TX)
- …the representative and/or end client; be a strong advocate for the client; be a consultant to the client on claim issues. Ideal candidates must possess strong ... **General Description (SUMMARY, Scope, Purpose)** The role of the Claims Adjuster is to handle the complete adjudication of...to change) + Provide guidance to client as to claim process along with direction regarding likely outcome and… more
- Access Dubuque (Dubuque, IA)
- …as suggested by the claim status; and provides written resumes of specific claims as requested by client. + Assures that direct reports are properly licensed in ... . Licenses as required. Professional certifications as applicable to line of business preferred . **Experience** Six (6) years of claims experience or equivalent… more
- Sedgwick (Houston, TX)
- …Forbes Best-in-State Employer Account Consultant **PRIMARY PURPOSE** **:** To manage claim caseload of basic to highly complex claims within granted ... table discussions within the assigned team. + Investigates, evaluates and resolves claims ; identifies potential problems/trends in claim files and takes… more
