- Merck & Co. (Rahway, NJ)
- …industryTherapeutic area experience in HIVUS secondary data assets such as claims , EMR, SP/SD etc.Current Employees apply HERE Current Contingent Workers apply ... HERE US and Puerto Rico Residents Only:Our company is committed to inclusion, ensuring that candidates can engage in a hiring process that exhibits their true capabilities. Please click here if you need an accommodation during the application or hiring… more
- Merck & Co. (San Antonio, TX)
- …in the company's areas of interest-*Scientific exchange does not include promotional claims about any drug, vaccine, or biologic product.-- RMSDs have no sales ... objectives or accountability for prescribing or sales of any company product and are required-to avoid any situations that could create the appearance that they have such-responsibilities. A-RMSD-may not comment on or make suggestions with respect to the… more
- Eisai, Inc (Nutley, NJ)
- …pharmaceutical laws and industry guidelines including the Anti-Kickback Statute, False Claims Act, federal and state pricing-related laws and regulations, PhRMA Code ... and FDA regulatory guidelines.Serves as the legal representative for market access materials on promotional review committees.Proactively informs assigned business client of important legal, enforcement and other industry developments, including DOJ and OIG… more
- Eisai, Inc (Phoenix, AZ)
- …(eg, PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state ... transparency and disclosure laws) preferred.Demonstrated skills at building and maintaining professional relationships with key customers and others in the customer influence network, preferred.Experience in business analytics to understand and analyze… more
- Sedgwick (Indianapolis, IN)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY PURPOSE** **:** To analyze ... complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to coordinate case… more
- Sedgwick (Raleigh, NC)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Liability (REMOTE -HAWAII Lic Required; Bodily Injury Exp, REMOTE) ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...**PRIMARY PURPOSE** **:** To process low level general liability claims to determine benefits due; to ensure ongoing adjudication… more
- WelbeHealth (Phoenix, AZ)
- ** Claims Audit Analyst** At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option (PACE) to the most vulnerable ... Services team helps ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role in ensuring timely and accurate… more
- Providence (TX)
- …empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional, general, ... and other liability claims under the PSJH Insurance Program:** + Communicate with...review + Develop a plan of action for assigned claims and update the claims file following… more
- Guidehouse (San Marcos, CA)
- …billing, secondary billing, and payer audit follow-up for government and non-government claims . Must work with other departments to facilitate the meeting of both ... Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides...electronic and hardcopy claims + Submits Adjusted claims + Provides Follow-up Billing + Prepares Billing Reconciliation… more
- USAA (Chesapeake, VA)
- …truly makes us special and impactful. **The Opportunity** As a dedicated Claims Litigation Manager Senior (Western States), you will responsible for **managing ... resource for colleagues with less experience. + Applies advanced knowledge of claims litigation processes. + Proactively manages litigation and acts as liaison with… more
- Sedgwick (Tampa, FL)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Adjuster - Workers Compensation - Remote FL - Licensed in FL **PRIMARY ... PURPOSE** **:** To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company… more
- Sedgwick (Cleveland, OH)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner | OH Jurisdiction Knowledge Are you looking for an opportunity ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...**ARE YOU AN IDEAL CANDIDATE?** To analyze Workers Compensation claims on behalf of our valued clients to determine… more
- CVS Health (Franklin, TN)
- …with healthcare providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical ... claims for reimbursement through knowledge of medical coding and...**What you will do** + Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy, efficiency, and… more
- TEKsystems (Brookfield, WI)
- Location: + Remote (must be located in WI) Description As a Claims Processor, you will be tasked with the following: - Examine and process paper claims and/or ... role determines whether to return, pend, deny or pay claims within established policies and procedures. - Determines steps...policies to resolve claim and claim issues. - Settles claims with Claimants in accordance with policy provisions. -… more
- Sedgwick (Buffalo, NY)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner | NY Jurisdiction | NY Licensing Preferred Are you looking ... workers compensation knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...**ARE YOU AN IDEAL CANDIDATE?** To analyze workers compensation claims on behalf of our valued clients to determine… more
- Sedgwick (Cincinnati, OH)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Liability Claims Representative | Dedicated Client | Hybrid Schedule **PRIMARY PURPOSE** : To ... process low level general liability claims to determine benefits due; to ensure ongoing adjudication...to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and… more
- HUB International (Brentwood, TN)
- …that investigate, coordinate, evaluate, and negotiate complex Non-Subscriber/Occupational Accident claims presented by insured's or claimants. This includes, but is ... resolution. We are seeking a detail oriented Non-Subscriber or Occupational Accident Claims Supervisor/Manager to join Avant Specialty Claims , a Third-party… more
- AIG (Chicago, IL)
- …play your part in that transformation. You'll work with some of the best claims and underwriting minds in the industry addressing challenging claims and ... of Casualty insurance. In Casualty Coverage and Mass Tort Claims , we strive to live AIG's corporate values: Take...recent awards and accreditations. Make your mark in Casualty Claims As a seasoned industry professional, in this role… more
- TEKsystems (Fairfax, VA)
- Description PURPOSE: Under direct supervision reviews and adjudicates paper/electronic claims . Determines proper handling and adjudication of claims following ... policies and procedures. ESSENTIAL FUNCTIONS: 60 Examines and resolves non-adjudicated claims to identify key elements of processing requirements based on contracts… more
- Axis (New York, NY)
- …part in the selection process. **Job Description** AXIS is seeking a **_Senior Claims Specialist - Design Professional_** to join our North America Claims . ... should possess the ability to handle primary & excess Design Professional claims such as architects & engineers, surveyors, designers, and design build… more
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