- Merck & Co. (North Wales, PA)
- …well as a deep technical understanding of Life Sciences data sets (eg, claims , electronic health records) and advanced modeling approaches. Using this expertise, ... omnichannel orchestration engines.Proven experience with Life Sciences data sets-such as claims data, electronic health records (EHRs), and prescription… more
- Merck & Co. (Rahway, NJ)
- …analyze data leveraging advanced analytical/statistical techniques from disparate databases/sources ( claims data/EMR Data and other sources) to drive optimization ... or Doctorate degree in Decision Science, Marketing, Engineering, Public Health , Biological Sciences, Nursing, Pharmacy, Mathematics, Economy, Statistics, Computer… more
- Eisai, Inc (Nutley, NJ)
- …healthcare provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that is breaking ... to contribute to the development and the communication of clinical, real-world, health economics outcomes data. This role primarily focuses on late-stage pipeline… more
- Eisai, Inc (Atlanta, GA)
- …healthcare provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that is breaking ... hear from you. : The Area Business Leader (ABL) will engage with assigned health systems for Eisai's oncology portfolio and manage a team of sales professionals. The… more
- Merck & Co. (Rahway, NJ)
- …and educational collaborations, interactions with global scientific societies and health organizations, publications, or other Develop and execute global input ... management Substantive contributions to labeling committees. Ensure labels contain fair-balanced claims supported by data and supportive of asset value proposition… more
- Eisai, Inc (Pittsburgh, PA)
- …healthcare provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that is breaking ... (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… more
- LA Care Health Plan (Los Angeles, CA)
- Specialty Health Plans Auditor III Claims Job Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: ... net required to achieve that purpose. Job Summary The Specialty Health Plans Auditor III Claims is responsible for all aspects of planning, execution, reporting… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities This position requires relocating to Ontario, California. TheVice President of Health Plan Operations and Claims is responsible for the ... to improve the quality and minimize process cost of Claims for all Prime Healthcare's self-insured Employee Health... Claims for all Prime Healthcare's self-insured Employee Health Plans. Through in-depth audit and review of … more
- AIG (Lenexa, KS)
- …skills and experience as a valued member of the team. Make your mark in Accident and Health Claims Our Claims teams are the proven problem solvers of choice ... at least 1+ year(s) with exposure to Identity Theft and/or Accident and Health claims , which include identity theft, sickness and bodily type injury claims … more
- Axis (Red Bank, NJ)
- …for candidates taking part in the selection process. Job Title: Accident and Health Claims Specialist Level: "I" Division: A&H Position Summary: This position ... provides claims handling expertise for all of the accident and health claims , both claims adjudicated in-house and by third party administrators (TPAs).… more
- Elevance Health (Woodbridge, NJ)
- …(word processing, spreadsheets, etc.) strongly preferred. + Previous experience working in health claims is strongly preferred. For candidates working in person ... ** Claims Representative I** **Location:** This role enables associates...Jersey, New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
- CVS Health (Phoenix, AZ)
- … Analyst is responsible for reviewing pharmacy claims submitted through the CVS Health claims processing systems. The Claims Analyst will identify and ... At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming … more
- TEKsystems (Fresno, CA)
- …or equivalent: minimum one (1) to three (3) years year of experience as a Health Claims Examiner or comparable industry experience preferred. * A minimum of one ... for reviewing and processing medical, dental, vision and electronic claims in accordance with state, federal and health... claims in accordance with state, federal and health plan regulatory requirements, department guidelines, as well as… more
- WTW (Chicago, IL)
- …the posted locations. **Qualifications** **Qualifications** + 5+ years' experience in health claims adjudication gained preferably in a consulting environment ... and/or in a major insurance claims administrator or health plan environment + Solid understanding of health and welfare plan design and all areas of … more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …or GED + Excellent oral and written communication skills + 1 - 3 years of Health claims processing experience + Working knowledge of COB and MSP preferably + ... Position Purpose: The Claims Examiner is responsible for providing expertise and/or...Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing and adjusting… more
- Elevance Health (Roanoke, VA)
- **Title: Claims Representative I ( Health & Dental) - FEP** **Roanoke, VA** **Location:** This role enables associates to work virtually full-time, with the ... 10/20/2025** **Hours:** **8 AM - 4:30 PM EST, Monday - Friday.** The ** Claims Representative I** will be responsible for successfully completing the required basic… more
- Alight (TX)
- …and financially secure workforce by unifying the benefits ecosystem across health , wealth, wellbeing, absence management and navigation. With a comprehensive total ... role provides leadership and guidance to a team of Claims Specialist who work to resolve billing inquiries &...for the whole person. Options include a variety of health coverage options, wellbeing and support programs, retirement, vacation… more
- UCLA Health (Los Angeles, CA)
- …Take your career to the next level. You can do all this and more at UCLA Health . The Claims Quality Auditor will be responsible for the daily audit of all ... + Knowledge of claims adjudication systems + Flexibility and adaptability UCLA Health is a world-renowned health system with four award-winning hospitals and… more
- Ascension Health (Austin, TX)
- …**Additional Preferences** Additional Preference: + Three (3) years of experience in health -care claims adjudication required. + Expertise in the Facets platform ... Must reside in Austin, Texas **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Claims Research and Resolution Professional 2 reports to the Claims Research and ... **Use your skills to make an impact** **Required Qualifications** + 2+years of health insurance claims experience, with claims systems, adjudication,… more
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