- Lincoln Financial (Raleigh, NC)
- …**Requisition #:** 74647 **The Role at a Glance** We are excited to bring on a Claims Customer Care Associate to join our claimant excellence team supporting ... coaching and development to perform in this fast-paced environment. As a Claims Customer Care Associate , you will be responsible for answering claimants… more
- Sedgwick (Raleigh, NC)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Associate - Liability (REMOTE - NY or Hawaii License preferred) Are ... brands? + Apply your knowledge and experience to analyze claims in the context of an energetic culture. +...path. + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.… more
- Zurich NA (Raleigh, NC)
- …you. Overview: + Monitor business processes to identify opportunities for customer care 's improvements. + Handle first and third-party claims taking ... Auto Claims Call Center Senior Represent 127692 Zurich is...area OR + Zurich Certified Insurance Apprentice including an Associate Degree and No prior experience required in the… more
- Humana (Raleigh, NC)
- …and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs ... of decisions to internal associates, and possible participation in care management. May occasionally participate in discussions with external physicians… more
- Evolent (Raleigh, NC)
- …a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to ... a mission with a company behind it. **What You'll Be Doing:** ** Associate Director, Performance Analytics - Oncology & Member Product Focus** **Overview:** Evolent… more
- Evolent (Raleigh, NC)
- …people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care ... system and ensure people get the same level of care and compassion we would want for our loved...our specialty programs and administrative platform. Role Overview The Associate Director role on Client Analytics will support both… more
- Travelers Insurance Company (Raleigh, NC)
- **Who Are We?** Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our ... Claim Counsel team conducts thorough investigation, analysis, evaluation, and disposition of claims and claim litigation to achieve superior customer service and to… more
- Walgreens (Cary, NC)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Walmart (Durham, NC)
- …Floor in accordance with Company policies and procedures by properly handling claims and returns, zoning the area, arranging and organizing merchandise, and ... digital tools to drive sales, improve the shopping experience, and elevate associate engagement; utilizing hand held technology to make immediate business decisions… more
- Wells Fargo (Raleigh, NC)
- **About this role:** Wells Fargo is seeking an Associate Customer Service Representative in **Everyday Banking** . Find out why we're the #1 financial services ... Services include deposits, payments and ATM operations, global fraud and claims , account reconciliation, cash vault services, mail and courier solutions, print… more
- Walmart (Durham, NC)
- …thinking You will make an impact by: * Ensuring high-quality products are taken care of and available for our members * Ensuring shelves are clean, maintaining ... area in accordance with Company policies and procedures by properly handling claims and returns; zoning the area; receiving and stocking merchandise; setting up,… more
- Intermountain Health (Raleigh, NC)
- **Job Description:** Provides extraordinary care to our customers through friendly, courteous, and professional service through a broad understanding of account ... + Perform other duties as assigned **Skills** + Insurance Claims + Medical Billing + Explanation of Benefits (EOB)...hourly rate dependent upon experience. $18.81 - $27.45 We care about your well-being - mind, body, and spirit… more
- Sedgwick Government Solutions (Raleigh, NC)
- …with Agency, state, and federal policies and procedures, standards, and guidelines. Care Coordinator Qualifications + High School diploma, associate degree (or ... Job Details Care Coordinator 2025-1451 Remote (Strong Internal) Raleigh, NC,...medical record review, triage, customer service, prior authorizations, medical claims , and billing, assessing patient health, and/or related experience… more
- UNC Health Care (Chapel Hill, NC)
- …party reports, attorney requests for medical records and administrative or associate referrals. Develops innovative approaches intended to reduce the frequency and ... severity of medical malpractice and patient injury claims . 3. Manages incident reporting database documentation of reported...events. 6. Facilitates legal consultation from the UNC Health Care System Office of General Counsel to staff and… more
- UNC Health Care (Morrisville, NC)
- …amounts. + Assists with the open enrollment process. + Process life claims and assist beneficiaries. + Assist with administration of voluntary benefits. **Other ... Information** Other information: **Education Requirements:** * Associate 's degree in HR or related field or equivalent....NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services… more
- Humana (Raleigh, NC)
- …community and help us put health first** Design and maintain Medicaid claims analytics dataset using Databricks. Conduct in-depth analysis of healthcare claims ... Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. Maintain dashboards to communicate key trends to stakeholders. The… more
- Humana (Raleigh, NC)
- …looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and ... provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments. Analyzes, enters… more
- Humana (Raleigh, NC)
- …achieving operational and compliance key performance indicators. In addition, the associate will participate in cross functional teams and support analyzing business ... an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and… more
- Humana (Raleigh, NC)
- …have expertise in conducting retrospective observational studies using administrative claims data using a collaborative approach across multiple stakeholders. Humana ... + An understanding of research methodology and the managed care arena, and how it applies to health outcomes...with cloud base analytics platforms + Experience with clinical, claims , pharmacy or other healthcare data. + Strategic thinking… more
- CenterWell (Raleigh, NC)
- …of the Pharmacy Analytics division, with responsibilities that include working with pharmacy claims data. The team to which this position reports is dedicated to ... PowerBI + Experience in Databricks is preferred + Experience in analyzing pharmacy claims data Travel: While this is a remote position, occasional travel to Humana's… more