- Sedgwick (Harrisburg, PA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr . Claims Specialist , Medical Malpractice (LTC) **PRIMARY PURPOSE** ... : To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …member of Ward's Top 50 and rated A++ by AM Best. We are looking for a Sr . Claims Specialist to join our team! Summary: Investigate, evaluate and settle more ... complex first and third party insurance claims . A typical day will include the following: Communicates with all relevant parties and documents communication as well… more
- UPMC (Pittsburgh, PA)
- …of excellence to which all work is to conform. The expertise of the Authorization Specialist Senior shall include an in depth working knowledge in the area of ... **University of Pittsburgh Physicians is hiring a full-Time Sr . Authorization Specialist to help support...denials, across service areas or business units. The Authorization Specialist Senior shall demonstrate the philosophy and… more
- Sedgwick (Philadelphia, PA)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Estimate Review Specialist Sr . (Repair Solutions) **PRIMARY PURPOSE:** To review all estimates ... your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...+ We offer a diverse and comprehensive benefits including medical , dental vision, 401K, PTO and more beginning your… more
- Citizens (Pittsburgh, PA)
- …to continuously learn, consider a career at Citizens as a Fraud Customer Support Sr . Specialist . In this role, you'll play a crucial part in safeguarding ... the customer's consent on a resolution. + Provide accurate complete claims processing, and records management using established procedures in moving/placing… more
- Sedgwick (Harrisburg, PA)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Life Science Claims Specialist (REMOTE US) **PRIMARY PURPOSE** ... **:** To analyze complex claims specific to the product liability / life sciences...deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as… more
- CVS Health (Harrisburg, PA)
- …And we do it all with heart, each and every day. **Position Summary** The ** Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ... amount levels on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical necessity guidelines, determine… more
- Gilead Sciences, Inc. (Philadelphia, PA)
- …will improve the lives of patients with life-threatening illnesses worldwide. As a Senior Field Activation Specialist within Gilead's HIV Prevention team, you ... with local cross-functional colleagues (Prevention Specialists, Community Liaisons, Market Access, Medical Scientists, and other field team members) to ensure a… more
- Robert Half Accountemps (Gibsonia, PA)
- …are looking for a meticulous Healthcare Healthcare Billing and Accounts Receivable Specialist to join our team in Gibsonia, Pennsylvania. This Contract to Permanent ... healthcare billing with a focus on skilled nursing. The Billing/Accounts Receivable Specialist would be responsible for the following duties: + Generate and process… more
- Guardian Life (Bethlehem, PA)
- …Overview:** We are seeking a highly skilled and proactive **Data Management Operations Specialist ** to join our Data Management team in the insurance industry. This ... governance and quality. This is a unique opportunity to work closely with senior leadership and contribute to the evolution of data management within a fast-paced… more
- Highmark Health (Harrisburg, PA)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... questionable claim patterns of renewal clients and issues with competitor's claims experience for prospect clients and develops recommendations to account for… more
- Highmark Health (Harrisburg, PA)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses ... of financial exhibits. This is an entry level position, with oversight by Senior Underwriters and/or Management until the individual is acclimated to the Company… more
- Medtronic (PA)
- …articulate to customers. + Execute engaging field sales and clinical specialist field education programs that are targeted, purposeful, and support electrophysiology ... Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through… more