- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Professional Reimbursement Strategy, the Payment Policy and Network Coding Sr. Manager is responsible for leading the research development, proposal, implementation, ... Regulatory Affairs, Network Management, Medical Economics, Benefit Administration, Provider Services, Audit , IT and Claim Operations to determine the impact of… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …This role does not manage people + This role reports to this job: MANAGER , PROVIDER REIMBURSEMENT + Necessary Contacts: In order to effectively fulfill this position ... participant to Information Technology staff, Benefits Administration staff, Provider Audit , Network Administration and/or Medicare Advantage staff, and entry level… more
- AIG (Alpharetta, GA)
- Senior Claims Analyst Join us as a Senior ...team, you will act as a deputy for the Team Manager , and will provide training, and be a technical referral ... strengths and experiences. This position provides the opportunity to engage/work with senior claim, underwriting and actuarial management as well as for growth… more
- University of Rochester (Rochester, NY)
- GENERAL PURPOSE: With general oversight from department leadership, the Manager is primarily responsible for the financial management and monitoring of the health ... accounting systems, measurement and performance of the health plan to University senior leadership and stakeholders, as well as New York State Department of… more
- WTW (New York, NY)
- The claim account manager will operate within significant coverage, reserve and settlement authority. They will develop customer centric claim handling guidelines ... and conduct quarterly claim review meetings, and act as the focal relationship manager . Reporting directly to the head of claims, this position requires working… more
- Chewy (Plantation, FL)
- **Our Opportunity:** Chewy is looking for a Sr. Program & Compliance Manager to join our business team in location-flexible. This position is an exciting opportunity ... status of risks, and changes of program milestones to stakeholders and senior Executives including the C-suite. _Core compliance_ + Responsible for ensuring… more
- AIG (Wilton, CT)
- …F etc). + Work closely with financial controls unit, internal and external audit on reinsurance. + Partner closely with FP&A to work on reinsurance budgeting, ... knowledge of existing constraints. + Position has high visibility at departmental senior management level, and interacts with various levels of internal and external… more
- PulteGroup (Atlanta, GA)
- …throughout the year. Assure compliance with internal controls and external audit . Interact with internal departments regarding premium and loss allocations. ... Ability to communicate effectively with internal and external customers ( senior and Area/Division management, auditors, insurance regulators, insurance brokers,… more
- Medical Mutual of Ohio (OH)
- …with a strong focus on member experience. Conducts outreach to Pharmacy Benefit Manager (PBM) for refills, claim reprocessing and to members to provide status of ... Part D and Part B inquiries, grievances, and CTMs, updating tracking documents, audit research items, and marketing material reviews. . Assists in outbound calls to… more
- Axis (Red Bank, NJ)
- …Developing and implementing claims technical claims handling quality file review and audit processes for direct handled and oversight claims handling of Program and ... delegated/TPA claims as well as Manager Quality File Reviews conducted by the claims managers...to claims best practices and current regulatory requirements, analyzing audit results, reporting on the results, and developing post-… more
- Amazon (New York, NY)
- …globally by engaging with operations, finance, and legal teams. Reporting to a Risk Manager within Treasury, this Sr. Risk Analyst will join a technical risk team ... stakeholders on insurance program changes, retentions, and exposures. * Assist Risk Manager on collection and review of necessary legal documents and exposure… more