- CVS Health (Springfield, IL)
- …And we do it all with heart, each and every day. Reviews and adjudicates routine claims on HRP system in accordance with claim processing guidelines. Claims ... Aetna compliance and business requirements. Analyzes and approves routine claims that cannot be auto adjudicated. - Applies medical...applies all cost containment measures to assist in the claim adjudication process. - Proofs claim or… more
- Molina Healthcare (Columbus, OH)
- …+ Review and interpret member's eligibility, claim history, and pharmacy benefit information using the PBM claims software to provide information to ... **JOB DESCRIPTION** **Job Summary** The Specialist , Pharmacy Operations is responsible for the oversight...be the primary contact for affiliated health plans, Pharmacy Benefit Managers and Corporate shared services with respect to… more
- Banc of California (Santa Ana, CA)
- …We are committed to supporting your growth and well-being with comprehensive benefits , career development programs, a variety of employee resource groups, and more. ... WE WIN(R) **THE OPPORTUNITY** As a Sr. Deposit Operations Specialist , you will be a team-oriented, ambitious, and dedicated...and Subpoena processing and research, Reg E and Zelle claim research, Reg CC Review, Closed Account Review, Account… more
- AIG (Jeffersonville, IN)
- …to find innovative service solutions to resolve issues & escalations. The T2 Ops Specialist help uphold our contracts appropriately while also ensuring an ... acceptable claim resolution. They are a liaison between the client,...customers. As a contributor at AIG, the Tier 2 Ops Specialist are who our clients rely… more
- MyFlorida (Tallahassee, FL)
- …as 8:00am and end at 5:00pm. + This advertisement may also be used to fill OPS Regulatory Specialist I positions at $15.00 per hour. + This advertisement package ... REGULATORY SPECIALIST I - 79000736 Date: Apr 29, 2025...Career Service Position Number: 79000736 Salary: $1,439.31 Biweekly / OPS $15.00 hour Posting Closing Date: 05/19/2025 Total Compensation… more
- MyFlorida (Tallahassee, FL)
- …to six months from opening date. + This advertisement may also be used to fill OPS Regulatory Specialist II positions at $16.50 per hour. + The applicant will be ... REGULATORY SPECIALIST II - 79010180 Date: Apr 30, 2025...candidate maybe eligible for a flex time schedule. The Benefits of Working for the State of Florida: "… more
- MyFlorida (Fort Lauderdale, FL)
- …initial or additional claims . This is accomplished through tracking the assigned claim load and utilizing the benefit payment system. + Answers inquiries ... 06/30/2025 Total Compensation Estimator Tool (https://compcalculator.myflorida.com/) JOB TYPE: FULL TIME/ OPS POSITION LOCATION: Ft Lauderdale,FL (relocation benefits … more
- MyFlorida (Orlando, FL)
- …initial or additional claims . This is accomplished through tracking the assigned claim load and utilizing the benefit payment system. + Answers inquiries ... Salary: $20.70 Posting Closing Date: 06/30/2025 JOB TYPE: FULL TIME/ OPS POSITION LOCATION: Orlando,FL (relocation benefits are...potential issues and the chargeability of employer accounts for benefit payments on claims . This may be… more
- MyFlorida (Tallahassee, FL)
- …initial or additional claims . This is accomplished through tracking the assigned claim load and utilizing the benefit payment system. + Answers inquiries ... 06/30/2025 Total Compensation Estimator Tool (https://compcalculator.myflorida.com/) JOB TYPE: FULL TIME/ OPS POSITION LOCATION: Tallahassee,FL (relocation benefits are… more
- Nucor Steel Auburn, Inc. (Crawfordsville, IN)
- …Random Drug Testing + Site POC for investigations and appeals + Partner with Payroll Specialist , Finance and Ops to support payroll processing for the site + ... Nucor? With a firm commitment to our teammates, strong benefits and performance incentives, its easy to see why...all aspects of talent management + Partner with Payroll Specialist to ensure site compliance with training + Partner… more
- Insight Global (Rock Hill, SC)
- …Random Drug Testing - Site POC for investigations and appeals - Partner with Payroll Specialist , Finance and Ops to support payroll processing for the site - ... all aspects of talent management - Partner with Payroll Specialist to ensure site compliance with training - Partner...with HR Generalist for open enrollment and administration of benefit programs for the site - Process all site… more
- Waystar (Lehi, UT)
- …engineer with specialist -level depth in data modeling, performance engineering, ML Ops , and cloud data platform optimization. The ideal candidate will have a ... Cycle Management (RCM) technology company, is seeking an expert-level Specialist Data Engineer to join our Data Architecture team....will also play a key role in implementing ML Ops practices to operationalize machine learning models and drive… more
- St. Luke's Health System (Boise, ID)
- …in this bold ambitious journey. We'd love to hear from you! The Pharmacy Benefits Specialist assists our members in identifying and navigating pharmacy ... accurately process prior authorization requests for medications under the pharmacy benefits . + Facilitate resolutions to issues involving claims adjudication,… more
- Aston Carter (Gardena, CA)
- …and follow up. * Research and dispute chargebacks, as considered necessary (ie Co- ops , marketing promos, price claims , shortages). * Internal and external follow ... Our manufacturing client is looking for a skilled AR specialist with big box store experience to join the...Ability to work in a fast-paced environment Pay and Benefits The pay range for this position is $30.00… more
- Dickinson Financial Corporation (Kansas City, MO)
- …business hours and/or assigned hours. + Other specified duties as assigned. **Compensation & Benefits ** The Branch Ops Support Spec III position pays a range of ... deposit requests.+ Complete incoming garnishments, tax levies, child support claims . Handle incoming/outgoing collections, foreign currency, and unfit/mutilated currency.… more
- Healthfirst (NY)
- …+ Works with key stakeholders (including, but not limited to Regulatory, Claims Configuration, Provider Ops , Appeals & Grievance, Medical Management, Enrollment ... & Billing, Sales) to identify, scope and accurately implement new benefits , services, or other product changes, update processes and/or edit systems to accommodate… more
- UIC Government Services and the Bowhead Family of Companies (Aberdeen, MD)
- …overall security guidance and security administrative duties for PEO C3N HQ OPS . The Site Security Officer will be responsible for all security administrative ... or university and 6 years' experience as a Security Specialist , Personnel Security Specialist , and/or Physical Security...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- Montana State University (Bozeman, MT)
- …charges related to substance use. Position Number 4M5293 Department SWC AVP OPs Division Division of Student Success Appointment Type Classified Contract Term Fiscal ... specify End date FLSA Non-Exempt Union Affiliation FOCUS-MFPE FTE 1.0 Benefits Eligible Eligible Salary $21.99 per hour, commensurate with experience, education,… more
- Cognizant (Teaneck, NJ)
- …Insurance** Cognizant's Insurance (INS) Markets is seeking a Service Line Sales Specialist -Digital Operations to be actively involved in continuing to grow our ... key Insurance accounts. In this role, the Service Line Sales Specialist will balance client/project responsibilities with business development and sales… more
- UIC Government Services and the Bowhead Family of Companies (Alexandria, VA)
- …Security Analyst + Information Systems Security Engineer (ISSE) + Information Technology Specialist + IT Architecture and Cyber + Network and Computer Administrator ... + SAAS Functional Team Lead + Senior Plans and Ops System Analyst + Software Developer + Software Quality...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
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