- The Coca-Cola Company (Atlanta, GA)
- The Risk Claims Consultant is an integral part of...Ensure accuracy of data in RMIS databases and utilize systems to perform analysis of claim trends in ... the Risk Management Claims Team participating in management and resolution of ...vendors. **What You'll Do for Us:** + **Manage Insurance Claim Process** + Conduct initial analysis to determine applicable… more
- CVS Health (St. Paul, MN)
- …do it all with heart, each and every day. **A Brief Overview** The ** Claims Research** ** Consultant ** handles escalated customer service inquiries and issues for ... processing, pricing disputes, and escalated issues. + Manage pending claims , claim follow-ups, and complex claim...Serve as a subject matter expert on workflows, policies, systems , and daily operations. + Keep documentation of all… more
- Guardian Life (Bethlehem, PA)
- The **RN Clinical Consultant , Disability Claims ** serves as a clinical resource for the investigation and assessment of medical information regarding disability ... by providing comprehensive medical reviews and analysis of long-term disability claims . You will be responsible for restrictions, limitations and duration impacting… more
- Commonwealth of Pennsylvania (PA)
- Mechanical Engineer Consultant Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5011444) Apply Mechanical Engineer Consultant Salary ... of Corrections (DOC) is seeking a highly motivated and innovative Mechanical Engineer Consultant to join our dynamic team of professionals. We are looking for a… more
- MyFlorida (Tallahassee, FL)
- ( Systems Administrator) SYSTEMS PROGRAMMING CONSULTANT - 79011394 Date: Jul 29, 2025 The State Personnel System is an E-Verify employer. For more ... . Requisition No: 857701 Agency: Business and Professional Regulations Working Title: ( Systems Administrator) SYSTEMS PROGRAMMING CONSULTANT - 79011394 Pay… more
- Commonwealth of Pennsylvania (PA)
- Electrical Engineer Consultant Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5022021) Apply Electrical Engineer Consultant Salary ... of Corrections is searching for a dedicated and enthusiastic Electrical Engineer Consultant to represent the Bureau of Operations on construction projects contracted… more
- American Water (Camden, NJ)
- …with a large, complex firm is highly desirable. * Experience as an insurance claims consultant or a corporate in-house litigation counsel or a claims ... expects to invest $40 to $42 billion in infrastructure repairs and replacement, system resiliency and regulated acquisitions over the next 10 years. The company has… more
- Thrivent Financial (WI)
- …in response to audit inquiries or compliance examinations as determined by the Claims Consultant . + Provide consultation to Associate Claims Examiners ... liability within established guidelines. This position is accountable for analyzing claims to determine benefit/contract eligibility and processing claim … more
- MetLife (Aurora, IL)
- …managers and MetLife claim offices for benefit interpretation and escalated claim issues. The Opportunity The Client Services Consultant II is responsible ... Team You Will Join The National Accounts Client Services Consultant II team is part of MetLife's National Accounts...acting as a liaison between benefit managers and MetLife claim offices for benefit interpretation and escalated claim… more
- Huron Consulting Group (Van Buren, AR)
- …Huron and shape the future of consulting! As the Oracle Health Solution Consultant , you will: *Partner with healthcare clients and other stakeholders to ensure the ... effective use of their Oracle health's Cerner system *Collaborate with a team of consulting professionals to...1 or more):** **Oracle Health Revenue Cycle Registration Solution Consultant :** + Expertise in the Oracle Health Revenue Cycle… more
- MyFlorida (Tallahassee, FL)
- EMPLOYEE RELATIONS CONSULTANT -SES - 73000800 Date: Jul 23, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... No: 857109 Agency: Department of Revenue Working Title: EMPLOYEE RELATIONS CONSULTANT -SES - 73000800 Pay Plan: SES Position Number: 73000800 Salary: $52,530.12… more
- R1 RCM (Chicago, IL)
- …solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the ... AI, intelligent automation, and workflow orchestration. As our Complex Denials Consultant , you will represent healthcare providers in their disputes with medical… more
- Prime Therapeutics (Denver, CO)
- …in Microsoft Word, Excel, Project, PowerPoint, and Visio **Preferred Qualifications** + Rx Claims system proficiency + Previous PBM or healthcare experience + ... Consultant serves as a project manager **,** business system or business process subject matter expert with a...satisfaction + May facilitate testing for new or improved systems or processes including creation of a test plan,… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …and group administrators across all product lines. The Account Service Consultant (ASC) handles inquiries received through various channels, including telephone, ... new product lines, and working closely with Operations, Customer Care, Claims , and Finance/Underwriting departments to support group implementations and address… more
- The Hartford (Hartford, CT)
- … volume forecasting process and refining an automated approach within TM1. The Consultant will partner with multiple teams including Claims Finance, Workforce ... Consultant will be a key member of the Claims Finance team, which oversees over $1 billion in...(ETL) processes to load data to TM1 from source systems or other cubes + Manage the WAVE tool… more
- Elevance Health (Louisville, KY)
- …visits, referral practices, and specialty care procedures. + Recommends policy changes and claim 's system changes to pursue cost savings. + Reviews results ... **Provider Contract/Cost of Care Consultant ** **Locations:** This role requires associates to be...Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing… more
- MyFlorida (Tallahassee, FL)
- …and support to management of the operational units and SSA in tracking individual claims on the federal and state data systems . Provides individual case input ... GOVERNMENT OPERATIONS CONSULTANT II - 64005320 Date: Jul 25, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …data mining and analytics to identify anomalies, trends, and recovery opportunities across claims systems . Your work will ensure compliance with BCBSMA Medical ... to blue. What We Need The Payment Integrity Audit Consultant role is responsible for high-impact initiatives that enhance...CPT, HCPC) and reimbursement methodologies. + Deep understanding of claims systems and audit platforms such as… more
- CVS Health (Plymouth, MN)
- …+ Process accurate and timely policy and eligibility data utilizing administration systems for claim payment purposes and product production ensuring services ... issues + Partner directly with clients, vendors, internal teams, and/or local claim operation to resolve problems and achieve positive outcomes + Anticipate and… more
- Access Dubuque (Dubuque, IA)
- Senior Employee Benefits Client Consultant **Cottingham & Butler/ SISCO** 1 Positions ID: 4808686008 Posted On 07/16/2025 **Job Overview** We are seeking an ... outcomes for clients and their programs. As an Employee Benefits Client Consultant , you'll play a critical role in building strong client relationships, providing… more