- Merck & Co. (Rahway, NJ)
- …analyze data leveraging advanced analytical/statistical techniques from disparate databases/sources ( claims data/EMR Data and other sources) to drive optimization ... deliver measurable impact in commercial pharma landscape.Knowledge in mining medical claims /EMR, social media, etc. data with a strategic/inquisitive mindset and… more
- Merck & Co. (Boston, MA)
- …patient level healthcare data, including but not limited to administrative claims , EHR/EMR, disease registry, and public-use databases. Develop machine learning ... in-depth hands-on professional experience and knowledge of RWD such as administrative claims , EHR/EMR, patient registry, and public-use databases, to generate RWE is… more
- Eisai, Inc (Seattle, WA)
- …(eg, PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state ... origin, citizenship status, marital status, sexual orientation, gender identity, disability or veteran status. Similarly, considering the need for reasonable… more
- Novo Nordisk Inc. (Plainsboro, NJ)
- …knowledge and clear understanding of the Anti-Kickback Statute and False Claims Act, FDA rules and regulations regarding the promotion of pharmaceuticals, ... programs including medical, dental and vision coverage; life insurance; disability insurance; 401(k) savings plan; flexible spending accounts; employee assistance… more
- City of New York (New York, NY)
- …available sources to gather information relevant to the investigation of the claim ; 11) Investigate, identify, and report fraudulent claims , utilize statistical ... in a permanent (not provisional) Civil Service title of Claim Specialist. To be considered for this position, PLEASE...your resume and cover letter. Qualified persons with a disability who are eligible for the 55-a Program are… more
- Travelers Insurance Company (Downers Grove, IL)
- …appropriate to resolve claims . Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of ... Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is… more
- AIG (Atlanta, GA)
- …will also be responsible for adjusting a selection of the department's most complex claims , and collaborate with NA Aerospace Claim leaders, Global and NA ... Make your mark in Aerospace Claims Our Claims teams are the...aviation clients. How you will create an impact The Claim Manager - General Aviation is a key leadership… more
- AIG (Atlanta, GA)
- …Policies, US based adjuster licensing process and leading efforts on various Global Claim initiatives. You will have oversight of Claims Compliance activities ... collaboration with Key Stakeholders and business partners, develop and maintain Global Claim policies, standards, and controls ensuring Claims personnel have… more
- Travelers Insurance Company (Walnut Creek, CA)
- …appropriate to resolve claims . Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of ... expertise to assist in the resolution of highly complex claims . Mentor other Claim Professionals + Participate...of the nature and extent of injuries, periods of disability , and treatment needed. + WC Technical: + Advanced… more
- CVS Health (Austin, TX)
- …PST or CST time zone** **Pay $18.00 per hour** Reviews and adjudicates routine claims in accordance with claim processing guidelines. Critical success factors - ... identifies discrepancies, and applies all cost containment measures to assist in the claim adjudication process. Routes and triages complex claims to Senior … more
- WTW (Hartford, CT)
- …regarding claim analytics + Manage, organize, and retain insurance claims records (electronic files), submissions and other correspondence + Liaise between ... **Description** The Senior Claim Advocate at WTW serves as a resource...following: + General + Assist in the management of claims , with a particular focus on Environmental and Life… more
- The Hartford (San Antonio, TX)
- …others accomplish theirs, too. Join our team as we help shape the future. The Claim Specialist role is crucial for handling claims within the Major Case team, ... Specialist Claims - CH07DE We're determined to make a...and Life Science Elite. This position, being the highest claim handling designation within the Liability Major case team,… more
- AIG (Atlanta, GA)
- … by investigating and gathering information to determine the exposure on the claim ; ensure proactive claims handling aimed at the prompt and cost-effective ... + Strong technical expertise interpreting insurance contracts. + In depth knowledge of claim handling procedures, claims performance strategies, and claim … more
- The Hartford (Las Vegas, NV)
- …accountable for planning, recommending, and executing the investigation of workers' compensation claims . Our dynamic team of claim professionals provide superb ... customer service with the valuation, disposition and settlement of worker compensation claims while consistently adhering to our corporate claim settlement… more
- AIG (Atlanta, GA)
- Make your mark in Complex Claims . The AIG Workers' Compensation (WC) Major Case Unit (MCU) is a group of well trained and highly dedicated claim professionals ... with an average of 26 years WC claim handling experience. We take a collaborative approach in...a collaborative approach in handling large, complex, and catastrophic claims . Team members excel from sharing each other's strengths… more
- WTW (New York, NY)
- **Description** **The Role:** **The claim account manager will operate within significant coverage, reserve and settlement authority. They will develop customer ... centric claim handling guidelines and service expectations, coordinate and conduct...client meetings, assist underwriting in their renewal process, audit claims performance against best practices, and implement value added… more
- Axis (Chicago, IL)
- …for candidates taking part in the selection process. AXIS is seeking a Senior Claim Director, Specialty Complex Claims to join our North America Claims ... America Claims teams regarding coverage issues, coverage disputes and claim handling issues, time limited demands, emerging issues, including strategic direction… more
- Specialist Claims - CH07DESpecialist Claims CA - CH07DN We're determined to make a difference and are proud to be an insurance company that goes well beyond ... is a visible and important role within our Complex Claims Unit (CCU) Hartford Global Specialty (HGS) Claims...trials and mediations as necessary. + Contributing to broader claim and enterprise goals by participating in audits, projects… more
- AIG (Atlanta, GA)
- Senior Claims Analyst Severity, Excess Casualty At AIG, we are reimagining the way we help customers to manage risk. Join us as a Senior Claims Analyst Severity ... of the team. Make your mark in Excess Casualty Claims Our Claims teams are the proven...position in which you will evaluate a wrongful death claim in New York, an employment practices claim… more
- CVS Health (Nashville, TN)
- …Reinsurance, and/or RX claims ; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider ... amount level on customer service platforms by using technical and claims processing expertise. + Applies medical necessity guidelines, determine coverage, complete… more
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