- Principal Financial Group (Des Moines, IA)
- **What You'll Do** Do you have a passion for and expertise in Paid Family Medical Leave claims ? If so, join Principal as a **Sr Paid Family Medical Leave ... ensure the efficient and compliant processing of paid family medical leave claims . This is an opportunity...field. + Consult and plan strategies for higher liability claims . + Review cases and formally audit… more
- Morley (CA)
- …case details? If so, this role could be a perfect fit for you! As a Legal Claims Analyst at Morley, you'll play a key role in managing small automotive claims ... to support the client's defense strategies, including lemon law claims + Serve as the "Person Most Knowledgeable" (PMK)...the time + Work in partnership with the California review team (located in Michigan), evaluating vehicle buyback requests… more
- Lyric (Newtown Square, PA)
- … editing solution, as a payment, reimbursement or medical policy analyst, medical claims processor, chart auditor/ reviewer , or claims edit/denial ... managing a team of high performing Clinical Managers and Medical Content Analysts. In this intricate role, the Senior...leadership skills to guide their team in delivering superior claims edits. The Senior Manager will meet regularly with… more
- Premera Blue Cross (Mountlake Terrace, WA)
- … medical policy changes, and coding changes. + Research and interpret medical claims utilization and program participation. Present findings to internal ... Coding Administrator_** will focus on identifying and coordinating appropriate codes to support claim system edits that direct payment of medical services. This… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …accurate adjudication of claim for reimbursement. They will process claims correctly following contractual arrangements the Medical Practice Foundation (MPF) ... not limited to; Commercial, Medi-Cal and Managed Care professional claims . This position is responsible checking status of unpaid...resolve a denial following our guidelines, they will forward claim on to leadership for further review … more
- Rady Children's Hospital San Diego (San Diego, CA)
- …flags to ensure clean claim submission. This position is responsible for pulling medical records to submit with claims and appeals as required by payors. ... the Billing & Collections Rep I is responsible to review and process charges via our EMR system. They...of the service. The incumbent completes daily processing of claim edits or rejected claims processed through… more
- GCI Communication Corp (Anchorage, AK)
- …employee records, assisting with HR help desk inquiries, and coordinating claims , reporting, and administrative processes that ensure compliance, consistency, and ... and attach to case files. + Keep stakeholders informed of dependencies (eg, claim docs needed before payroll action). + Analyze administrative workflows to identify… more
- Stony Brook University (East Setauket, NY)
- …but are not limited to:** + Develops staff work listing logic/strategy and claims resolution work flows. + Educates and trains new staff regarding departmental/unit ... programs and evaluations, scheduling and timesheets. + Analyzes and identifies claim payment issues, patterns, and root cause; tracks and pursues un-timely,… more
- Terumo Medical Corporation (Somerset, NJ)
- Sr. Medical Writer Date: Nov 18, 2025 Req ID:...risk and benefits of Terumo devices. + Create and/or review product claims based on the existing ... 5154 Location: Somerset, NJ, US, 08873 Company: Terumo Medical Corporation Department: Scientific Data & Communication **Job Summary** Combining knowledge of science… more
- Terumo Medical Corporation (Somerset, NJ)
- …asset review process + Develop, plan, and execute Professional Medical Education HCP programs, including identifying educational needs, and development of ... Professional Medical Education Manager Date: Nov 15, 2025 Req...execute contractual agreements with proctors to teach courses. + Review course curriculum and assist in developing new and… more
- Caris Life Sciences (Irving, TX)
- …companies. This role involves following up with insurance companies to check claim status, reviewing medical records request and submitting required ... documentation to payors. **Job Responsibilities** + Review insurance denials and take appropriate action....claims status via phone or poral. + Submit Medical Records upon request and follow up on submission.… more
- SanDisk (Milpitas, CA)
- …and Reporting teams and business partners from BU Finance, Sales Operations, Claims Settlement and IT teams. ESSENTIAL DUTIES AND RESPONSIBILITIES: + Manage the ... calculation and review of program reserves and oversight over the month...enhancement projects for our program reserves + Approver and reviewer of SOX controls and internal and external PBC… more
- Lyric (Newtown Square, PA)
- … medical insurance claim overpayments through recovery (40%) + Review claims for missing or incomplete information, calculate payment, or validation ... programming/queries, as well as advanced excel experience + 1+ Years' experience auditing medical claims to identify improper payments as a Payment Integrity… more
- Stony Brook University (East Setauket, NY)
- …include the following, but are not limited to:** + Prepare and submit hospital claims . Review denials. Investigate coding issue. Audits. + Follow-up on rejected ... and collection agencies. + Identify issues and patterns with claims /insurance companies and review to increase revenue...preferably in a healthcare setting such as revenue cycle, medical billing, or follow-up experience;OR in lieu of degree,… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …other contractual exclusion, or network structure. + Use clinical expertise to support claims review decisions, including level of care, pricing and complexity ... + Participate in the development, annual review , and approval of company medical review criteria as a member of the Premera Medical Policy Committee. +… more
- Sun Pharmaceuticals, Inc (Princeton, NJ)
- …signed are accurately reflected in Vistex agreement management platform 1. **Open Claims /Chargeback Team Lead:** _Manage end-end review and co-ordination of open ... required (by customer), in collaboration with Sales directors, to review and approve claims in a timely...setup, Direct & Indirect Contracts setup, customer rates updates, claim and settlement validation. 1. **Annual Sales Budget Team… more
- Rady Children's Hospital San Diego (San Diego, CA)
- …Include: Answering calls from provider offices and members of the medical group Performing PCP assignment updates Providing or scheduling translation services ... processing Researching and responding to provider calls regarding authorization or claim payment status Any other questions they may have Skills Required:… more
- Parexel (Charleston, WV)
- …Accountabilities: Leadership - Leads cross-functional teams to draft agreed-upon scientific/ medical content that addresses data interpretation, product claims , ... - Follows directions, templates, and structured processes for delivering documents for review and finalization - Participates in Medical Writing department… more
- Sun Pharmaceuticals, Inc (Princeton, NJ)
- …error-free and loaded correctly in operational systems (document anomalies as appropriate). Review , process and validate all claims , administrative fees and ... internal/external customers to resolve outstanding disputes in a timely manner. Provide claim processing reports and metric tracking statistics to management on a… more
- BWX Technologies, Inc. (Erwin, TN)
- …scheduling and performing FFD testing, recordkeeping, and follow-up with the FFDC & Medical Review Officer. 7. Assist the Emergency Services Unit Manager in ... of Energy and NASA facilities. BWXT's technology is driving advances in medical radioisotope production in North America and microreactors for various defense and… more
