- Sedgwick (Trenton, NJ)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr . Claims Specialist , Medical Malpractice (LTC) **PRIMARY PURPOSE** ... : To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to… more
- NJM Insurance (Trenton, NJ)
- NJM is seeking a Workers' Compensation (WC) Claims Specialist (I/II/ Sr .) . This is a full-time position and offers a hybrid schedule after training with a ... another day in our West Trenton office. The WC Claims Specialist will be responsible for contacting...internal and external stakeholders, including: NJM policyholders, injured workers, medical providers, the NJM Medical Claims… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …member of Ward's Top 50 and rated A++ by AM Best. We are looking for a Sr . Claims Specialist to join our team! Summary: Investigate, evaluate and settle more ... complex first and third party insurance claims . A typical day will include the following: Communicates with all relevant parties and documents communication as well… more
- CVS Health (Trenton, NJ)
- …And we do it all with heart, each and every day. **Position Summary** The ** Senior Claims Benefit Specialist ** will review and adjust SF ( _self-funded_ ... amount levels on customer service platforms, specifically by using technical and claims processing expertise. + Apply medical necessity guidelines, determine… more
- CVS Health (Trenton, NJ)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Gilead Sciences, Inc. (Philadelphia, PA)
- …will improve the lives of patients with life-threatening illnesses worldwide. As a Senior Field Activation Specialist within Gilead's HIV Prevention team, you ... with local cross-functional colleagues (Prevention Specialists, Community Liaisons, Market Access, Medical Scientists, and other field team members) to ensure a… more
- Highmark Health (Trenton, NJ)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... questionable claim patterns of renewal clients and issues with competitor's claims experience for prospect clients and develops recommendations to account for… more
- Highmark Health (Trenton, NJ)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses ... of financial exhibits. This is an entry level position, with oversight by Senior Underwriters and/or Management until the individual is acclimated to the Company… more