- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Claims Review Representative makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer… more
- Sedgwick (Trenton, NJ)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to ... YOU AN IDEAL CANDIDATE?** Join our team as a Claims Representative focused on Property Damage and...and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations,… more
- Ryder System (Philadelphia, PA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position handles worker's compensation claims under Ryder's self-insured, self administered worker's comp program....to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Ryder System (Trenton, NJ)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Director Claims directs...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- NJM Insurance (Trenton, NJ)
- …extremely lucky to have had this excellent opportunity!" Overview NJM Insurance Group's Claims Analytics Department is seeking a Claims Insights Analyst Intern ... efficiency, reduce operational friction, and enhance customer experience. RESPONSIBILITIES: + Review and report on loss activity within assigned line of business.… more
- NJM Insurance (Trenton, NJ)
- …customer service was reaffirmed by the most recent JD Power Auto Insurance Claims Survey. The Claims Team is seeking an Appraisal Assignment Coordinator ... to Appraisers based on resources available and regional assignment rules. + Review appraisal requests for accuracy. + Assist Adjusters with questions and corrections… more
- Cardinal Health (Trenton, NJ)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Subaru of America (Camden, NJ)
- SUMMARY Join our team as a Technical Service Representative for Techline, where you'll play a pivotal role in supporting retailer technicians by providing expert ... and collaborating with departments like Customer Advocacy, Parts Information Coordinators, Claims , and more. This role offers opportunities to tackle special… more
- Highmark Health (Trenton, NJ)
- …position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist distribution. Interpret ... added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance. + Perform effective on-site visits… more
- Ryder System (Trenton, NJ)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- Highmark Health (Trenton, NJ)
- …for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more
- NJM Insurance (Trenton, NJ)
- …including pre-work such as audit program development and file selection, assuring the review process is proper and timely. + Conduct WC Claim audits to ensure ... process improvements, data integrity, compliance, and best practices. + Collaborate with claims management in the development of meaningful action plans that detail… more
- NJM Insurance (Trenton, NJ)
- The Paralegal for the General Claims Legal department provides paralegal support to in-house staff attorneys for claims -based legal matters, assists attorneys' ... of staff attorneys. The GC Legal Paralegal develops reports to aid General Claims leadership through the analysis and assembly of data provided from various sources,… more
- Stantec (Philadelphia, PA)
- …System selection to be based on Project/Client needs as well as proactive Claims /Risk mitigation. - Oversee and approve development and management of the Project ... Development and maintenance of the Project Risk Register, based on review of contract conditions, project-specific delivery requirements, client characteristics, and… more
- Otsuka America Pharmaceutical Inc. (Trenton, NJ)
- …maintain the effectiveness of Quality Systems for managing the batch record review and release process Quality Management Activities supporting all phases of ... compliance. + Manages reports and trends to the Management Representative to help in the preparation of Management reviews...above. + Improves supplier quality performance for batch record review and release process for OAPI GMP release of… more
- NJM Insurance (Trenton, NJ)
- …+ Triaging and analyzing scorecards and outputs from predictive models for General Claims , Personal Lines, Personal Injury Protection (PIP) claims and Medical ... to fraudulent Personal Lines and Commercial Lines policies and claims . + Conduct background research on available public databases...support the need for the escalation of the claim review . + Review NJM databases, retrieve NJM… more
- CVS Health (Trenton, NJ)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- Otsuka America Pharmaceutical Inc. (Trenton, NJ)
- …to support product development and regulatory submissions. + Author and review INDs, NDAs, and other regulatory submissions, ensuring accuracy, completeness, and ... wider clinical development plans. + Serve as early-stage CMC representative of the department in effectively communicating program related...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Highmark Health (Trenton, NJ)
- …and report improper coordination of benefit billing practices through paid clams review . + Participate as pharmacy representative in onsite member appeals ... medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior… more
- Pfizer (Collegeville, PA)
- …industry and healthcare environment, specifically with an understanding of healthcare claims data and its application to marketing optimization + We look ... for prior experience in media analytics, healthcare claims data, and HCP data, especially digital media, with an understanding of what type of data should be tapped… more