- Eisai, Inc (Nutley, NJ)
- …This role will report into the Director, Government Pricing and Contract Operations and collaborate across all functions. Essential Functions Lead the Contract ... Operations team ensuring timely and accurate review and processing of claims .Serve as a subject matter expert supporting internal and external business partners… more
- Merck & Co. (Rahway, NJ)
- …Quantitative Sciences team uses big data to analyze the safety and efficacy claims of our potential medical breakthroughs. We review the quality and reliability of ... in face-to-face meetings, then your employment may pose an undue burden to business operations , in which case you may not be offered employment, or your employment… more
- Medina Center for Rehabilitation (Valley City, OH)
- …current changes. - Coordination - Interacts with Medicare, Managed Care and Medicaid claims review unit and compliance unit to assist facilities in complying with ... and documentation. - Assists in review and preparation of denied claims or administrative record reviews by outside intermediaries. Monitoring -Completes and… more
- Wells Fargo (San Antonio, TX)
- **About this role:** Wells Fargo is seeking a **Fraud & Claims Operations Director** in the Claims Assistance Center as part of the Fraud & Claims ... www.wellsfargojobs.com . Wells Fargo Consumer Operations is seeking a Fraud & Claims Operations Director to report to the Head of Claims and Recovery.… more
- Centene Corporation (Tampa, FL)
- …of Claims . Set the strategic vision and objectives of the claims operations to drive innovation, higher operational performance and quality outcomes. ... degree preferred. 10 years of experience in overseeing and developing claims operations , preferably in a managed care and/or Medicaid setting. Previous… more
- USAA (Phoenix, AZ)
- …of what makes us so special! **The Opportunity** We are seeking a dedicated Manager, Claims Operations , to lead a team of entry level Auto Adjusters. This team ... Auto Non-Injury Claims . In this role you will lead auto claims operations member service employees who are responsible for serving our members, and providing… more
- USAA (San Antonio, TX)
- …P&C Claims . Manages and is accountable for auto, property, and other claims operations member service teams who are responsible for delivering business ... members and providing appropriate solutions in auto, property and other claims operations through their teams. + Consistently coaches managers on leading their… more
- Wells Fargo (Roanoke, VA)
- **About this role:** Wells Fargo is seeking a Senior Fraud & Claims Operations Representative in the Detection Operations - F&C as a part of Consumer & Small ... wellsfargojobs.com . **In this role, you will:** + Support fraud and claims functional area by proactively identifying opportunities to improve customer experience,… more
- Concord Group Insurance (Bedford, NH)
- Our position of Claims Operations Supervisor is responsible for supervising and coordinating activities within an assigned Claims Division area. This also ... includes the responsibility of involving the products or services of the Company by working individually or through associates. Work is performed independently. Responsibilities + Make suggestions and recommendations as to the hiring, termination, advancement,… more
- Crawford & Company (Lake Zurich, IL)
- Excellence In Everything We Touch Position Summary Under the general direction of the Claims Data Operations Manager, the Senior Claims Analyst provides a ... to appropriate lockbox + Provides backup coverage to others in Claim Operations as needed and/or requested. + Maintains professional and positive relationship with… more
- Santander US (East Providence, RI)
- Director, Claims & Fraud Operations East Providence, United States of America USA Job Family Description: Responsible for the day-to-day operations of the ... translate them into operational implications for the company. The Director of Claims & Fraud Operations will lead a fraud operations support function with… more
- AmeriHealth Caritas (Manchester, NH)
- **Provider Network Operations Claims Analyst Sr (hybrid)** Location: Manchester, NH Primary Job Function: Provider Network ID**: 34151 **Job Brief** The Provider ... Network Operations Data Analyst Sr. will be responsible for supporting...reviews requests prior to initial submission to EO and claims post-production + Capitation reconciliations - building queries, comparing… more
- Crawford & Company (Lake Zurich, IL)
- …+ Candidates must be residing within Lake Zurich! Under the general direction of the Claims Data Operations Manager, the Claim Sys Ops Analyst provides a variety ... claim system changes and developments that impact the Claim System/ Operations area + Provides backup coverage to others in...area + Provides backup coverage to others in Claim Operations as needed and/or requested. + Upholds the Crawford… more
- USAA (San Antonio, TX)
- …+ Apply data analytics, in partnership with actuary and analytics team and Claims Operations leaders, reports on team health to drive business results, ... leadership experience + Experience applying advanced knowledge to partner with Claims Operations and provide guidance for complex claim settlements that mitigate… more
- Axis (Princeton, NJ)
- …and teamwork involving core operating functions (eg, reinsurance and insurance claims management, claims operations , technical accounting, underwriting, ... Description** AXIS is seeking a **Head of A&H** **Reinsurance** ** Claims ** to join our Global Reinsurance Claims ...review and validation + Managing costs and continuously improve operations . + Engaging in the health benefits industry to… more
- Randstad US (Corvallis, OR)
- …a talented individual with robust management experience to oversee and enhance our claims operations . This hybrid role requires onsite presence in Corvallis 2-3 ... healthcare claims manager - perm opportunity. + corvallis ,...days weekly, ensuring accurate and timely claims processing, mentoring a dedicated team, and driving the… more
- USAA (Phoenix, AZ)
- …Owner I** that will support Medicare Supplement Claims for USAA Life Company Claims Operations . This employee will report to the Life Company Chief Claims ... & Fraud Officer and will work on Medicare Supplement Claims activities and ensure a flawless execution of business-related processes, procedures, oversight and… more
- Magellan Health Services (Maryland Heights, MO)
- Provides support to Claims Operations by investigating and resolving systemic issues relative to claims processing system files and interfaces for ... in testing and documenting of account specific benefits to ensure accurate claims adjudication. The position assists in ensuring system performance and resolution of… more
- Citizens (Medford, MA)
- …Fraud Claims Sr. Specialist, you'll play a pivotal role in our Fraud and Claims Operations group, one of our most critical departments at Citizens. Our team ... use critical thinking skills to assist customers with existing claims and determine the best next step for the...in the banking industry, including an understanding of banking operations , compliance, and customer service best practices. + Workflow… more
- CVS Health (High Point, NC)
- …Responsible for the overall supervision of Claim Processing employees. Achieve superior service performance through an integrated process of operational, quality, ... medical cost and resource management tools and applications; meeting and/or exceeding department and company goals. Fundamental Components: - Develop, train, evaluate and coach staff to provide cost effective claim review/processing and claim service while… more
