- Novo Nordisk Inc. (Plainsboro, NJ)
- …Are you ready to make a difference? The Position The Associate Director , Research Partnerships (RP) is responsible for developing and executing Real-World Evidence ... with the Evidence Generation Plan (EGP). Externally, the Associate Director RP will be the lead for research within...focus on pharmaceutical research Strong knowledge of health care systems in the US, real-world data sources and analytical… more
- AIG (Atlanta, GA)
- …+ Developed computer proficiency with an aptitude for both common and specialized claims systems programs and applications. + Self-motivated, ability to manage ... manage risk. Join us as a North American Aerospace Claims Complex Director Severity to play your...serves as a technical referral point for NA Aerospace claim team members and will collaborate with NA Aerospace… more
- MTA (New York, NY)
- …Claim Agents and Senior Claim Agent staff in absence of Asst. Director & Director - Claims & Investigations, attend management meetings, participate in ... 657 DEPT/DIV : Legal and Compliance SUPERVISOR : Assistant Director Claims & Investigations LOCATION : 2...experts, special investigation experts). + Enable the facilitation of System Safety investigations by providing claim investigation… more
- Banner Health (Tucson, AZ)
- …APR DRG recovery, and TPL recoveries. This position works closely with IT to implement claims systems edits to reduce overpayments and increase claims auto ... by offering remote and hybrid work settings. As a Director , Claims Recovery Unit, you will lead...concepts not yet implemented within the organization to reduce claims overpayments within the claims system… more
- Travelers Insurance Company (Hartford, CT)
- …providing timely, accurate, and actionable information to all stakeholders. As a Director , Accounting, you will be responsible for ensuring timely and accurate books ... training, and mentoring on accounting and controls to business partners and Claim Finance. + Compile, review, and analyze complex financial data for variance… more
- Apex Health Solutions (Houston, TX)
- S ummary: Position is responsible for overall strategy and effectiveness of Claims Operations. Position is responsible for oversight of claims adjudication and ... also responsible for the timely processing and accuracy of claims and day to day interactions with any vendor...revenue impacting performance or delivery issues within core business systems as assigned through the creation of remediation plans;… more
- HUB International (Wilmington, MA)
- …process on new prospective clients. + Other responsibilities as assigned by the claims director . **Qualifications:** + BA or equivalent work experience. + ... Technical Manager** . The selected employee reporting to the Director of Claims is responsible for working...Acts as an intermediary between HUB and the insurers claims staff. + Schedule and coordinate claim … more
- Alight (SC)
- …vision and managing execution for Alight's Disability and Absence Management Claim Service. Accountable for defining, developing, implementing, and leading all ... aspects of Alight's STD & Absence Management claim operations. **Responsibilities** + Leading LOA, STD, ADA, and/or LTD claims service teams. It may also involve… more
- Molina Healthcare (KY)
- …Establishes and maintains benefits, provider contracts, fee schedules, claims edits, and other system settings in the claim payment system . * Directs the ... and maintenance of member benefits in the claims payment system and other applicable systems . **Business Acumen/Collaboration/Communication** * Supports… more
- AIG (New York, NY)
- Join us as a Senior Complex Claims Director - Cyber, Media, & Technology to grow your experience in Claims . Make your mark in Claims Our Claims teams ... you will create an impact As a Senior Complex Claims Director , you will be responsible for...preferred + Knowledge or experience in computer network and systems security or information security is a plus Ready… more
- Scripps Health (San Diego, CA)
- …quarter of our employees have been with Scripps Health for over 10 years. The Director of HMO Payment ( Claims ) Services for Scripps Health Plan, leads claims ... * Mailroom experience. **Job:** **Finance* **Organization:** **Scripps Health Corp* **Title:** * Director , HMO Claims Services* **Location:** *Central San Diego… more
- Elevance Health (Atlanta, GA)
- **Business Change Director - Claims /Payment Integrity Use-Case Lead** **Location:** This position will work a hybrid model (remote and office). Ideal candidates ... live within 50 miles of a PulsePoint location. The **Business Change Director - Claims /Payment Integrity Use-Case Lead** is responsible for collaborating with… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …Healthsource blog: https://healthsource.premera.com/ . We are seeking an experienced and dynamic ** Claims Operations Director ** to join our team and oversee our ... role in enhancing the quality and efficiency of our claims processes. In this capacity, you will lead a...Experience with quality and production management tools, strategies, and systems . + Experience in related business areas of sales,… more
- AON (IL)
- …initiatives. This role involves collaborating closely with our Third-Party Administrator (TPA), Director of Global Claims , Broker, Hotels, Legal and other ... summarizing findings, identify patters, risk exposures, emerging trends and recommendations to Director of Global claims and various leadership groups. +… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- MTA (New York, NY)
- …the effective and efficient management of claim information input into the Claims database system and accurate and timely management and processing of the ... follow-up to ensure payments are timely made. + Assist Claim adjuster and Claims secretaries as necessary,...tasks and functions at the direction of Asst. and/or Director - Claims & Investigations. + Tendering of … more
- University of Utah Health (Murray, UT)
- …team environment. + Performs routine and complex audits on phone calls and claims adjudication. + Researches claim processing problems and errors to determine ... customer service to members, providers, billing departments, and other insurance companies regarding claims . + Documents phone calls in system and follows up on… more
- Acosta Group (Charlotte, NC)
- …property and casualty risk management programs with an emphasis on Workers' Compensation claims . In addition to providing technical claim support and monitoring ... management efforts. + Provide data input and maintain claims administrator and RMIS system comments and...Windows environment, Word, Excel, software and use of on-line claims data systems . + Ability to learn… more
- GuideOne Insurance (Dallas, TX)
- …letters, disclaimers of coverage and reservation of rights letters. + Maintains effective claim file documentation and diary system . Monitor diary to achieve ... As a Commercial Casualty Claims Adjuster, you will serve as a real...you. Accountabilities: + This position handles Commercial General Liability, Director 's & Officer Liability, Employment Practices Liability, Commercial Auto… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... on financial ability and forecasting for small to large Operations Management + Collaborate system and data configuration into CES ( Claims Editing System )… more
