• Merck & Co. (North Wales, PA)
    …/ analytical techniques in the role - - Experience working with pharmaceutical/ healthcare claims , personal & non personal promotional data. - Minimum ... PowerPoint. - Preferred (but not required ): Prior Consulting , Pharmaceutical , Healthcare and/or Oncology Experience - Prior hands - on experience working with… more
    HireLifeScience (10/24/24)
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  • Daiichi Sankyo, Inc. (Bernards, NJ)
    …reimbursement assistance and expanded use programs, PIE, FDAMA 114 and healthcare economics initiatives) on an as-needed basis.- Liaise with Government Affairs ... partners and stakeholders on key policies, procedures, practices and requirements for healthcare and related legal compliance and educate clients and partners about… more
    HireLifeScience (11/02/24)
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  • Eisai, Inc (Louisville, KY)
    At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care ... the PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state… more
    HireLifeScience (10/19/24)
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  • Eisai, Inc (San Francisco, CA)
    At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care ... the PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state… more
    HireLifeScience (10/17/24)
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  • Eisai, Inc (Los Angeles, CA)
    At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care ... the PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state… more
    HireLifeScience (09/19/24)
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  • HealthCare Claims Intelligence…

    CGI Technologies and Solutions, Inc. (Knoxville, TN)
    ** HealthCare Claims Intelligence Engineer** **Category:** Analytics and Emerging Digital Technologies **Main location:** United States, Tennessee, Knoxville ... (ML), data analysis, Business Intelligence and Data Visualizations to streamline the claims processing, Payment Integrity and healthcare analytics systems. This… more
    CGI Technologies and Solutions, Inc. (10/08/24)
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  • Healthcare Claims Denials Specialist

    CenterWell (Topeka, KS)
    …caring community and help us put health first** As an **Accounts Receivable Specialist/ Healthcare Claims Denials Specialist** , you will: + Ensure the ... High School Diploma or the equivalent + Minimum of two years medical claims processing experience + Knowledge of healthcare collection procedures and… more
    CenterWell (10/30/24)
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  • Healthcare Medical Claims Coding Sr.…

    Commonwealth Care Alliance (Boston, MA)
    …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will ... be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and...Degree Required Experience (must have): + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+… more
    Commonwealth Care Alliance (10/17/24)
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  • Patient Account Representative - Healthcare

    Guidehouse (San Antonio, TX)
    …/ business setting. **What Would Be Nice To Have** **:** + Has active understanding of healthcare claims appeal process + UB-04 / CMS 1500 background + PC skills ... You Will Need** **:** + High School Diploma/GED or 3 years of relevant healthcare and/or business experience in lieu of High School Diploma/GED. + 0-2+ years… more
    Guidehouse (10/06/24)
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  • General Liability Claims Manager,…

    Providence (NM)
    …we must empower them._** **Providence Health Plan is calling a General Liability Claims Manager, Healthcare who will:** + Be responsible for day-to-day oversight ... of general and professional liability claims in accordance with the System's claims ...+ General Liability Legal Experience (EG Paralegal, Etc.) + Healthcare Risk Management + General Risk Management + Insurance… more
    Providence (10/05/24)
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  • Claims Complex Director - Healthcare

    AIG (Jersey City, NJ)
    Claims Complex Director - Healthcare Professional Liability (HPL) Join us as a Claims Complex Director to take on key responsibilities within a world-class ... create an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability ("HPL") Claims Department of General… more
    AIG (10/03/24)
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  • Claims And Billing Specialist…

    TEKsystems (Cary, NC)
    …for handling inbound and outbound calls to primary providers and insurance to process claims and resolve any healthcare billing issues. The ideal candidate is a ... our patients, clinicians, and clients. Essential Duties and Responsibilities + Performs healthcare information & medical claims processing, healthcare more
    TEKsystems (10/31/24)
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  • Claims Analyst / Claims Adjuster

    Hartford HealthCare (Hartford, CT)
    …Summary:* Manages a robust caseload, from inception to closure, of Hartford HealthCare 's claims and suits through HHC's Legal Department. Responsible to ... Listener who can exhibit empathy to claimants . Demonstrated history of proactive claims management . Demonstrated knowledge of the healthcare and insurance… more
    Hartford HealthCare (10/21/24)
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  • Medical Biller - Healthcare Claims

    Guidehouse (Lewisville, TX)
    …billing, secondary billing, and payer audit follow-up for government and non-government claims . Must work with other departments to facilitate the meeting of both ... Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides...GED. + 0-2+ years working within the following sectors: healthcare , insurance, business, finance or customer service. + Working… more
    Guidehouse (09/01/24)
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  • Healthcare Claims Specialist

    BrightSpring Health Services (Oklahoma City, OK)
    …of patients nationwide through our growing network of branches and healthcare professionals. The Adjudication Specialistwill be responsible for all aspects of ... pharmacy and medical claims adjudication, accuracy of pharmacy and medical claims...Pharmacy + 1+ years pharmacy experience + Pharmacy or healthcare -related knowledge + Knowledge of pharmacy terminology including sig… more
    BrightSpring Health Services (09/06/24)
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  • Patient Account Representative - Healthcare

    Guidehouse (San Antonio, TX)
    …GED. + 0-2+ year's experience in office, business, operations, customer service or healthcare field. **What Would Be Nice To Have** **:** + Knowledge and utilization ... of desktop applications to include Word and Excel is essential for job responsibilities. + Ability to initiate and follow through on projects and work independently with minimal supervision. + For insurance specific clients: 1+ year medical provider experience… more
    Guidehouse (11/03/24)
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  • Claims Examiner

    State of Connecticut, Department of Administrative Services (Hartford, CT)
    …documents from Probate Court, divorce decrees, third-party contracts, bankruptcy documents, healthcare claims , or similarly complex documents). Conclusion AN ... Claims Examiner Recruitment # 241007-1979CL-001 Location Hartford, CT Date Opened 10/24/2024 10:00:00 AM Salary $55,248.00 - $72,247.00/year (Employees new to state… more
    State of Connecticut, Department of Administrative Services (10/25/24)
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  • Claims Processor (Remote)

    System One (Fairfax, VA)
    ALTA IT Services is staffing a contract to hire opportunity for a Healthcare Claims Processor to support a leading health insurance customer. The individual will ... review and adjudicate paper/electronic claims , also use automated system..., also use automated system processes to send pending claims to ensure accurate completion according to medical policy,… more
    System One (09/05/24)
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  • Lead Product Owner - Claims (Remote)

    Commonwealth Care Alliance (Boston, MA)
    …including the MHK Market Prominence platform. **Knowledge, Skills & Abilities Required:** ** Healthcare Claims ** Strong knowledge of healthcare claims ... a related field **Education Desired:** Master's degree in computer science, Healthcare , Data Science, Business Administration **Experience Required:** + 5+ years'… more
    Commonwealth Care Alliance (09/15/24)
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  • SCA Claims Processor I

    Elevance Health (East Syracuse, NY)
    …past five years._** **Preferred Skills, Capabilities and Experiences:** + Experience with healthcare insurance claims processing highly preferred. + Strong data ... **SCA Claims Processor I** **Location(s):** **_This is a virtual...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
    Elevance Health (10/25/24)
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