- Merck & Co. (North Wales, PA)
- …data leveraging advanced statistical techniques from disparate databases or sources ( claims data, EMR/EHR, lab, and other sources) to drive optimization and ... pharmaceutical landscape.Expertise in mining and analyzing secondary real-world evidence data ( claims data, EMR/EHR, lab, etc.) and proven record of being able… more
- Merck & Co. (North Wales, PA)
- Job DescriptionResponsibilities:Utilize big data to analyze the safety and efficacy claims of potential medical breakthroughs.Review the quality and reliability of ... including resource forecasting.Coordinate the activities of a global programming team that includes outsourced provider staff.Requirements: Master's degree or… more
- Genmab (Plainsboro, NJ)
- …purpose. As our Associate Director, you must effectively implement Signal Management Group surveillance strategies for proactive and systematic detection and ... data, international regulatory safety databases, and other data sources, eg, claims and electronic medical records. This position develops and implements… more
- Staffing Now (Princeton, NJ)
- …drafting answers and pleadingsReview all evidence documentsCommunicate and discuss case claims with clientsPrepare and conduct court appearances, ... the ability to multitask & work with minimum supervisionMust experience with case management software., SmartAdvocate a plusBilingual English/Spanish is a plus… more
- Sedgwick (Trenton, NJ)
- …; to provide resolution of highly complex nature and/or high exposure surety claims ; to coordinate case management within Company standards, industry ... + Identifies and investigates for possible fraud, subrogation, contribution, recovery, and case management opportunities to reduce total claim cost. + Represents… more
- UMB Bank (Trenton, NJ)
- …managing fraud dispute claims . + Continually evaluate the effectiveness of the case management process. + Validate both UMB and vendor performance and ... This role will also assist with the oversight and management of third-party card fraud claim vendors and ongoing...reporting. Responsibilities will include: + Manage a card fraud claims team . + Oversee third-party vendors and… more
- NJM Insurance (Trenton, NJ)
- NJM's Workers' Compensation Claims Team is seeking an experienced Complex Claim Specialist. This is a full-time position and offers a hybrid schedule after ... to work opportunities under the regular guidance of Complex Claims Supervisor + Ensure quality management of...documentation of claim activity + Collaborate with the Nurse Case Manger (NCM) to resolve issues and authorize quality… more
- Sedgwick (Trenton, NJ)
- …Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Workers Compensation Complex Claims Advisor | Remote **This job will support workers' compensation for ... and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directs the… more
- Subaru of America (Camden, NJ)
- …the management of warranty, recall, and SAS (extended warranty) claims through comprehensive financial and management reporting, analysis, and accounting ... their unique perspectives and talents to the table. Our team members are driven by a common goal: to...tasks and special projects as required. + Contributes to Claims , Enterprise Performance Management (EPM), and Enterprise… more
- Zurich NA (Trenton, NJ)
- … Claims Professional Attorney 113452 Zurich North America is hiring an Surety Senior Claims Professional (Attorney) to join our team ! **We are open to hiring ... role, you will manage a caseload of moderate to high complexity Surety claims from start through settlement and resolution, and within specific authority limits. You… more
- Lincoln Financial Group (Trenton, NJ)
- …Role at a Glance** We are excited to bring on a highly motivated **Group Claims Specialist** to support our ever-growing claims organization in a work from home ... west coast employer groups. _Background details_ As a Group Claims Specialist, you will support our Short Term Disability...be successful. If you enjoy working in a fast-paced, team -oriented environment from the comfort of your own home,… more
- CVS Health (Trenton, NJ)
- …themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical ... care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible...in meeting goals and objectives, presents cases at interdisciplinary case conferences * Utilizes case management… more
- CVS Health (Trenton, NJ)
- …themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical ... care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible...in meeting goals and objectives, presents cases at interdisciplinary case conferences + Utilizes case management… more
- Sunrun (Trenton, NJ)
- …through our commitment to diversity, inclusion and belonging. **Overview** The O&M Case Manager is responsible for coordinating effective execution of field service ... or branch relationships including weekly/monthly reviews, utilization and workload management , process updates and identification and resolution of specific market… more
- Cardinal Health (Trenton, NJ)
- …* Track any payer/plan issues and report any changes, updates, or trends to management * Search insurance options and explain various programs to the patient while ... reporting any payer issues by region with the appropriate team * As needed conduct research associated with issues...practices, preferred * 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience * 1-2 years… more
- Cardinal Health (Trenton, NJ)
- …+ Track any payer/plan issues and report any changes, updates, or trends to management + Search insurance options and explain various programs to the patient while ... reporting any payer issues by region with the appropriate team + As needed conduct research associated with issues...practices, preferred + 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience + 1-2 years… more
- Guardian Life (Trenton, NJ)
- …worksite modifications and transitional work plans to help return claimant to employment. Case management of part-time work claims to increase full-time ... attitude. You can collaborate with stakeholders to provide effective case management within the boundaries of contractual...Serve as educational resource on vocational rehab aspect of claims . Educate parties involved in claim management … more
- Church & Dwight Co., Inc. (Ewing, NJ)
- …Government investigations and administrative charges. + Drive cost-effective methods for efficient case management through early case assessments, focused ... and collaboration. Knowing we have an open and supportive team means each of us has the freedom to...defense and/or prosecution of assigned Company litigation and legal claims - eg, commercial, product liability, personal injury and employment… more
- PPL Corporation (Allentown, PA)
- …commitments to ensure all deliverables are met to scope, schedule, and budget. Team player capable of working with management , project controls, and contractors. ... prompt resolution of contractor issues and change order submittals, including analyzing claims and disputes, and subsequently consults with management to… more
- University of Pennsylvania (Philadelphia, PA)
- …Associate General Counsel Job Description Summary Collaborates with Senior Counsel in management of all medical malpractice claims involving the Health System ... Management and advice to Health System physicians and staff on risk management -related issues, and makes educational presentations on claims and risk … more
