- Sedgwick (Raleigh, NC)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Liability Claims Representative | Remote Are you looking for an ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...OF THE ROLE:** To analyze mid-level Commercial General Liability claims on behalf of our valued clients to determine… more
- Ryder System (Raleigh, NC)
- …small to medium 3rd party property damage and cargo claims under Ryder's self-insured, self-administered liability program. **ESSENTIAL FUNCTIONS** Investigates, ... to medium exposure 3rd party property damage and cargo claims pursued against Ryder Ensures the most appropriate and...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Humana (Raleigh, NC)
- …a part of our caring community and help us put health first** The Pharmacy Claims Representative assists local pharmacies with claims adjudication to support ... & LTC hospice patients and reconcile historic billing issues. **Location: Remote US** **Shift: Monday-Friday 2:30pm-11pm EST. Flexibility to work alternating… more
- Concentrix (Raleigh, NC)
- Job Title: Seasonal Customer Service Representative - Remote (Healthcare) Job Description **JOB DESCRIPTION** The Customer Service Representative - Remote ... and " **Best Companies for Career Growth** " awards every year? Then a remote Customer Service Representative (Healthcare) position at Concentrix is just the… more
- UNC Health Care (Chapel Hill, NC)
- …of complex duties, including but not limited to, working outstanding insurance claims having no response from payors, having claim edits, and/or having received ... at acceptable aging levels by prompt follow-up of unpaid claims and denied claims . Review credit balances...determined by experience and internal equity Work Assignment Type: Remote Work Schedule: Day Job Location of Job: US:NC:Chapel… more
- Prime Therapeutics (Raleigh, NC)
- …decision we make. **Job Posting Title** Sr Data and Reporting Analyst - Remote **Job Description** The Senior Data & Reporting Analyst is responsible for supporting ... levels of leadership within the organization, acting as a representative of the broader Reporting and Analytics team +...experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data… more
- United Therapeutics (Raleigh, NC)
- …the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine ... to the Food Drug and Cosmetic Act, the False Claims Act, Anti-Kickback Statute, the Sunshine Act and other...healthcare related laws and regulations + Serve as Legal representative on the Company's promotional review committee, including review… more
- HealthEdge Software Inc (Raleigh, NC)
- …implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior ... level role in analyzing claims data, as well as translating contract terms, policies,...permanent **Work Environment:** The physical demands described here are representative of those that must be met by an… more
- HealthEdge Software Inc (Raleigh, NC)
- …and QE. We have divided our product teams into Value Streams (ie, Claims , Billing & Financials, Enrollment, BlueCard, Integration, and Platform). Each Value Stream ... integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a… more
- HealthEdge Software Inc (Raleigh, NC)
- …issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite ... of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working...None **Work Environment:** The physical demands described here are representative of those that must be met by an… more
- HealthEdge Software Inc (Raleigh, NC)
- …root-cause issues areidentifiedand addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete ... and deliver excellent software and services to our customers._ **Geographic Responsibility:** Remote but ideal candidate would live within the driving distance to… more
- HealthEdge Software Inc (Raleigh, NC)
- …solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a ... permanent **Work Environment:** The physical demands described here are representative of those that must be met by an...Work across multiple time zones in a hybrid or remote work environment. + Long periods of time sitting… more
- UNC Health Care (Morrisville, NC)
- …the auditors and negotiates with the auditor, his supervisor as the representative for UNCHCS provider (hospital, skilled nursing facilty, etc.) 3. Coordinates the ... complex databases from finance, payroll, accounts payable and the Federal and State claims databases to compile the Medicare, Medicaid and Tricare cost reports while… more
- Humana (Raleigh, NC)
- …managed care organizations, as well as state and federal employees. **WORK STYLE:** Remote /work at home with Up to 10-15% travel (local, regional, national) will be ... investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated formal or informal people management + Excellent PC… more