- Sedgwick (Trenton, NJ)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative | Auto | Remote Are you looking for an opportunity to ... YOU AN IDEAL CANDIDATE?** Join our team as a Claims Representative focused on Property Damage and...and commercial lines policies and endorsements + Ability to review and assess Property Damage estimates, total loss evaluations,… more
- Ryder System (Philadelphia, PA)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position handles worker's compensation claims under Ryder's self-insured, self administered worker's comp program....to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Ryder System (Trenton, NJ)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The ... Director Claims directs...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- Ryder System (Trenton, NJ)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... position supervises adjusters and directly handles claims within Ryder's self-insured, self-administered liability program. Oversees claim-handling processes… more
- St. Luke's University Health Network (Allentown, PA)
- …RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to assure ... care for appropriate reimbursement. + Work with the physician advisor in review of patient medical records identified by RAC/MIC/QIO and other governmental or… more
- NJM Insurance (Trenton, NJ)
- …including pre-work such as audit program development and file selection, assuring the review process is proper and timely. + Conduct WC Claim audits to ensure ... process improvements, data integrity, compliance, and best practices. + Collaborate with claims management in the development of meaningful action plans that detail… more
- Highmark Health (Trenton, NJ)
- …for the implementation of effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the… more
- NJM Insurance (Trenton, NJ)
- The Paralegal for the General Claims Legal department provides paralegal support to in-house staff attorneys for claims -based legal matters, assists attorneys' ... of staff attorneys. The GC Legal Paralegal develops reports to aid General Claims leadership through the analysis and assembly of data provided from various sources,… more
- Stantec (Philadelphia, PA)
- …System selection to be based on Project/Client needs as well as proactive Claims /Risk mitigation. - Oversee and approve development and management of the Project ... Development and maintenance of the Project Risk Register, based on review of contract conditions, project-specific delivery requirements, client characteristics, and… more
- Otsuka America Pharmaceutical Inc. (Trenton, NJ)
- …maintain the effectiveness of Quality Systems for managing the batch record review and release process Quality Management Activities supporting all phases of ... compliance. + Manages reports and trends to the Management Representative to help in the preparation of Management reviews...above. + Improves supplier quality performance for batch record review and release process for OAPI GMP release of… more
- NJM Insurance (Trenton, NJ)
- …+ Triaging and analyzing scorecards and outputs from predictive models for General Claims , Personal Lines, Personal Injury Protection (PIP) claims and Medical ... to fraudulent Personal Lines and Commercial Lines policies and claims . + Conduct background research on available public databases...support the need for the escalation of the claim review . + Review NJM databases, retrieve NJM… more
- PCI Pharma Services (Philadelphia, PA)
- …data and follow up with CAPA's. + Assist in management of workers compensation claims . Assist in the completion and/or review of incident investigations to help ... adequately shared with employees and kept up to date. + Assist in the review , updating, and development of EHS related programs, training, policies and procedures. +… more
- Highmark Health (Trenton, NJ)
- …and report improper coordination of benefit billing practices through paid clams review . + Participate as pharmacy representative in onsite member appeals ... medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior… more
- Prime Therapeutics (Trenton, NJ)
- …with various levels of leadership within the organization, acting as a representative of the broader Financial Systems team + Provide consulting services to ... experience, preferably leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in… more
- ARAMARK (Wynnewood, PA)
- …other locations required. **Job Responsibilities** **Leadership:** + Act as company representative at management appeal interviews + Act as company representative ... has been won. + Prepare reports as needed + Review employee relations queries that the HR Advisors are...to disciplinary action + Prepare material for employment tribunal claims . + Ensure that all managers in the region… more
- APTIM (Lawrenceville, NJ)
- …will be responsible for project reporting, quantity control, payment review and documentation, material certification, and field inspection. **Key ... Resident Engineer (RE) + Support the RE and Inspectors on the review and validation of contractor quantities, certified payrolls, payments/invoices, monthly schedule… more
- Pfizer (Collegeville, PA)
- …compliance and management of all research activities + Participate in RWE/Epi peer review of study protocols and study reports + Document all requests and track ... working with real-world data (RWD) including Electronic Medical Records (EMR), claims , and surveys + Excellent problem-solving and decision-making abilities +… more
- Globus Medical, Inc. (Collegeville, PA)
- …and payments. + Collaborate with Sales, Finance, Pricing, and Legal teams to review rebate terms and ensure alignment with business goals. + Perform monthly, ... accruals and prepare related journal entries as needed. + Validate rebate claims submitted by customers and partners, ensuring proper documentation and adherence to… more
- Globus Medical, Inc. (Collegeville, PA)
- …processing of received documentation through prior authorization, appeals support, detailed claims review , and hotline support. The Patient Access Specialist ... and achievable turn-around times for all department functions. + Review documentation provided by physicians for completeness and have...**Physical Demands** **:** The physical demands listed here are representative of those that must be met by an… more
- Globus Medical, Inc. (Limerick, PA)
- …and records management; summarize exit interview trends and observations for review with the HR Manager. + Support employee engagement initiatives, recognition ... or similar systems preferred. + File and manage workers' compensation claims , including incident intake, coordination with managers and carriers, documentation, and… more