- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Claims Review Representative makes appropriate claim decision based on strong ... procedures, contract provisions, and state and federal legislation. The Claims Review Representative performs advanced administrative/operational/customer… more
- Sedgwick (Fayetteville, NC)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Representative - Workers Compensation (REMOTE- State License Required)) Are ... or equivalent combination of education and experience or successful completion of Claims Representative training required. **TAKING CARE OF YOU** + Flexible… more
- Sedgwick (Raleigh, NC)
- …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 (Raleigh, NC)
- _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
- Elevance Health (Winston Salem, NC)
- **Utilization Management Representative I** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law. The **Utilization Management Representative I** is responsible for coordinating cases for precertification and prior… more
- Mass Markets (NC)
- …staff and managerial for resolution as needed + Attend meetings and training and review all new training material to stay up to date on changes to program ... 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service,… more
- Mass Markets (NC)
- …to complete account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, and procedures ... through problems solving and effective call handling + Attend meetings and training and review all new training material to stay up to date on changes to program… more
- Highmark Health (Raleigh, NC)
- …position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist distribution. Interpret ... added benefits. Meet with all identified practices in assigned territory to review practice financial and quality performance. + Perform effective on-site visits… more
- Ryder System (Raleigh, NC)
- _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
- CRC Insurance Services, Inc. (Charlotte, NC)
- …strategies. + Review and analyze moderately complex documents related to claims or litigation; use Relativity or other e-discovery tools for document review ... **Work Shift:** 1st Shift (United States of America) **Please review the following job description:** The Assistant General Counsel,...Department by managing a broad range of litigation and claims matters, with a primary focus on insurance broker… more
- Highmark Health (Raleigh, NC)
- …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
- CVS Health (Raleigh, NC)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- Stantec (Raleigh, NC)
- …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. (Raleigh, NC)
- …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
- Stantec (Charlotte, NC)
- …community. Your Opportunity Stantec is seeking an individual to act as an Owner's Representative , Project Manager for the design and construction of a mix of higher ... or commercial expansion or renovation projects as an Owner's Representative . Managing the approved scope, schedule and budget are...and budget throughout all phases of the project. - Review and track all contracts, invoices, and payments to… more
- CRC Insurance Services, Inc. (Charlotte, NC)
- …Fluency:** English (Required) **Work Shift:** 1st Shift (United States of America) **Please review the following job description:** This role will serve as a trusted ... laws and regulations. + Manage and strategize responses to employment-related claims , including EEOC charges, wrongful termination, and wage and hour disputes.… more
- Prime Therapeutics (Raleigh, NC)
- …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
- Sunrise Senior Living (Winston Salem, NC)
- …internal business controls. + Process and manage unemployment and worker's compensation claims and update claim activity as necessary. + Clearly communicate and ... Monitoring, Process, and Systems** + Set up ongoing procedures to collect and review information needed to assist in billing and accounting support services to meet… more
- North Carolina Central University (Durham, NC)
- …alarm and security systems, HVAC equipment and controls, and Life Safety systems- representative of the full range of facilities found in a higher-education ... of SCO regulations and Life Safety Systems. + Ability to independently review and evaluate complex project contracts, change orders, schedules, submittals, and… more
- UNC Health Care (Morrisville, NC)
- …Develop appropriate teammate relations plans and interventions. Effectively investigate claims /charges, review all pertinent facts and information without ... experience. Areas of primary responsibility include investigations, corrective action review , coaching and counseling for people leaders, workplace accommodations… more