- CRC Insurance Services, Inc. (SC)
- …job description:** This role is focused on technical claim handling of complex general liability claims , both litigated and non-litigated. This role requires ... affecting primary and excess policies in a fast-paced E&S Claim remote environment 2. Independently evaluating information...and underwriters in the handling and adjudication of all claims 10. Handling complex claims … more
- Lincoln Financial Group (Columbia, SC)
- …You will oversee and ensure the fair, ethical and timely management of more complex claims . If you are passionate about Supplemental Health Claims , ... the processing and administration of all aspects of more complex claims for their assigned area(s) of... claim management. + Approves and makes more complex claim management related financial decisions consistent… more
- AmeriHealth Caritas (Charleston, SC)
- …ACFC and the Plan.; + Ensures provider contracting is consistent with claim payment methodologies. + Maintains familiarity with Medicare fee schedules and analyzes ... comparable Plan pricing guidelines. + Resolves complex contract issues to ensure that provider contracts comply with state, federal, and national accrediting… more
- Zurich NA (Columbia, SC)
- …+ Understands, analyzes, and applies the component parts of an insurance policy for complex claims . + Ability to follow reserving process for indemnity and ... claims at the highest authority levels on commercial claim assignments reflecting the highest degree of technical complexity,...expense in analyzing the potential exposure of complex claims . + Ability to determine the… more
- Prime Therapeutics (Columbia, SC)
- …we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst participates in the assessment of value ... or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses, and provide consultation and analytic insight to… more
- Prime Therapeutics (Columbia, SC)
- …drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides analyses, consults and ... with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness &… more
- Prime Therapeutics (Columbia, SC)
- …**Job Posting Title** PBM Sr Business Intelligence Data Visual Consultant - Remote **Job Description** The Senior Data Visualization Consultant is responsible for ... new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more
- Prime Therapeutics (Columbia, SC)
- …Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing analyses of moderately complex external claims ... and drives every decision we make. **Job Posting Title** Underwriter - Remote **Job Description** The Underwriter is responsible for assisting in the development… more
- Prime Therapeutics (Columbia, SC)
- …we make. **Job Posting Title** Senior Business Integration Consultant - Remote **Job Description** The Senior Business Integration Consultant is responsible for ... leading multiple complex small to mid-sized client and/or product implementations, projects,...Proficiency in one or more of the following areas: claims , eligibility, prior authorization, accumulators, and/or benefits + Previous… more
- AECOM (Columbia, SC)
- …Description** **Job Description** AECOM is currently seeking an experienced Construction Manager /Resident Engineer for the Amtrak ADA Stations Program (ADASP). The ... The COTR/RE works directly with the Contracting Official, Design Manager and Designer of Record, and reports directly to...within the approved contract time and price + Implementing claim preventive actions by working with the contractor to… more
- UNUM (Columbia, SC)
- …and join Team Unum today! **General Summary:** The Home Office National Client Manager (HO NCM) is responsible for maintaining a consultative relationship with ... complex group, VB, and integrated customers with 2,000 or...one single large client on the west coast. Existing remote or field office employees are eligible to apply.… more
- UIC Government Services and the Bowhead Family of Companies (Wedgefield, SC)
- **Overview** Bombing and Gunnery Range Site Manager (PTR-2024-21975): Bowhead seeks to network withBombing and Gunnery Range Site Managers for an upcoming/potential ... daily operations of the permanent site and its associated remote site locations. + Available, during scheduled hours of...problem areas. After scheduled hours of operations, the site manager is required to be available within 2 hours,… more
- Humana (Columbia, SC)
- …part of our caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. ... The Manager , Fraud and Waste works within specific guidelines and...and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives… more
- HUB International (Myrtle Beach, SC)
- …experience and in-depth knowledge of insurance markets, policy provisions, claim processes, business environment, and risk mitigation, applies independent and ... discretionary judgment to make decisions independent of manager approval on books of insurance business for which the incumbent is responsible. These include… more
- Zurich NA (Columbia, SC)
- …Construction team in Zurich's Philadelphia office. We are also open to hiring remote talent. This role will be filled at either the Senior Construction Professional ... or AVP, Construction Property Underwriter (Leve IV). The hiring manager will determine the appropriate level based upon the...Level III or AVP Level IV) you will handle complex new and renewal domestic Construction Professional Liability accounts… more
- Tidelands Health (Myrtle Beach, SC)
- …point of contact for CDI and other team members when the supervisor/ manager is not available. **Position Responsibilities & Functions** + Assigns and sequences ... and verifies all information required to produce a clean claim including special billing procedures that may be defined...in the coder's home in compliance with Tideland Health's Remote /Telecommuter Policy. * Must be able to work in… more
- Apartment Management Consultants, LLC (Mount Pleasant, SC)
- …Insurance and Captive Programs to measure program effectiveness, cost performance, and claims outcomes over time. + Collaborate with actuarial partners to perform ... level agreements and key performance indicators (KPIs). + Articulate complex insurance and risk management concepts clearly to diverse...and no history of disciplinary offences as a Risk Manager or in any other capacity. + Ability to… more
- Highmark Health (Columbia, SC)
- …to perform a certain level of production each month, as determined by the manager to ensure compliance with DLP changes. This role will be required to support ... level of production each month as determined by the manager . + Other duties as assigned or requested. **EXPERIENCE**...procedures and terminology + 3 years of Health Care claims , Health Insurance and Benefit Administration **SKILLS** +… more
- Danfoss (Easley, SC)
- …the overall sales and business development plans for the region. This is a remote role, preferring someone in the Southeast area of the United States. **Job ... and product development departments * Supporting Sales Driver and Sales Manager in technical discussions with customers * Conducting, creating, and presenting… more