- MISTRAS Group, Inc. (Princeton Junction, NJ)
- …legal and compliance activities at MISTRAS. and manage litigation, activities, draft, review and negotiate company agreements, review and monitor compliance and ... and counsel executives on risk mitigation. **Major Responsibilities/Activities:** + Draft, review , and negotiate a broad range of commercial agreements/renewals and… more
- Humana (Trenton, NJ)
- **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 (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 (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 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
- NJM Insurance (Trenton, NJ)
- …extremely lucky to have had this excellent opportunity!" Overview NJM Insurance Group's Claims Analytics Department is seeking a Claims Insights Analyst Intern ... efficiency, reduce operational friction, and enhance customer experience. RESPONSIBILITIES: + Review and report on loss activity within assigned line of business.… more
- Highmark Health (Trenton, NJ)
- …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 (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
- 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
- CVS Health (Trenton, NJ)
- …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
- 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
- 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
- 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
- Novo Nordisk (Plainsboro, NJ)
- …and other customers. Maintains a positive working relationship as an NNI representative to all stakeholders. Essential Functions + Supports resolution of government ... contract issues and compliance with 340B regulations and review of MFP refund payments within the 14-day payment...are not treated as unclaimed funds and that related claims must be resolved directly with dispensing entities outside… more
- CRC Insurance Services, Inc. (Jenkintown, PA)
- …English (Required) **Work Shift:** 1st Shift (United States of America) **Please review the following job description:** Supports a team by identifying, soliciting, ... guidelines, approving policy changes, maintaining workload, solving coverage issues, monitoring claims and managing written business up to and including the time… more
