- Aequor (Parsippany, NJ)
- Job Title: Medicaid Claims Analyst Location: Parsippany, NJ Duration: 6 Months Core Essential Skill sets:- Medicaid rebate experience in pharm enviornment.- Prior ... high degree of accuracy in data processing and reviews.Position Summary:The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which includes… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …Chain, Compliance , Quality Assurance, pharma-specific litigation issues, promotional brand review , etc.) preferred- 1 or More Years Relevant experience in ... centered around rare diseases and immune disorders.Summary The Manager, Data Privacy & Compliance Investigations, is a member of the Compliance Department who is… more
- The George Washington University (Washington, DC)
- …to resolution, ensuring all necessary information is obtained for accurate processing. Review claims for eligibility, completeness, and accuracy while handling ... Manager to manage the District of Columbia Workers' Compensation claims . This role ensures compliance with relevant...claims . The Workers' Compensation & Liability Manager will review claim details and impacts, prioritize claims … more
- Merck & Co. (Rahway, NJ)
- …of ERISA benefits claims /appeals and related litigation Work with internal benefit review committees to respond to severance, savings and pension claims and ... global plans and programs, draft plan documents and amendments and review employee benefit related communications, including annual enrollment materials and summary… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …Labeling and Pricing Committees and as legal representative on the promotional materials review team for market access team and materials (including, but not limited ... legal issues pertaining to assigned business areas. Work collaboratively with Compliance colleagues to develop and implement training to internal clients, partners… more
- Aequor (Austin, TX)
- …PLEASE SUB AT MARKET RATE! CANDIDATES MUST COMPLETE THE PRESCREENING QUESTIONS FOR REVIEW ON RESUME: (1) Please confirm that you have hands-on experience with an ... use Ariba to process the final Master Agreement for review and obtain the electronic signatures. If experience is...teams Be the Procurement Process and Systems expert ensuring compliance with all relevant global sourcing policies and procedures,… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …contracts, correspondence (eg, to regulatory agencies), both independently and for review , approval, and use by Legal Affairs management. Independently negotiates ... school experience required- 4 or More Years experience in regulatory, compliance , and legal matters relating to investigational products, product promotion,… more
- Eisai, Inc (Louisville, KY)
- …working with appropriate Health Care Providers. Complete ongoing clinical acumen and compliance training with goal of being expert level for customers. Achieve sales ... territory business plan, aligned with overall business plan and regularly review with management to ensure appropriate strategic, tactical components and call… more
- Eisai, Inc (San Diego, CA)
- …working with appropriate Health Care Providers. Complete ongoing clinical acumen and compliance training with goal of being expert level for customers. Achieve sales ... territory business plan, aligned with overall business plan and regularly review with management to ensure appropriate strategic, tactical components and call… more
- Merck & Co. (Upper Gwynedd, PA)
- …under the Innovative Strategy groupContributions at MISP and sponsored Protocol Review Committees (PRCs)Builds trust with the external scientific community via ... and lead resolution of regulatory, reputational (ie public relations), compliance and other asset issues managementSubstantive contributions to labeling committees.… more
- Pacer Staffing (Atlanta, GA)
- …and track timeliness of retrospective claims reviews to ensure compliance with required timelines. Identify questionable review decisions and escalate ... and supports both non-clinical and clinical staff on coding and retrospective medical claims review processes. Key Responsibilities: Perform claims coding… more
- Valley Water (San Jose, CA)
- …Management Analyst/ Management Analyst II to lead pre-award efforts within our Grants, Compliance , and Claims Management Unit. If you're looking for a role ... of vital water projects, this is the opportunity for you!Overview: The Grants, Compliance , and Claims Management Unit with Valley Water is the centralized… more
- Eisai, Inc (Nutley, NJ)
- …functions. Essential Functions Lead the Contract Operations team ensuring timely and accurate review and processing of claims .Serve as a subject matter expert ... Summary This role will lead Contract Operation activities such as membership review , chargebacks, and rebate processing. This position will analyze and interpret… more
- Merck & Co. (North Wales, PA)
- Job DescriptionResponsibilities:Utilize big data to analyze the safety and efficacy claims of potential medical breakthroughs. Review the quality and reliability ... clinical data management concepts; CDISC and ADaM standards; ensuring process compliance and deliverable quality; and designing statistical databases with objective… more
- Globe Life Inc. (Broadview Heights, OH)
- …with daily responsibilities. * Work with legal and compliance on regulatory inquiries. * Review high dollar claims and claims over the authority level of ... You will be an expert in all life, accident and health products, monitoring claims status reporting, overseeing activities to ensure compliance standards are met… more
- MultiPlan (Atlanta, GA)
- …coding and pricing errors using accurate HCPCS, ICD-10, and CPT codes. 4. Lookup and review medical claims in payer system to determine methods of payment and ... bright people come to shine! JOB SUMMARY: This role reviews medical paid claims against provider contracts and policies to ensure medical payments have been… more
- MultiPlan (Irving, TX)
- …for the electronic setup, testing and go-live of IT projects that involve Client Claims Processing. These claims may be received either via EDI (Electronic Data ... and to customize how they access/utilize MultiPlan Products using EDI and Web Services claims processing workflows. It includes but is not limited to the below *… more
- Senior Living Communities (North Branford, CT)
- …at High Schools, etc.) 25. Check in with employee regarding any open workers' comp claims 26. Review benefit enrollments coming due & send reminders 27. ... Review Relias and assist with other annual training compliance 28. Attend Senior Leadership Meetings 29. Update training files with team member check offs and… more
- MultiPlan (Atlanta, GA)
- …and provides suggestions for process efficiencies. Uses independent decision-making skills to review claims after business hours to meet deadlines. Apply ... as well as to monitor bills for accuracy and compliance . JOB ROLES AND RESPONSIBILITIES: Review and...national coding standards and regulations to claims billed. Research and review individual … more
- Cambia Health Solutions, Inc (Portland, OR)
- …member of the Clinical Audit team, the Payment Integrity RN (I) conducts post service review of claims in prepayment, post payment or audit capacity to ensure ... appropriate clinical review , reimbursement of claims and accuracy of...other healthcare practices.Competency to apply clinical expertise to ensure compliance with medical policies and/or reimbursement policies.Ability to read… more
