- Merck & Co. (North Wales, PA)
- …to the Director/Senior Director in the Office of Promotion and Advertising Review (OPAR)The Associate Director is responsible for the review and ... objectives.Serve as the liaison and manages correspondence with FDA's promotional review divisions Office of Promotion and Advertising Review (OPDP)/Advertising… 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)
- …contracts, correspondence (eg, to regulatory agencies), both independently and for review , approval, and use by Legal Affairs management. Independently negotiates ... scientific exchange, and disease state communications (including FDA regulations, False Claims Act, Anti-Kickback Statute, OIG guidance, the PhRMA Code, state and… 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 ... matters relating to pricing and Market Access (including FDA regulations, False Claims Act, Anti-Kickback Statute, OIG guidance, the PhRMA Code, and product… 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 ... agreement. How did you use Ariba to process the final Master Agreement for review and obtain the electronic signatures. If experience is not with Ariba, then an… more
- Eisai, Inc (Fort Worth, TX)
- …territory business plan, aligned with overall business plan and regularly review with management to ensure appropriate strategic, tactical components and call ... the PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state… more
- Eisai, Inc (San Diego, CA)
- …territory business plan, aligned with overall business plan and regularly review with management to ensure appropriate strategic, tactical components and call ... the PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state… 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 ... of clinical studies using deep scientific knowledge, statistical analysis and high-quality data to support decision making in clinical trials.Support statistical programming activities for Early Oncology clinical development projects.Responsible for the… more
- AIG (Atlanta, GA)
- Claim Compliance Reviewer Join us as a Claims Compliance Reviewer to make more of your specialist expertise and experience. Make your mark in Claims Our ... claim adjudication or claim operations experience for multi-line commercial claims . Claim Audit or file review experience...multi-line commercial claims . Claim Audit or file review experience is desirable. + Knowledge of key regulatory… more
- Randstad US (St. Paul, MN)
- claims reviewer . + st paul , minnesota + posted 1 day ago **job details** summary + $21 - $23 per hour + temp to perm + no requirements + category business and ... or send your most updated resumes to ###@randstadusa.com for immediate consideration and include " Claims Reviewer - MN" in your subject line. salary: $21 - $23… more
- Zelis (Morristown, NJ)
- …ensuring adherence to proper billing guidelines. They will work closely with Expert Claims Review and Concept Development staff to efficiently identify and ... Position Overview: At Zelis, the Itemized Bill Review Facility Reviewer is responsible for...identification of billing and coding opportunities for all payor's claims including restricted list + Review client… more
- Point32Health (MA)
- …performing clinical reviews of provider claims payment disputes, perform retrospective claims audits of medical records, and review potential quality of care ... here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Behavioral Health Psychologist Reviewer will primarily perform utilization management and provider payment… more
- ManpowerGroup (Columbia, SC)
- **Job Title: Medical Claims Reviewer ** **Pay Rate:23/Hr (REMOTE opportunity after training)** **Duration:3+ Months on W2** **Location:4101 Percival Road Columbia ... the state of hire. **Job Description:** As a Medical Claims Reviewer /Utilization Management Specialist, you will be...Ensure thorough documentation of each determination for utilization or claims review . + Review first-level… more
- The Hartford (Alpharetta, GA)
- …GA) that will perform Utilization Review for Work ers' Compensation Claims . An Initial Clinical Reviewer (ICR) is responsible for evaluating treatment ... Medical Reviewer - CT08BE We're determined to make a...nursing judgment, treatment criteria guidelines and Physician Advisor/Peer Clinical Review referral process. Conduct first level prospective, concurrent, or… more
- Kepro (Nashville, TN)
- …health solutions in the public sector. Acentra is looking for a Physician Medical Claims Reviewer to join our growing team. Job Summary: The primary ... responsibilities of a Physician Medical Claims Reviewer include conducting independent medical service...+ Prepare independent reviews of medical services appeals. + Review records, prepare and submit all reviews in keeping… more
- Zelis (Morristown, NJ)
- …a health care organization or provider preferred. + 2+ years of auditing or performing claims review in specialty pharmacy claims or specialty drugs + Strong ... Position Overview: The Nurse Reviewer is primarily responsible for conducting post-service, pre...financial negotiation with providers + 3-5 years of auditing, claims , review and/or billing experience with a… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review /Medical and Case Management services for Group Health and Workers' Compensation and ... other Casualty clients. The Workers' Compensation Nurse Case Reviewer collaborates with medical care providers, employers, employees, and at times, attorneys to… more
- Randstad US (North Chicago, IL)
- medical reviewer /safety reviewer iii. + north chicago , illinois (remote) + posted today **job details** summary + $45 - $51.65 per hour + contract + ... work hours: 9 to 5 education: Doctorate responsibilities: + Provide Medical Review consultant to support the US Immunology Medical Affair teams. Services provided… more
- Randstad US (Minneapolis, MN)
- loan document reviewer . + minneapolis , minnesota + posted 1 day ago **job details** summary + $19 - $20 per hour + temp to perm + high school + category business ... have high attention to detail, have previous experience managing cases, claims and pipelines, let's connect and see if this...send an updated resume to ###@randstadusa.com and include "Loan Reviewer - Minneapolis" in your subject line. salary: $19 -… more
- Zelis (TX)
- Position Overview: The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG reviews ... clinical criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA… more
