16 general claims manager jobs found in Indianapolis

At Otsuka our mission is to create new products for better health worldwide. Our purpose is to defy limitation so that others can too. In this exciting role, as a Sr. Analyst within OAPI supply chain team, you will work cross-functionally across various departments to support implementation of the S&OP (Sales & Operations Planning) process. You will assist in managing a complex portfolio of products with competing priorities that include balancing inventory, managing vendor / supplier relationships, optimizing total delivered cost to meet finished goods demand with focus on delivering value to our patients, our suppliers, and to Otsuka. You will create an environment for proactive communications with cross functional collaborators that will help ensure both internal and external customer demands are consistently met with no laps in supply and availability of products to our patients. Additional facets of the role include coordinating purchase requisitions in the...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Eligibility Analyst- REMOTE Job Description The Eligibility Analyst is responsible for representing commercial or government programs' eligibility and acts as a subject matter expert for department projects, Run functions and escalated client issues. This role is responsible for mentoring and training the Eligibility Specialist. Responsibilities Serves as subject matter expert representing eligibility on file process for new and existing clients and department projects; monitors eligibility mailbox and Prime Resolution daily, participates in workstream meetings, assists with providing information regarding business requirements, and performs User Acceptance Testing Serves as primary contact for external...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Performance Suite Analytics team offers candidates the opportunity to generate meaningful impact through translating disparate data points into tangible insights and actions....

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Performance Suite Analytics team offers candidates the opportunity to generate meaningful impact through translating disparate data points into tangible insights and actions....

At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option (PACE) to the most vulnerable senior population while serving as a care provider and care plan to those individuals we serve. Our Health Plan Services team helps ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role in ensuring timely and accurate pre-payment or denial of claims while meeting federal/state regulations, provider agreements terms, and/or company policies and procedures. Essential Job Duties: Review processed claims for accuracy prior to payment while maintaining acceptable levels of claim's aged inventory by verifying various aspects of the system and claim Complete and maintain detailed documentation of audit findings which include decision methodology, system or processing errors, and monetary discrepancies Move claims free of processing errors through for full adjudication and...

? Business Information Analyst Senior - Carelon Payment Integrity Locations: GA-ATLANTA, 740 W PEACHTREE ST NW IN-INDIANAPOLIS, 220 VIRGINIA AVE Hybrid: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to...

Business Information Analyst RFP Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. PLEASE NOTE: This position is not eligible for current or future VISA sponsorship. The Business Information Analyst RFP is responsible for supporting Commercial Pharmacy Administrative Services Only (ASO) business and work required for prospective and renewal client bids....

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title IT Analyst Job Description The IT Business Systems Analyst is responsible for solving moderately complex system problems and for utilizing Software Development Life Cycle (SDLC) methodology employed by Prime and partnering with the business, IT, and other project stakeholders to elicit, define, and document the requirements and technical solutions for changes to Prime's claims systems. Responsibilities Ensure understanding of business requirements and IT Business Requirement Specification acceptance criteria is successfully met prior to sign-off; identify and document system enhancement scope for assigned project Provide work plan and detailed estimate, based on scope; drive scope management, prioritization...

Job Description As part of the Network Services team within Oracle's Global Information Technology organization, you will be responsible for the delivery of IT services to Oracle's businesses worldwide, these services include the management and delivery of network infrastructure. Responsibilities Maintain records of equipment failure and liaise with engineers and suppliers as necessary. Escalate client problems according to established procedures. Manage the network using network management tools, analyze network performance and recommend network enhancements. Analyze network performance to ensure adequate bandwidth for business needs. Recommend enhancements to the network infrastructure, and with management agreement enhance proactive network management tool set. Troubleshoot network problems on the campus network, remote locations and country wide area network though to resolution. Perform Project Engineering including specification definition, design of solution in...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Treasury Analyst Sr - Remote Job Description The Senior Treasury Analyst is responsible for working across the Finance team on the implementation and shared support of daily company cash operations, and develops cash forecast and investment strategy and provides key financial analysis on the consolidated cash flow forecast and investment portfolio. This role is responsible for providing leadership to the other members of the Treasury Team and guidance to the Accounting, Finance, Information Technology and Claims operation functions, as well as Pharmacy Networks and Government Programs. This position is also responsible for creating, developing and implementing strong controls and performing complete and accurate complex in...

Job Description This role is responsible for the design, implementation, support and maintenance of Oracle Health's Microsoft Active Directory infrastructure, DNS and associated infrastructure platforms. This role provides support, testing and monitoring of Microsoft Active Directory services and requisite services through adherence to best practices, the execution and development of automation tools utilizing PowerShell and collaboration across the Organization Key Activities Perform daily system operations tasks across multiple Active Directory forests/domains to verify system integrity and availability Perform ongoing performance tuning of Directory Services, upgrades, and resource optimization Utilize SCOM to monitor Active Directory and Windows-based servers; respond to alarms in a timely manner, preventing client impact and performance degradation Core Networking and DNS principles. Microsoft Configuration Manager Coordinate...

Senior Healthcare Economics Analyst Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. PLEASE NOTE: This position is not eligible for current or future visa sponsorship. The Senior Healthcare Economics Analyst (Advanced Analytics Analyst Senior) creates statistical models to predict, classify, quantify, and/or forecast business metrics. Measures financial performance of...

Work for Indiana Begin a fulfilling career with the State of Indiana by joining one of the largest employers in the state, offering a range of opportunities across 60+ agencies. At the state, you'll find competitive compensation, a robust benefits package and a commitment to work-life balance. Most importantly, you'll have the chance to make a real and measurable impact on the lives of Hoosiers across Indiana. About the Indiana Department of Health (IDOH) : The Indiana Department of Health’s mission is to promote, protect, and improve the health and safety of all Hoosiers so that they can reach their optimal health regardless of where they live, learn, work, or play. Role Overview : The Financial Analysts are the analytical review and knowledge base to support IDOH and program directors to include understanding and ensuring proper financial requirements, spending, reposting, draws, and rebates activities of each grant. They are the critical oversight and...

Coding Analyst Location: Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Coding Analyst is responsible for reviewing, auditing, and coding medical records for the purpose of reimbursement, training, education and compliance. How you will make an impact: Audits and reviews medical documentation for appropriate ICD-9 and CPT coding and...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for building positive client relationships, providing education, and analyzing client claim losses as well as current issues regarding client activities; disseminates necessary information to the management. Follows up on pended claims in accordance with department standards. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve. ESSENTIAL RESPONSIBILITIES Processes daily incoming Stop Loss claims including...

Company : United Concordia Dental Job Description : JOB SUMMARY This job provides account support activities associated with the implementation and administration of groups and accounts. Provides assistance with non-standard benefit implementation tasks. Identifies and resolves problems related to benefit interpretations, non- standard benefits, handle rating concerns, and coordinate claim extracts and any subsequent adjudication requirements. The incumbent may have direct interaction with producers, clients and sales reps to ensure complete implementation, on-going service and all renewal activity. The incumbent is new to the role and is developing competence in performing work assignments. ESSENTIAL RESPONSIBILITIES Load and maintain group information and benefit files. Interact and provide support activities to Account Managers (For UCD: Accounts Support Analysts are account managers for all small market clients. May also be involved with managing...