312 claims jobs found

What our Employees Have to Say: BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include: BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work. I have worked at several state agencies and BWC is the best place to work. Best place to work in the state and with a sense of family and support. I love the work culture, helpfulness, and acceptance I've been embraced with at BWC. I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC. If you are interested in helping BWC grow, please BWC’s core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work...

For a quick application text APPLY1 to 82174 About Dent Wizard Dent Wizard is the nation’s undisputed leader in automotive reconditioning services and vehicle protection products – and our success is the result of the great people who serve our customers. We’re stable, growing and have a strong business model, with opportunities in 43 states, 2.5 million vehicles repaired every year and more than 3,000 highly skilled employees. Help us reach new heights and receive the respect, rewards and recognition you deserve. As a Coordinator, Claims is responsible for managing the dispatch and resolution of vehicle claims, ensuring timely communication with technicians, third-party vendors, and customers. This role requires strong organizational skills, attention to detail, and the ability to manage multiple claims efficiently using the portal and internal systems. Key Responsibilities Dispatch over 750 vehicles weekly using internal technology to technicians and/or...

Please note: This is a non-exempt, remote-based position with a projected starting pay rate of $21.64 per hour, with an annual bonus target of 3%. The STD/Absence Claims Case Manager I (CM) is responsible for administering and medically managing Short Term and Absence claims with specific diagnoses or leave types that tend to resolve quickly. The CM will work with employers, employees, and health care providers to administer Short Term disability in conjunction with other paid or unpaid leaves covered by Guardian. These leaves can be Family and Medical Leave Act (FMLA), State Paid Medical Leave, and or State Paid Disability. The CM will manage the claim according to the plan provisions, state and federal guidelines, and established protocols. The CM must demonstrate the knowledge to work independently, interpret contract provisions, and utilize critical thinking skills for medical management to administer benefits through the appropriate claim duration or return to work. The CM...

Who Are We? Taking care of our customers, our communities and each other. That's the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards....

Summary: We are seeking a candidate for a key leadership role in scheduling for a portfolio of Data Center projects of strategic importance to Meta. The Area Schedule Lead, Leased will act as a technical Schedule subject matter expert overseeing all schedule management and reporting for the Leased portfolio of projects.The successful candidate will have focus on speed to market and be a critical partner for the Delivery Team and the Project Controls Lead to forecast and help mitigate schedule related risks and issues on the project, enable commercial accountability, manage schedule health reporting/escalation, and ensure that schedule change management is effective and expedient.This position will work closely within the DEC Technical Operations team and various internal departments including Site Project Management teams, Pre-Construction, Contracts, Finance, Accounting, Sourcing and Operations Engineering. Required Skills: Area Schedule Lead, Leased Data Centers...

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 Data & Reporting Analyst Sr - Remote Job Description The Senior Data & Reporting Analyst is responsible for supporting the business in decision making and operations efforts by providing data, reporting and business intelligence services. This role is responsible for acting as a data and reporting expert for other members of the Reporting and Analytics team. Responsibilities Develop reporting solutions following internal reporting standards and best practices by translating business requirements for development within multiple reporting and prototyping platforms and determining appropriate solution design Maintain and improve the reliability, efficiency and functionality of existing reports...

This position is responsible for representing OAPI with the largest and most complex National Payers and/or PBM's. These accounts represent over 74% of portfolio gross sales. Specific responsibilities include interacting with all levels of the largest Payers within the Trade & Clinical departments. The Senior NAD will lead the creation, negotiation, and execution of OAPI National Account Contracts to ensure profitable portfolio access across the portfolio to enable successful pull-through execution with the internal matrix teams. This is accomplished through collaboration with internal Otsuka Market Access NAD, RAMs, Market Access Marketing, Sales, and Pricing & Contracting. The Senior NAD will have direct reporting responsibility for the aligned National Account Director. This role reports to the Vice President Managed Markets KEY RESPONSIBILITIES : National Account Contract Strategy & Negotiations : Plan, initiate, and lead Payer/PBM account...

Otsuka is seeking an experienced Director of Statistics to join our Data Science and AI group to provide statistical leadership and solutions to efficient phase 3b/4/Real-World-Evidence (RWE) study design, global Health Technology Assessment (HTA) and regulatory requirements on advanced statistics needs for our portfolio across therapeutic areas and indications. This role will lead statistical innovation and data insights in HTA and Integrated Evidence Plan (IEP), including efficient statistical design and execution of late-phase clinical trials and real-world studies, AI/ML-based population enrichment, Bayesian methods, RWD/external control, and collaborate closely with cross-functional teams including Global Value Evidence, Global Medical Affairs, Market Access, Regulatory, Biostatistics, Global Clinical Development and Clinical Management. Key Responsibilities: Strategic Leadership in Advanced Statistics : Provide expert statistical guidance for late-phase...

Appeals Professional III Fully Remote-United States Job Type Full-time Description Overview Tanaq Support Services (TSS) delivers professional, scientific, and technical services and information technology (IT) solutions to federal agencies in health, agriculture, technology, and other government services. TSS is a subsidiary of the St. George Tanaq Corporation, an Alaskan Native Corporation (ANC) committed to serving Federal customers while also giving back to the Tanaq native community and shareholders. About the Role We are seeking an Appeals Professional III to support a contract with our federal client. The Appeals Professional III performs complex (senior-level) work. Provides dissatisfied parties with the opportunity to present documentation to demonstrate why an appeal should be allowed. Provides an independent second level determination based on the documentation, facts, laws, regulations, and guidelines. Works under general supervision, with...

Summary: We are seeking a candidate for a key project leadership role leading project controls operations for our Leased program, a portfolio of critical strategic importance for Meta's infrastructure growth. The Project Controls Lead will not only be a technical subject matter expert overseeing all cost controls & commercial deliverables on the program and across multiple Vendors and Landlords, but also lead a team of analysts representing Meta that will manage invoicing, commitments, financial reporting, and commercial management for the program.This person will be a critical partner for the Delivery Team. Leadership, communication, and organization skills are important in this highly collaborative, analytical, and strategic role. This position will work closely within the DEC (Design, Engineering and Construction) Business Controls team and various internal departments including Site Project Management teams, Pre-Construction, Contracts, Finance, Accounting, Sourcing...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

Director Financial Operations Department - CarelonRx Revenue Cycle Management Location: This role requires associates to be in-office 3 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. CarelonRx is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member's health. 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 Data & Reporting Analyst Sr - Remote Job Description The Senior Data & Reporting Analyst is responsible for supporting the business in decision making and operations efforts by providing data, reporting and business intelligence services. This role is responsible for acting as a data and reporting expert for other members of the Reporting and Analytics team. Responsibilities Develop reporting solutions following internal reporting standards and best practices by translating business requirements for development within multiple reporting and prototyping platforms and determining appropriate solution design Maintain and improve the reliability, efficiency and functionality of existing reports...

CULTIVATE A BETTER WORLD Food served fast does not have to be a typical fast-food experience. Chipotle has always done things differently, both in and out of our restaurants. We are changing the face of fast food, starting conversations, and directly supporting efforts to shift the future of farming and food. We hope you will join us as we continue to learn, evolve, and shape what comes next on our mission to make better food accessible to everyone. THE OPPORTUNITY As the Specialist, Customer Incident, you will support the protection of the Chipotle brand through the direct oversight of escalated customer incidents that are primarily received from the Customer Service Team and restaurants through Chipotle’s Online Customer Incident Reporting Site. You will triage, investigate, and thoroughly document and resolve each case, issuing appropriate appeasements within policy and escalating to the appropriate internal stakeholders where appropriate. You will engage with...

Position Description & Qualifications If you love a high energy and fast pace environment - Serco has a great opportunity for you! The Task Lead will be on a dynamic team, supporting customers with processing their retirement pensions. Bring your expertise and collaborative skills to make an impact towards servicing our retirees. Serco and PBGC protects the retirement security of over 35 million Americans in single employer and multiemployer pension plans. Our goal is to provide the highest level of customer support and to work to protect workers and retirees hard earned pension benefits. This position is responsible for meeting daily tasks associated with their assigned operational activities, processes, and workflows. The candidate will support the Operations Supervisor through daily monitoring and reporting on the status of their assigned tasks, by providing training and feedback to include providing Subject Matter Expert (SME) input to staff in support of their...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and...

Company : United Concordia Dental Job Description : JOB SUMMARY *MUST BE A US CITIZEN * This job turns data into information, information into insight, and insight into business decisions. More specifically, this job drives and supports all activities related to collecting, analyzing, and reporting on the Organization's key performance indicators including developing dashboards, scorecards, forecasting, trending, tracking results, and executive presentations for the purpose of supporting operational excellence, management intelligence for effective decision-making, and overall tracking of organizational performance. Consults with cross-functional enterprise groups and levels to identify data and analytical needs, conduct analyses, review analyses and findings with leadership, facilitate related process/data improvement efforts and develop executive level presentations. Prepares similar intelligence for customers and interacts with customers as such....

Details: Stefanini Group is hiring! Stefanini is looking for an Warranty Services Representative in Cuyahoga Falls, OH 44223 For quick Apply, please reach out to Avneesh Katiyar, call 248 582 6528/ email: avneesh.katiyar@stefanini.com Job Title: Warranty Services Representative Location: 3773 State Road, Cuyahoga Falls, OH 44223 Shift Timings: M-F; 8:00 AM to 4:30 PM; 30 Minutes Lunch Qualifications: What We're Looking For: High school diploma or equivalent. Strong computer skills including Microsoft Office Suite and internet. Experience with SalesForce, Docuware, and AS400 preferred. Ability to communicate, both written and verbal with customers, internal organizations across AMI cross functionally. Ability to work in a fast-paced, high-volume environment, utilizing strong customer service skills and attention to detail. Fenestration or building products industry experience preferred. Ability to manage multiple priorities and meet deadlines in...

Company : United Concordia Dental Job Description : JOB SUMMARY *MUST BE A US CITIZEN * This job turns data into information, information into insight, and insight into business decisions. More specifically, this job drives and supports all activities related to collecting, analyzing, and reporting on the Organization's key performance indicators including developing dashboards, scorecards, forecasting, trending, tracking results, and executive presentations for the purpose of supporting operational excellence, management intelligence for effective decision-making, and overall tracking of organizational performance. Consults with cross-functional enterprise groups and levels to identify data and analytical needs, conduct analyses, review analyses and findings with leadership, facilitate related process/data improvement efforts and develop executive level presentations. Prepares similar intelligence for customers and interacts with customers as such....

Job Description Medical Receptionist Setting/Hours: 100% In-Office | M 7:30-7, T 7:30-5, W 7:30-5, Th 7:30-7, F 8-5, Sat 8-12, and possibly Sun 8-12 Join trak group in partnering with a growing client in Loveland, Ohio that's expanding its Shared Services team. Responsibilities: Serve as the first point of contact for patients, providing a welcoming and professional experience Coordinate scheduling by booking and confirming appointments to support efficient clinic operations Maintain accurate patient records through detailed data entry and organization Manage incoming calls and direct inquiries to the appropriate departments Support insurance processes by verifying coverage and assisting with claims Ensure patient confidentiality and compliance with privacy regulations Collaborate with medical staff to keep daily operations running smoothly Handle general administrative duties to support overall office efficiency Skills: Strong communication and interpersonal skills with 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 Health Data Analyst - Remote Job Description The Health Data Analyst provides information, analyses, and consultation to internal and external stakeholders. This position assesses the performance of pharmacy benefits and/or networks and develops recommendations for improvements or enhancement to support departmental and organizational objectives. This position will participate in the development of new reports, analytical models, and products/benefit programs that align with Prime's strategic imperatives. Responsibilities Assumes responsibility for moderately complex analytic and consultative work such as analyzing and interpreting client pharmacy benefit data, trends and reports and partnering with analytics team...

LTSS Service Coordinator - RN Clinician (Case Manager) Hiring in the following counties: Champaign, Clarke, Darke, Logan, Miami or Shelby County. Location : This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. 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 MyCare Ohio health plan is to deliver high-quality, trauma informed, culturally competent, person-centered coordination for all members that addresses physical health,...

Skilled Rehabilitation Company Seeking a Clerk/ Administrative Assistant to join our team in Canfield Ohio office Clerk for our satellite office of Clinical Auditing and Compliance for a National Rehabilitation Company General Purpose: Responsible for follow up on appeals, audits, denials, claim management, etc Job Functions include but are not limited to: Develops and maintains spreadsheets for tracking and follow up on claims Attention to detail required for thorough follow up and timely calls as well as keeping files with details Detail oriented individual Dependable to be on time and report to manager daily with job requirements Ability to utilize computer skills Excellent Professional conduct required for all communication duties Good communication skills for calls and office assistance Able to follow through with job duties without prompting Willing to learn new skills and an array of job duties for various clerical needs Able to...

Job Summary This position will execute and maintain master data policies, collect and protect agreed master data standards, and promote a need for fit-for-purpose master data to support business processes. Partner with IT on system enhancements; provide requirements and testing support for master data process improvements. The position is to ensure high-quality master data and to advance the use of master data critical to SAP, acting as the primary operational point of contact for master data requests and issue resolution to stakeholders. Additionally, you'll address challenges in master data management and governance, set up a governance model with appropriate business accountabilities, and utilize innovative technologies to streamline master data processes. This role will also assist the FP&A team with management reporting for domestic and global leadership. This role requires a strategic thinker with strong analytical skills and the ability to manage cross-functional...