6 claims examiner jobs found

Company : Highmark Inc. Job Description : JOB SUMMARY The incumbent is responsible for developing and maintaining an anti-fraud program which includes development and delivery of training and filing of Fraud Plans and Reports. The incumbent is responsible for conducting investigations of organizational or functional activities related to alleged fraud, waste and abuse perpetrated by providers, members, facilities, pharmacies, groups and/or employees of the organizations and Subsidiaries. The incumbent is responsible for interviews which might include providers and members and may be conducted onsite or offsite. The incumbent is also responsible for the field investigative work necessary to complete a review of a special project, potential fraud, waste and abuse case, conducting the initial investigations and coordinating the recovery/savings of money related to fraud, waste and abuse. Must be able to testify in a court of law, prepare cases for referral to various...

Job ID: 372813 About the Job Position Overview The Administrative Operations Specialist (Administrative Associate 2, 8208A2) is a 1.0 FTE employee at the Multidisciplinary Institute for Child Welfare (MICW), which houses several dynamic research and training entities, including The Center for Advanced Studies in Child Welfare (CASCW), the Minnesota Linking Information for Kids (Minn-LInK) project, and the Minnesota Child Welfare Training Academy (MNCWTA). This position provides daily administrative support to the Operations team and the Evaluation and Certification team. Key responsibilities include assisting with human resources processes such as hiring, managing time approvals for approximately 40 temporary and casual employees, and coordinating onboarding and offboarding with the MICW Operations Manager and Department of Children, Youth, and Families (DCYF) administrative staff. The role also collaborates closely with the...

Required Qualifications BA/BS degree with at least two years of related experience or a combination of education and related work experience equal to six years. Demonstrated relational skills, involving collaboration, teamwork, and consultation. Consistent communication skills, both written and verba. Experience working independently using strong organizational skills, including managing multiple tasks effectively and keeping track of deadlines. Proven problem-solving skills. Preferred Qualifications Four years of experience in coordination of substantive project or program in higher education. Familiarity with UMN systems, operations, and human resource policies. Systems to include: Qualtrics, Canvas, Survey Monkey. Experience working with budgets and contracts. Experience in program coordination and leadership. Familiarity with child welfare. Experience with Google Workspace (Google Drive/Shared Drives). Position Overview The Administrative...

Are you looking for a stable job with great benefits and pay? Consider becoming part of the Avient team! We know your time is valuable and you have a lot of job ads to review. Let us break down the important details! Pay: $25.32 - $37.98 Hours: 11:00PM- 7:30AM Days: Sunday night - Friday morning What is the job : As a Maintenance Technician with Avient, you are responsible for completing maintenance assignments to build, repair and/or maintain all equipment in good operating condition as quickly and accurately as possible; while keeping associated costs to a minimum to help meet Plant goals. To be successful in this role you should be multi-skilled and able to contribute to plant maintenance activities in a variety of craft disciplines. At Avient, we're a global team creating materials that make a real difference in people's lives. From the world's strongest fiber used in personal protective equipment to recycling innovations and...

Overview At PNNL, our core capabilities are divided among major departments that we refer to as Directorates within the Lab, focused on a specific area of scientific research or other function, with its own leadership team and dedicated budget. Our Science & Technology directorates include National Security, Earth and Biological Sciences, Physical and Computational Sciences, and Energy and Environment. In addition, we have an Environmental Molecular Sciences Laboratory, a Department of Energy, Office of Science user facility housed on the PNNL campus. The National Security Directorate (NSD) drives science-based, mission-focused solutions to take on complex,?real-world?threats to our nation and the world. The AI and Data Analytics Division, part of the National Security Directorate, combines profound domain expertise and creative integration of advanced hardware and software to deliver computational solutions that address complex data and analytic challenges. Working...

Overview At PNNL, our core capabilities are divided among major departments that we refer to as Directorates within the Lab, focused on a specific area of scientific research or other function, with its own leadership team and dedicated budget. Our Science & Technology directorates include National Security, Earth and Biological Sciences, Physical and Computational Sciences, and Energy and Environment. In addition, we have an Environmental Molecular Sciences Laboratory, a Department of Energy, Office of Science user facility housed on the PNNL campus. The National Security Directorate (NSD) drives science-based, mission-focused solutions to take on complex,?real-world?threats to our nation and the world. The AI and Data Analytics Division, part of the National Security Directorate, combines profound domain expertise and creative integration of advanced hardware and software to deliver computational solutions that address complex data and analytic challenges. Working...