18 claims representative jobs found

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...

DESCRIPTION Overview The Retail Supervisor-Events is responsible for the management of effective, efficient and quality event execution in a designated location. They are to audit, train and coach Event Specialists on proper team compliance measurements to effectively represent the CROSSMARK Events team. RESPONSIBILITIES Responsible for recruiting, supervising and motivating employees. Developing them to deliver on our client's expectations. Train Events Specialists on company processes, policies, procedures, and position responsibilities. Ensure quality execution by conducting audits and work-withs of Event Specialists and develop event execution skills and knowledge while ensuring Food Safety practices are maintained. Communicates with store management about the upcoming events and the execution of past event in their store. Will be the point of contact for all events being conducted in the store. Assist Event Specialist with event...

If you are a current State of Maine employee, please submit your application through the internal application process using the Find Jobs report in PRISM. Seasonal employees who do not have PRISM access should apply through the State’s career page and indicate on the application that they have previously worked for the State. . Department of Labor - Bureau of Unemployment Compensation Job Class Code : 0753 Grade: 19 /Professional & Technical Salary: $19.84 - $27.49 - Hourly Location: Augusta Opening Date: March 27, 2026 Closing Date: April 13, 2026 This position is in office with hybrid work available after the probationary period. Join the Department of Labor, where your passion for public service can make a positive impact. As part of our team, you will interact with diverse populations and break down eligibility barriers to allow greater access to Unemployment Benefits. As an Unemployment Compensation (UC) Eligibility...

Job Description Overview The Retail Supervisor-Events is responsible for the management of effective, efficient and quality event execution in a designated location. They are to audit, train and coach Event Specialists on proper team compliance measurements to effectively represent the CROSSMARK Events team. Responsibilities Responsible for recruiting, supervising and motivating employees. Developing them to deliver on our client's expectations. Train Events Specialists on company processes, policies, procedures, and position responsibilities. Ensure quality execution by conducting audits and work-withs of Event Specialists and develop event execution skills and knowledge while ensuring Food Safety practices are maintained. Communicates with store management about the upcoming events and the execution of past event in their store. Will be the point of contact for all events being conducted in the store. Assist Event Specialist with event kits, materials and tools as...

Overview The Retail Supervisor-Events is responsible for the management of effective, efficient and quality event execution in a designated location. They are to audit, train and coach Event Specialists on proper team compliance measurements to effectively represent the CROSSMARK Events team. Responsible for recruiting, supervising and motivating employees. Developing them to deliver on our client’s expectations. Train Events Specialists on company processes, policies, procedures, and position responsibilities. Ensure quality execution by conducting audits and work-withs of Event Specialists and develop event execution skills and knowledge while ensuring Food Safety practices are maintained. Communicates with store management about the upcoming events and the execution of past event in their store. Will be the point of contact for all events being conducted in the store. Assist Event Specialist with event kits, materials and tools as needed. Monitor and manage...

Brice Integrated, LLC Regular Pay Range: $50,000 - $60,000 Why choose us? Our founding company was built more than 50 years ago and has a legacy of welcoming new employees with our commitment to provide the best place to work by inspiring financial security and premier health and wellness programs for you and your family while enjoying an adventurous and dynamic culture. Our employees’ commitment to protecting the environment is intrinsic and deeply rooted, both individually and collectively at Brice, giving you purpose-driven work that is impactful. What does Brice Integrated do? Brice Companies are a family of businesses providing civil construction, marine services, equipment rentals and quarry materials. We complete projects in remote locations throughout Alaska, continually performing exceptional work through the challenging conditions of these regions. Our outstanding reputation is built on the foundation of getting the job done, regardless of the...

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Care Team Patient Services Representative works collaboratively with all members of the care team providing world class service to both the patients and staff of Martin's Point. Answers all Care Team Phone Calls within established quality metrics. Supports various other Care Teams by answering their phones (as...

About Us SolomonEdwardsGroup, LLC ("SolomonEdwards") is a full-service professional services firm offering financial, operational, and technology consulting and operations support. We work with some of the world's most prominent companies to help them envision and achieve a better future. We know that our consulting services are only as meaningful as the people and talent behind them, and we are committed to recruiting incredibly talented, committed, and collaborative individuals who can help us deliver exceptional client service. For more information, visit SolomonEdwards Position Summary: We are seeking a Data Modeler to join a leading healthcare organization with operations supporting data-driven clinical, pharmacy, and business decision-making. This consultant will design, build, and maintain data models that transform complex healthcare data into actionable insights, analytics, and business intelligence solutions that support strategic planning and improved patient...

If you are a current State of Maine employee, please submit your application through the internal application process using the Find Jobs report in PRISM. Seasonal employees who do not have PRISM access should apply through the State’s career page and indicate on the application that they have previously worked for the State. . Department of Health and Human Services (DHHS) Opening Date: March 20, 2026 Closing Date: April 2, 2026 Job Class Code: 3065 Grade: 25 (Professional & Technical) Salary: $54,412.80 - $76,315.20 per year Position Number: 020004012, 020004013, 020004014, 020004015, 020004016, 020241622 Location: Winthrop Currently, this position is not eligible for visa sponsorship or STEM OPT extensions. Are you interested in a career in Public Service and assisting some of Maine’s most vulnerable? Do you enjoy complex, fast-paced work with a high degree of independence? Do you want to be part of a growing team and have a positive work...

If you are a current State of Maine employee, please submit your application through the internal application process using the Find Jobs report in PRISM. Seasonal employees who do not have PRISM access should apply through the State’s career page and indicate on the application that they have previously worked for the State. . Department of Health and Human Services (DHHS) Reimbursement Specialist Opening Date: March 20, 2026 Closing Date: April 2, 2026 Job Class Code: 0441 Grade: 20 (Professional & Technical Services) Salary: $43,014.40 - $60,070.40 per year Position Number: 02000-3301 Location: Augusta This position allows for partial telework with management approval. Currently, this position is not eligible for visa sponsorship or STEM OPT extensions. Core Responsibilities: As a reimbursement Specialist for PHIP (Private Health Insurance Premium) you will manage a portfolio of cases, determine whether or not the applicant is...

The difference is We Care…..about our employees, our customers and our community. Maritime Energy has an opening for a full time Credit Department Representative at our office in Rockland. The successful candidate must be self-motivated, detail oriented, a strong communicator, both oral and written, possess the ability to multi-task with efficiency, maintain customer awareness and provide exceptional customer service. Responsibilities include review accounts for adherence to credit terms, generate various reports used for analysis and delivery releases, review new customer accounts for completion of credit and delivery status, track and monitor various customer payment arrangements, maintain customer files, process checks received for NSF, review and analyze customer accounts for possible legal action, and assist Credit Manager in small claims process as directed as well as assist in collection efforts. Maritime Energy offers a competitive pay, a benefit package that...

Company : Highmark Inc. Job Description : JOB SUMMARY This job provides front line staff guidance, ensures effective and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings. The incumbent responds to physician and pharmacy network provider inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network providers to evaluate, educate and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. ESSENTIAL RESPONSIBILITIES Communicate effectively with physician and pharmacy network providers to ensure that the needs of the...

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...

Position Summary The purpose of this position is to lead the clinical development activities in support of domestic and international clinical development initiatives. The Senior Director, GCD works in a multidisciplinary matrix environment and supports the further development and commercialization of pharmaceutical products, for global launches. This position requires deep understanding of all aspects of the drug development process from early clinical stages to post commercialization; with emphasis on the large global clinical trials and regulatory filing activities. The Senior Director, GCD is responsible for all the clinical development activities for the projects assigned and for the successful implementation and completion of trials leading to NDA and/or Global filings. Key Job Responsibilities Conceives, implements, and analyzes drug development programs, including: Understanding pharmacology of drugs and unmet medical needs. Formulating a...

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...

The Manager, Manufacturing Product Quality (Small molecule) is responsible for ensuring GMP and GCP compliance in the manufacturing packaging, labeling, and distribution of commercial and clinical trial materials across global operations. This role supports the oversight of manufacturing and packaging activities performed internally and at external vendors, ensuring that quality standards are met and regulatory requirements are maintained throughout the commercial and clinical supply chains. The manager will collaborate with cross-functional teams including Clinical Operations, Regulatory Affairs, and Supply Chain to ensure the integrity and traceability of investigational products from manufacturing and packaging through delivery. Key Responsibilities Oversee manufacturing of commercial and clinical products at contract manufacturers to ensure compliance with GMP, GCP, and applicable global regulatory requirements. Performs batch record review and quality...

Job Summary: The Senior Manager, Clinical Technical Operations within Clinical Operations is responsible for supporting the implementation, integration, and optimization of technical systems and processes that support the planning, execution, and oversight of clinical trials. This role bridges the gap between clinical operations and technical functions, ensuring that digital tools, platforms, and data systems are effectively leveraged to drive operational efficiency, compliance, and data integrity. The Senior Manager will collaborate cross-functionally with Clinical, Data Management, IT, Quality, and external vendors to support system implementation, process automation, and continuous improvement initiatives. This role also includes oversight of technical service providers and may involve line management responsibilities. Key Responsibilities: Technical Systems Oversight - Support the implementation, configuration, and maintenance of clinical operations systems...

Position Summary The Associate Director of MSAT (Manufacturing Science & Technology) - Analytical Sciences will serve as a scientific and technical leader supporting tech transfer, and commercial manufacturing of biologic drug substances and drug products. This role oversees analytical lifecycle management, method qualification/validation, comparability, control strategy implementation, and investigations. The ideal candidate brings deep expertise in biologics analytics, strong cross-functional leadership, and experience working with external contract manufacturing companies. Key Responsibilities Lead the analytical sciences function within MSAT to ensure robust support for commercial manufacturing of biologics (e.g., mAbs, fusion proteins). Drive analytical control strategy, specification setting, and lifecycle management in alignment with QbD principles. Oversee method performance monitoring and trending, analytical capability assessments, and...