24 claims representative jobs found

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...

Job Summary Under the direction of the Director/Associate Director of Clinical Management, the Senior Clinical Study Manager is responsible for the oversight and management of Otsuka clinical studies, including coordination with other relevant parties (e.g., other Otsuka departments, external service providers (ESPs), etc.). Responsibilities include the planning, execution and completion of clinical trials according to applicable regulations and guidance; ICH Guidelines Good Clinical Practices (GCP), and Otsuka SOPs, within agreed-upon timeframes and budget. Job Description Provides oversight and management of clinical studies at Otsuka, including planning, execution, and completion of clinical trials according to all applicable regulations and guidance, ICH/GCP, and Otsuka SOPs. Contribute to the development and review of all critical clinical study documents, including clinical protocols, informed consent forms, or other study-related clinical documents....

Job Summary In collaboration with the Senior Director of Clinical Management, the Director is responsible for the operational strategy and management of Otsuka clinical programs, including coordination with other relevant parties (e.g., other Otsuka departments, external service providers (ESPs), etc.). Responsibilities include the planning, execution, and completion of clinical programs according to applicable regulations and guidance; ICH Guidelines, Good Clinical Practices (GCP), and Otsuka SOPs, within agreed upon timelines and budget. Job Description Provides scientific clinical research and operational expertise in the development of overall strategy and objectives of the Global Clinical Development Plan (GCDP), including performing/overseeing and providing background research. May represent Clinical Management in the development of the Clinical Development Plan, timelines, and budget for Business Development opportunities. Ensures program specific...

Job Description At EXP, we’re driven to provide innovative solutions for the world’s built and natural environments. As a team of engineers, architects, designers, scientists, creators and a community of professionals, we bring diverse and talented people together to solve the world’s most complex challenges. Here, you join a team that leverages differences, harnesses their entrepreneurial spirit in an employee-owned company, that believes diversity is what gives us strength, seeks sustainable results and shares ambitions for each other, our clients and the communities we are part of and serve. To be a part of EXP means to have your own experience, while staying connected to a global network of professionals, who believe we are a part of something bigger. Together, we are EXP. Are you ready to design your future? Be our next Senior Construction Project Manager! Your work environment at EXP In this role, you will be a part EXP’s Infrastructure & Transportation...

Job Description At EXP, we’re driven to provide innovative solutions for the world’s built and natural environments. As a team of engineers, architects, designers, scientists, creators and a community of professionals, we bring diverse and talented people together to solve the world’s most complex challenges. Here, you join a team that leverages differences, harnesses their entrepreneurial spirit in an employee-owned company, that believes diversity is what gives us strength, seeks sustainable results and shares ambitions for each other, our clients and the communities we are part of and serve. To be a part of EXP means to have your own experience, while staying connected to a global network of professionals, who believe we are a part of something bigger. Together, we are EXP. Are you ready to design your future? Be our next Senior Construction Project Manager! Your work environment at EXP In this role, you will be a part EXP’s Infrastructure & Transportation...

JOB REQUIREMENTS: The HR Manager directs all Human Resource functions, including developing, implementing, and enforcing company polices, employment laws, and safety requirements. This role leads labor relations, including union negotiations and grievance management, oversees talent acquisition, employee development, employee relations, payroll, benefits, and workers\' compensation and safety and fosters an engaged, compliant, and high-performing workforce. PRIMARY RESPONSIBILITIES: 1. Oversee, direct, and lead the Human Resources department and its staff. 2. Serve as liaison between various staff (both union and non-union); lead union contract negotiations, mentor leadership in employee relations, engagement, and conflict resolution. Lead union grievance process to resolve grievances and issues in compliance with established practices, company policies and the union contract. 4. Enforce company polices, including conducting employee investigations and issuing disciplinary...

The Director, Corporate Counsel will provide strategic and pragmatic day-to-day legal support for one or more marketed pharmaceutical brands in the United States. This attorney will serve as a primary legal advisor to sales and marketing stakeholders with a strong focus on direct brand support, promotional committee review, and counseling on sales and marketing tactics across the product lifecycle. The ideal candidate brings substantial experience advising on issues affecting commercialized pharmaceutical products, including review of promotional and non-promotional materials, field medical content, market access communications, sales training, patient support initiatives, and/or external engagement programs. This role requires sound judgment, strong cross-functional partnership skills, and the ability to deliver practical, risk-based advice in a fast-paced environment. The candidate must demonstrate the ability to understand and apply legal risks within his/her areas of...

Provide leadership and management direction of a claim adjusting team. Claim adjusting teams investigate and maintain property/casualty claims. Determines liability, secures information, reviews coverages, arranges appraisals, and settles claims. May work in the field or central location. Directs conformity with the terms of each policy and in compliance with applicable laws, regulations, established standards, and procedures of the company. You will report to the Adjusting Services Senior Manager. In this primarily home-based role must be proximate to one of our office locations in Phoenix, AZ; Boston, MA; Madison, WI; St. Joseph, MO; Keene, NH; Denver, CO or Minneapolis, MN; Atlanta, GA. #LI-Remote Position Compensation Range: $88,000.00 - $145,000.00 Pay Rate Type: Salary Compensation may vary based on the job level and your geographic work location. Relocation support is offered for eligible candidates. Primary Accountabilities -Create a collaborative,...

Summary: Customer Care Representatives respond to inquiries from policyholders, prospects, and coworkers through multiple channels of communication. Uses general insurance and jewelry knowledge gained through education and/or experience to promote personal jewelry insurance to potential policyholders and jewelers. Position involves handling both inbound and outbound customer interactions. Why Jewelers Mutual: Since 1913 we’ve been committed to supporting the Jewelry industry and putting customers at the center of everything we do. With over a century of trusted expertise, we’re financially strong, forward-thinking, and driven by curiosity. Guided by our core values of Agility, Accountability, and Relevancy, we lead through innovation. As a technology focused organization, we embrace cutting-edge tools and data-driven insights to continuously improve our products, services, and customer experience. Our mission is to be the industry’s most trusted advisor by investing...

Company : Highmark Inc. Job Description : JOB SUMMARY 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. This job supervises and coordinates the day to day activities of the various claims processing or claims adjustment units responding to internal inquiries or inquiries received by members, providers, or account representatives across all markets. ESSENTIAL RESPONSIBILITIES Communicate effectively. Effectively supervise all assigned personnel. Coordinate any claim backlog distribution for regular and overtime work both interdepartmentally and companywide. Monitor and manage daily inventories to ensure adequate...

Company : Highmark Inc. Job Description : JOB SUMMARY 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. This job supervises and coordinates the day to day activities of the various claims processing or claims adjustment units responding to internal inquiries or inquiries received by members, providers, or account representatives across all markets. This job administers the day-to-day activities related to collecting, analyzing and reporting on source data and key performance metrics for the purpose of supporting operational efficiency, overall tracking of business performance and management intelligence for effective decision-making. Along...

Current Employees: If you are currently employed at any of the Universities of Wisconsin, log in to Workday to apply through the internal application process. Job Category: Academic Staff Employment Type: Terminal (Fixed Term) Job Profile: Academic Program Specialist Job Summary: Job Description The University of Wisconsin-Madison is a public, land-grant institution that exemplifies the "Wisconsin Idea" that the resources of the university should benefit all the citizens of the state. The Division of Continuing Studies (DCS) provides and supports high-quality continuing education, outreach, service and scholarship related to personal enrichment and professional development. The Prison Education Initiative (PEI) is housed within DCS and supports UWs statewide in delivering degree and other college programs to students incarcerated in Wisconsin state prisons. This position will work independently under the...

Current Employees: If you are currently employed at any of the Universities of Wisconsin, log in to Workday to apply through the internal application process. Job Category: Academic Staff Employment Type: Terminal (Fixed Term) Job Profile: Academic Program Specialist Job Summary: Job Description The University of Wisconsin-Madison is a public, land-grant institution that exemplifies the "Wisconsin Idea" that the resources of the university should benefit all the citizens of the state. The Division of Continuing Studies (DCS) provides and supports high-quality continuing education, outreach, service and scholarship related to personal enrichment and professional development. The Prison Education Initiative (PEI) is housed within DCS and supports UWs statewide in delivering degree and other college programs to students incarcerated in Wisconsin state prisons. This position will work independently under the supervision of the Prison Education Initiative...

Description Overview: The Associate is responsible for completing in-store food and non-food demonstrations. Acquires and maintains knowledge of products represented. Prepares, serves, and breaks down product, equipment, and supplies. Intercepts consumers and demonstrates products in a professional manner. Maintains an overall professional appearance consistent with the requirements of the job. Pay Rate is $15.00/Hour Responsibilities Possesses the aptitude and ability to gain adequate knowledge of the products represented. Has desire and ability to proactively intercept, engage, interact, and sell product to the consumer in a positive manner. Effectively communicate the features and benefits of the product. Ability to prepare and serve food samples using small appliances such as microwaves, fryers, skillets, coffee makers and knives. Maintain a clean, sterile and safe work station using cleaning chemicals. Maintains a professional appearance consistent with...

NOW HIRING Open Availability Preferred Overnight - 3rd Shift Part Time *Paid Weekly* Starting at $15.00 per hour + $.75 shift differential CrossAmerica Partners is a leading wholesale distributor of motor fuels, operator of convenience stores, and owner and lessor of real estate used in the retail distribution of motor fuels. With a geographic footprint across 34 states, we strive to be an industry leader, providing fuel and convenience products essential to keep people moving across America! Position Description: The Overnight Team Member will be responsible for managing store operations during the night shift, ensuring the store is clean, well-stocked, and secure while providing excellent customer service. This role requires strong attention to detail, the ability to handle cash and merchandise, and a commitment to maintaining a safe and welcoming environment for customers. Responsibilities: Greet and assist customers in a friendly and...

Are you looking for an exciting job where you can put your skills and talents to work at a company you can feel proud to be a part of? Do you want a workplace that will challenge you and offer you opportunities to learn and grow? A position at Xcel Energy could be just what you’re looking for. Position Summary The Inside Sales Representative is accountable for managing the Conservation Improvement Programs (CIP) - Demand Side Management (DSM) relationship with small and mid-size commercial customers. Energy Efficiency Consultants must develop consultative business relationships and increase market penetration by engaging business owners, understanding their needs, analyzing complex details of programs and technologies and recommending solutions concerning energy utilization and efficiency needs. Responsible for the implementation of customized CIP-DSM solutions by creating successful sales strategies, influence through multiple channels, including on-site visits, collaborative...

Are you looking for an exciting job where you can put your skills and talents to work at a company you can feel proud to be a part of? Do you want a workplace that will challenge you and offer you opportunities to learn and grow? A position at Xcel Energy could be just what you’re looking for. This position is based in Eau Claire, WI 54702 on a hybrid (3 days per week in office) work schedule. It can be hired at the Agent or Senior Agent level, depending on overall qualifications, experience, skills, and interview results. Position Summary - Agent Level - salary range $73,700 - $104,633 Performs the range of agent activities associated with the planning, siting and acquisition of permits and land rights for the construction, operation and maintenance of electrical and gas utility facilities for Xcel Energy and its operating and subsidiary companies. Works under minimal supervision conferring primarily on unusual matters and has appreciable latitude for unreviewed actions...

Your responsibilities Job Summary Uses extensive product knowledge in a particular product or product family to maximize profitability and sales positioning of assigned products. Job Description Key Accountabilities: Develop and maintain deep product expertise in assigned product(s) / product line(s). Function as internal product expert for both purchasing and sales activities. In conjunction with Outside Sales, contact new and existing customers to discuss how their needs could be met by specific products. Emphasize product features based on analyses of customers’ needs and on technical knowledge of product capabilities and limitations. Assists customers in making product selections based on customers’ needs, product specifications, and applicable regulations. Develop Sales/Marketing Plan for their respective product line and monitor results Responsible for quoting and supporting sales contracts. Convert Purchase Requisitions to purchase orders. Provide product...

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...

Job Description: The Senior Manager of Field Training and Development, collaborates and communicates closely with the Team Leader in the Field Training and Development Department to develop and drive the achievement of department objectives and responsibilities. Leads in coordinating closely with peers to ensure that learning needs are identified, training programs are developed, and actively implements learning experiences that strengthen the capabilities of customer-facing field personnel to drive business growth. Works cross-functionally with Brand teams, Field Leadership, Medical, and other internal key stakeholders along with external vendors to ensure Field Training and Development programs/deliverables are in alignment with brand/company strategies to support the achievement of commercial business objectives. Key Functions: Collaborates and communicates with peers in Field Training and Development Department to achieve department...

Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. This job is open to The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Clarification from the agency NOTE: The 2-page Resume requirement does not apply to this position. For more information, refer to Required Documents below. Open to all U.S. Citizens Duties The incumbent is a GS-11 Social Worker who works within the interdisciplinary Mental Health Clinic (MHC) as a Clinical Social Worker at the Wm. S....

Introduction Join an organization that strives to exceed customer expectations by delivering efficient, high-quality state government services. DOA provides direct services to state agency stakeholders and designs and leads initiatives to make government more innovative and cost-effective. Working at DOA offers you the opportunity to make an impact on the quality of life in Wisconsin. The Division of Enterprise Operations (DEO) administers enterprise policies governing procurement, risk management, and continuity of operations planning; provides services to DOA and other agencies in the areas of financial management, procurement, risk management, continuity of operations planning, and the State Prosecutors Program; and facilitates opportunities for diverse businesses to sell goods and services to state agencies. As the flagship agency of the State of Wisconsin, our core values at Department of Administration are Adaptability , Collaboration , Stewardship , Equity ,...

In this hybrid, you will be expected to work a minimum of 10 days per month from our Madison, WI 53783 office. You will report to a director, legal. Position Compensation Range: $150,000.00 - $255,000.00 Pay Rate Type: Salary Compensation may vary based on the job level and your geographic work location. Relocation support is offered for eligible candidates. Primary Accountabilities You will select and manage outside counsel to assist with corporate litigation in class actions, employment, life and agent matters. You will review and edit briefs and motions prepared by outside counsel. You will participate in and supervise exposure analysis and setting reserves. You will participate in mediations and settlement conferences. You will provide legal advice and participate in development of corporate and enterprise strategies. You will manage case budgets and reviews outside counsel billing. You will analyze legal questions,...