Sr. Claims Analyst Jobs

337 jobs

Responsibilities: The Sr. Analyst handles 3rd party liability claims (general liability, product liability, auto liability) as well as 1st party property damage and subrogation claims to conclusion. This position also handles insurable litigation matters in partnership with National Coordinating Counsel. It partners with our Third Party Administrator (TPA) handling our workers compensation clai...

Designated a 2015 Military Friendly® Employer NCI: As the Medical Review Team Lead / Sr. Lead Claims Review Analyst ( Medical Review IV ) at AdvanceMed, you will review and analyze medical records and makes medical necessity determinations utilizing clinical judgment. In assuming this position, you will be a critical contributor to meeting NCI's mission: To deliver innovative, cost-effective solu...

Responsibilities: The Sr. Analyst handles 3rd party liability claims (general liability, product liability, auto liability) as well as 1st party property damage and subrogation claims to conclusion. This position also handles insurable litigation matters in partnership with National Coordinating Counsel. It partners with our Third Party Administrator (TPA) handling our workers compensation claim...

Sr. Claims Analyst Reviewing and updating consumer eligibiilty; reviewing and evaluating accuracy of claims data; analyzing claims data; analyzing eligibility data Responsibilities for this position: Review policy numbers for consumers that encounters have been rejected from the State of Utah Review consumer demographic data to ensure that it matches the data in the State of Utah database and ...

The Sr. Claims Specialist provides service strategy and integrated service management, claim consulting and advocacy services to clients. The Claims Specialist will be responsible for the quality and consistency of products and services for a large international client. Job Duties: Has extensive experience of handling claims of a complex nature Help develop and execute the strategies of the prac...

Job Category: Finance Clinical Licensure Required : N/A Job Type: Full Time Position Summary: Perform detail oriented claim analysis to determine the financial impact to clients, participants, pharmacies, and Caremark due to adjudication errors. Sr. Analyst will be required to perform impact analysis, claims/medical transaction analysis, financial analysis, and root cause analysis. Sr. Analys...

Perform detail oriented claim analysis to determine the financial impact to clients, participants, pharmacies, and Caremark due to adjudication errors. Sr. Analyst will be required to perform impact analysis, claims/medical transaction analysis, financial analysis, and root cause analysis. Sr. Analyst will be expected to quickly triage client issues and take necessary steps to remediate them. Th...

Title Senior Analyst, Claims Adjustment Req ID 304589BR Business Area CVS Health Job Category Finance Location - State/City IL - Northbrook Position Summary Perform detail oriented claim analysis to determine the financial impact to clients, participants, pharmacies, and Caremark due to adjudication errors. Sr. Analyst will be required to perform impact analysis, claims/medical transaction a...

Description: Do you have experience investigating healthcare claims? Experience working in a Special Investigations Unit (SIU)? Are you a hotshot Microsoft Excel user? Want to work with an elite team of some of the brightest and most inventive people in the healthcare & technology industries? Optum is a health services business, part of the UnitedHealth Group family of companies, dedicated to mak...

Description: Do you have experience investigating healthcare claims? Experience working in a Special Investigations Unit (SIU)? Are you a hotshot Microsoft Excel user? Want to work with an elite team of some of the brightest and most inventive people in the healthcare & technology industries? Optum is a health services business, part of the UnitedHealth Group family of companies, dedicated to mak...

Job Description This is an office-based position in the Maryland Health Plan of Amerigroup, located in Hanover, Maryland. Your Talent. Our Vision. At Anthem, Inc ., it's a powerful combination, and the foundation upon which we're creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health ...

Senior Business Analyst - Bodily Injury Claims-59177 Description Advance your career at Liberty Mutual Insurance- A Fortune 100 Company! Personal Insurance is searching for a Sr. Business Analyst to support special projects and process implementation for Bodily Injury claims. In this role, you will be a part of the Personal Insurance Claims, Bodily Injury (BI) Product Team. Under limited superv...

Advanced Systems Analyst, Medicare Part D Job Description Departmental Summary Responsible for identifying, collecting, analyzing, and maintaining data to support the clinical pharmacy team. Analyze in bound requests and determine the appropriate technology solution for an effective and efficient delivery. Utilize SAS software to create datasets from multiple, primary sources, conduct analyses ...

AIG is seeking an experienced medical malpractice claims analyst. This challenging role involves negotiating, analyzing and resolving medical malpractice and GL claims on primary and excess levels. Ideal candidate will analyze coverage issues, execute investigations, negotiate settlements and be responsible for participating in mediations, attending trials and conducting outside claim audits. A m...

Sr. Benefit Analyst National Express Corporation is currently seeking a Sr. Benefit Analyst to assist with the delivery and implementation of the Company’s health and welfare benefits plans in both the United States and Canada. To support, manage and report the HR data and ensure plans are consistently administered and in compliance with company and government regulations. This position reports d...

The Senior Configuration Analyst is responsible for accurate and timely development of automated rules and pricing. This position will also need to help develop new business plans that will help promote technology and automation. Additional responsibilities: Builds rules within the Peradigm System, in coordination within State and Federal guidelines Monitors and tests the accuracy of price rule...

Sr. Customer Development Analyst / Sr. Customer Insight Analyst (Walgreen's)-3890150715 Description Johnson & Johnson Consumer, Inc, a member of Johnson & Johnson’s Family of Companies, is currently recruiting for a Sr. Category Insight Analyst to be based out of our Buffalo Grove, IL location, supporting the Walgreen’s business. Johnson & Johnson Consumer, Inc, a division of Johnson & Johnson ...

Description: You believe data can help reshape the future, and you find yourself loving the thrill of diving into challenging analysis. At UnitedHealth Group, you'll find an organization that will recognize those talents and have lots of growth potential. Here, you will be empowered, supported and encouraged to use your analysis expertise to help change the future of health care. Does the challen...

KEY OBJECTIVE: The ESIS Sr. Financial Analyst will be responsible for the following: · Revenue Reporting & Analytics · InterCompany Support · Project Support · Business Unit Support (HSE, RSI, Compliance, Claims) · Controls / Balance Sheet Support MAJOR DUTIES & RESPONSIBILITIES: 1. Responsible for preparing monthly management reports for ESIS senior management. a. This will includ...

Description: You thrive on developing new solutions to solve tough challenges. As a critical member of our business team, you will help rewrite the future of UnitedHealth Group. Here, your innovative skills will help us with our mission of helping people live healthier lives. And passion for improving the lives of our customers is a motivating factor in everything that happens. The United Clinica...