Out-of-Network Claims Negotiation Leader (NSA)
CVS Health
CVS Health is seeking a Manager, Out-of-Network Claims Negotiation to lead NSA and elective out-of-network reimbursements. You will guide strategy, oversee negotiators, ensure compliance, and balance provider relations, client expectations, and member experience. The role requires strong leadership, analytical skills, and expertise in NSA regulations to drive savings and improve negotiation outcomes across the network. #J-18808-Ljbffr CVS Health
- CVS Health is seeking a Manager, Out-of-Network Claims Negotiation to lead NSA and elective out-of-network reimbursements. You will shape strategy, oversee a negotiation team, and balance provider relations, regulatory requirements, client expectations, and member experience...NetworkClaims
$66.33k - $145.86k
...and one community at a time. Position Summary: The Manager, Out-of-Network Claims Negotiation is responsible for leading the strategy, operations, and... ...claims negotiation team supporting both No Surprises Act (NSA) claims and elective out-of-network reimbursement negotiations...NetworkClaimsHourly payFull timeTemporary workWork at officeLocal area$66.33k - $145.86k
...a time. Position Summary The Contract Negotiation Manager will negotiate and execute high-... ...Manages contract performance in support of network quality, availability, and financial... ...escalated issues related, but not limited to, claims payment, contract interpretation and...NetworkClaimsHourly payFull timeContract workTemporary workLocal area- Role Overview The MDM Strategic & Consulting Leader will drive the vision, strategy, and execution of Master Data Management... ...: Increased speed to insight, higher prescription and claim capture rate, improved customer network Intel. The member should have experience in handling...NetworkClaimsFull time
- ...focused on analyzing, auditing, and recovering underpayments from No Surprises Act eligible claims. You will ensure maximum legitimate reimbursement and oversee Open Negotiations and IDR timelines, driving productivity and quality in a fast-paced environment. You will...Claims
$80k - $120k
...team-based model of care.Our network includes Brown & Toland Physicians... ...healthcare from the inside out. At Altais, we support one... ...support of payer and provider negotiations and medical cost management... ...reporting with Cozeva, internal claims and Power BI, organizing and...NetworkClaimsLocal area- ...opportunities through client relationships, networking, and referrals. Handle all phases of... ...commercial litigation matters. Strong courtroom, negotiation, and advocacy skills. Excellent client... ...of contract Business torts and fraud claims Fiduciary duty litigation Construction-...NetworkClaimsContract work
$43k - $100k
...loss. You will be responsible for each claim until it is settled, traveling up to 75%... ...applications proficiency. Communication, negotiation, and conflict resolution skills. Reliable... ..., mental health services, fitness network membership, and Headspace subscription....NetworkClaimsFull timeLocal areaRemote work- ...This role requires strong technical expertise, a wide industry network, and excellent communication skills. The ideal candidate will develop... ...implement comprehensive strategies to enhance market presence, negotiate high-value deals, and maintain robust professional...Network
- ...Central, or Southern). You will expand and strengthen OCCU’s dealer network across the state, traveling as needed to support partnerships... ...growth. The role requires strong relationship-building and negotiation skills, with eight+ years in-dealership leadership and at...NetworkRemote job
- ...site operational and functional leaders to develop a high-performance... ...cost savings through active negotiations. Own relationships with:... ...Vehicle Suppliers, Maintenance networks and fuel providers. Repair &... ...prevention programs and support claims resolution. Capital Equipment...NetworkClaimsRelocationHome office
$230k - $270k
...national healthcare provider operating a large network of hospitals and services across the... ...issues including discrimination claims, wage and hour compliance, and employee... ...administrative claims. Draft, review, and negotiate employment-related agreements such as offer...NetworkClaimsFull timeLocal areaRelocation2 days per week- ...Litigation Manage and oversee complex PAGA claims and representative actions from... ...compliance and PAGA developments Participate in networking and business development activities... ...standing Excellent legal research, analytical, negotiation, and advocacy skills Strong written and...NetworkClaimsCasual workWork at officeRemote workFlexible hours
$200k - $235k
...utilization trends, high-cost services, inpatient stays, readmissions, out-of-network utilization, gaps in care coordination, and other clinical... ...skills with the ability to interpret utilization trends, claims data, clinical review data, and operational metrics. ~ Excellent...NetworkClaimsFull time- ...experienced Bodily Injury Adjuster to manage auto and homeowners liability claims in the Pacific time zone states. The role requires 8am-5pm Pacific time hours and strong analytical and negotiation skills to assess coverage, liability, and damages. The ideal candidate...Claims
$35.29 - $43.17 per hour
...journey has already begun. As an auto damage claims adjuster, you’ll serve as Progressive's... ...closely with body shops and others to negotiate repair pricing and assess liability.... ...Estimating Software Strongly Preferred Prior Non-Network Estimating Experience Preferred...NetworkClaimsTemporary workWork experience placementH1bWork at officeLocal areaFlexible hours$75k - $165k
...across the region Grow your network working with top-tier agents... ...more years of experience in the Claims or Underwriting Support area... ...profitable portfolio of customers Negotiation experience with large,... ...insurance. Zurich North America is a leader in risk management, with over...NetworkClaimsContract workTemporary workApprenticeshipWork at officeLocal area- Chumashcareers is seeking a dedicated Risk Manager to oversee the risk management team. This role includes managing insurance and claims, ensuring compliance with regulations, and fostering a safe work environment. Candidates should have a Bachelor's degree and five years...Claims
- ...auditing, and recovering underpayments from No Surprises Act eligible claims. You will drive throughput, quality, and productivity while... .... The ideal candidate brings extensive experience with NSA, IDR, and ON processes, with a proven track #J-18808-Ljbffr AspirionClaimsRemote job
- ...discovery, motion practice, settlement negotiations, and trial. Evaluate and manage a high-volume... ...caseload involving vehicle warranty claims under California's Song-Beverly Consumer... ...your experience, expertise, professional network, and be supported with a package of...NetworkClaimsPermanent employmentFull timeInterim roleWork at officeRemote workWorldwideFlexible hours
$63.09k - $82k
...Location US-MO-Columbia Job Category Claims and Investigation Position Type... ...we offer more than just a paycheck. Check out our suite of benefits designed to give you... ...medical plans provide 100% coverage for in-network preventative care, AND you and your family...NetworkClaimsFull timeWork at officeRemote workWork from homeFlexible hours$80k - $90k
## Claims Examiner - Workers Compensation (HYBRID- West Hills, CA... ...opportunity to join a global industry leader where you can bring your big... ...Sedgwick’s broad, global network of experts to both learn from... ...the exposure on the claim.* Negotiating settlement of claims within...NetworkClaimsRemote jobWork at officeFlexible hours$150k - $225k
...Peacock’s newest #1 series), and Claim to Fame (ABC/Hulu’s summer... ...portfolio. This strategic leader will collaborate with content... ...drive revenue growth across the network. With a deep understanding of... ...hosts and key creators Negotiate talent deals in coordination...NetworkClaimsSummer workFlexible hoursShift work- ...Home) Join Crawford & Company, a global leader in claims management, and help drive growth that... ...of insurance carrier distribution network. Responsibilities Develops strategic sales... ...written communication skills. Strong negotiating techniques and sales closing skills....NetworkClaimsContract workRemote workWork from homeWorldwide
$100k - $160k
...opportunity to work within a supportive culture emphasizing collaboration and innovation. The role involves drafting legal documents, negotiating claims, and interacting with clients to build strong relationships while maintaining a high level of detail and integrity. The firm...ClaimsRemote jobFull time$294.53k - $385.56k
...for people. Altais includes a network of physician-led organizations... ...transforming healthcare from the inside out. At Altais, we support one... ...network management.As the leader of the team, this role... ...compromising health outcomes.* Lead claims and cost analyses to identify...NetworkClaimsLocal areaFlexible hours$58.53k - $87.8k
...satisfaction, retention, and engagement. This leader ensures Specialists answer questions and... ..., benefits, eligibility, provider networks, claims, grievances, and support services Ensures... ...in a onsite environment. Carries out supervisory responsibilities in accordance...NetworkClaimsRemote workMonday to FridayRotating shiftWeekend work2 days per week$73.01k - $111.97k
...relations activities. Supports network development, network adequacy... ...to larger groups, such as leaders and management of provider offices... ..., provider services, or claims experience in a managed care... ...operations, and/or contract negotiations in a Medicaid, Medicare, and/...NetworkClaimsContract workWork experience placementWork at officeNight shift$25 - $32 per hour
...Acrisure is a global Fintech leader that combines the best of humans... ...and who can identify and seek out opportunities to enhance the... ...globally. We are a committed network of entrepreneurs dedicated to... ...information for endorsements, claim reporting and follow-ups, billing...NetworkClaimsImmediate startFlexible hours- ...will complete field and desk assignments that support insurance claims referred to and accepted for investigation by the Special... ...as well as independently Experience using internet and social networking for investigative purposes Must possess oral and written communication...NetworkClaimsWork at officeRemote work
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