Sr. Pharmacy Resolution Specialist - Complex PA & Claims
Centene Corporation
Get notified about new Director Of Pharmacy jobs in United States . 3,000+ Director Of Pharmacy Jobs in United States Director of Pharmacy, UPMC North Central Director, Pharmacy - Pharmacy - Full-Time Pharmacy Director, Specialty Pharmacy and Ambulatory Care Pharmacy Services Director of Pharmacy at Clifton T. Perkins Hospital (Sign-On Bonus) Director of Pharmacy, Transitions of Care; Mount Sinai Healthcare System, Full Time Days Pharmacy Services and Medication Safety Director Director of Pharmacy, Transitions of Care; Mount Sinai Healthcare System, Full Time Days #J-18808-Ljbffr Centene Corporation
$19.43 - $32.98 per hour
...workplace flexibility. Position Purpose The Senior Pharmacy Resolution Specialist will act as a subject matter expert and handle more complex pharmacy issues and respond to escalated... ...provider offices to provide resolution to claims (i.e. additional information requests and...SeniorClaimsHourly payFull timePart timeWork at officeRemote workFlexible hours- Continental General is seeking a Claims Specialist II in the Austin, TX area to deliver responsive... ...process. You will handle moderately complex claim servicing tasks, review details,... ...external partners to ensure accurate resolutions. The ideal candidate brings strong...Claims
$125k - $175k
...Description Position Summary We are seeking an experienced Liability Complex Claim Director to lead an MGA claims organization. This role... ...role overseeing claim outcomes, litigation direction, and resolution strategy. Key Responsibilities Direct handling of a portfolio...SeniorClaims- Continental General is hiring a Claims Specialist II in the Austin, TX area. This full-time, non... ...11001 Lakeline Blvd. You will handle complex claim servicing tasks, communicate... ...internal teams to ensure accurate, timely resolutions. Ideal candidates will have 3+ years...ClaimsHourly payFull timeWork at office3 days per week
- ...to lead and support forensic and dispute resolution engagements for owners, contractors, and... .... The Senior Consultant performs claims analysis, schedule delay and damages assessments... ...a self-directed approach to mastering complex work, taking initiative to deepen expertise...SeniorClaimsFor contractorsFor subcontractorLocal area
$22 - $24 per hour
Job Description Licensed Pharmacy Benefits Specialist Location: The Colony, TX | Onsite... ...benefit questions and claim-related concerns. You'll provide... ...next steps. Escalate complex cases to the appropriate internal... ...to ensure timely resolution. MINIMUM QUALIFICATIONS Active...ClaimsFull timeMonday to FridayShift workWeekend work- ...handling cases that are primarily high complexity and exposure and/or involve unique insurance... ...all phases of cases from intake to resolution. Assumes first and/or second chair responsibility... ...to other attorneys. Consults with Claims Executive team and renders legal...SeniorClaimsRemote jobWork at officeFlexible hoursShift workNight shift
$77k - $202k
...organizations improve policy, claims, and billing processes within... ...Senior Associate you will analyze complex problems, manage assigned... ...to inform enhancements, issue resolution, and implementation decisions-... ...Francisco; CA-Silicon Valley; PA-Philadelphia; AZ-Phoenix; PA-Pittsburgh...SeniorClaimsFull timeH1b$138k - $243k
...join our Trial Division and lead complex litigation matters involving... ..., and construction defect claims. This is an opportunity to work... ...from inception through trial or resolution Serve as lead counsel in jury... ...The national salary range for Sr Trial Attorney : $138,000.00-$...SeniorClaimsTemporary workFor contractorsFor subcontractorCasual work$77k - $202k
...Senior Associate you will analyze complex client needs, manage assigned... ...policy administration, claims management, and billing for insurance... ...defects, and supporting issue resolution across development and... ...Francisco; CA-Silicon Valley; PA-Philadelphia; AZ-Phoenix; PA-Pittsburgh...SeniorClaimsFull timeH1b- ...Workplaces in Financial Services & Insurance Sr. Claims Specialist, Professional Liability | Medical... ...PRIMARY PURPOSE OF THE ROLE: To analyze complex or technically difficult medical malpractice claims; to provide resolution of highly complex nature and/or severe injury...SeniorClaimsLocal area
- ...benefits tailored to your lifestyle Job Responsibilities Claims Management: Adjudicate complex litigated high net worth primary and excess liability... ...technical complexity. Handle claims from inception to resolution, ensuring timely, accurate, and fair resolution. Coverage...ClaimsWork experience placementWork at officeLocal areaImmediate startFlexible hours3 days per week
$124k - $280k
...workstreams, bring sound judgment to complex situations, coach teams... ...solutions that support policy, claims, and billing operations, while... ...cause analysis, and issue resolution across the software development... ...Francisco; CA-Silicon Valley; PA-Philadelphia; AZ-Phoenix; PA-Pittsburgh...SeniorClaimsFull timeH1b- ...candidate will manage a diverse caseload of complex defense matters, provide strategic... ...and coverage matters from intake through resolution, including trial when necessary.Conduct... ...coverage analysis and advise clients and claims teams on coverage issues, reservation of...SeniorClaims
$1,000 - $2,000 per month
...lives and make a difference. The Accounts Resolution Specialist contributes to the financial viability... ...performs these functions at a complex level of implementation, analysis, and... ...timely and accurate validation of denied claims and determines appropriate denial resolution...ClaimsFull timeTemporary workPart timeWork at officeImmediate startRemote workFlexible hours- Tarrytown Expocare Pharmacy seeks a detail-oriented DME Billing Specialist to support durable medical equipment billing across multiple locations. This remote... ...Medicare Part B and Medicaid compliance, claim resolution, and collaboration with pharmacy teams nationwide...ClaimsRemote job
$37.66 - $44.33 per hour
...meet the unique coverage and claims-handling needs of businesses.... ...Richmond (VA), or Rockwood (PA) . This role will adjudicate... ...compensation claims of higher technical complexity for our customers in the... ...financial outcome and timely resolution. Properly setting claim...ClaimsRemote jobHourly payTemporary workLocal area$88k - $120k
...Description The Commercial General Liability (CGL) Claims Adjuster is responsible for the end-to-end handling of complex third-party bodily injury and property damage... ...liability exposures. Drive timely claim resolution through proactive file management, strategic planning...SeniorClaimsWork experience placementWork at officeLocal areaFlexible hours- # DME Pharmacy Billing SpecialistFully Remote • Remote Worker - NA... ...detail-oriented **DME Billing Specialist** to support durable medical... ...review documentation, resolve claim issues, and communicate effectively... ..., and denials through resolution.* Use billing systems including...ClaimsLocal areaImmediate startRemote workMonday to Friday
$145k - $155k
...to individuals and families navigating complex immigration matters. Our team combines strong... ...strategy through filing, hearing, and resolution. Handle USCIS, humanitarian, and removal... ..., asylum, withholding of removal, CAT claims, cancellation of removal, bonds, detained...SeniorClaimsRemote work$750 per month
...Solutions is seeking a Sr. Manager, Specialty Network... ...providing specialty pharmacy clinical expertise, PBM... ...benefit design, claims processing concepts, network... ...the ability to translate complex specialty network... ...service concerns. Lead resolution of specialty pharmacy escalations...SeniorClaimsContract workRemote workFlexible hours- Turner Construction Company is seeking an experienced Claims Manager to lead complex construction-related claims across the Midwest and Western Region... ...will direct litigation strategy from inception through resolution, perform early case assessments, oversee defense counsel,...SeniorClaims
- Sedgwick is seeking an experienced Sr. Claims Specialist for Professional Liability focusing on medical malpractice. You will analyze complex claims, coordinate investigations, and... ...to achieve favorable, cost-conscious resolutions. The ideal candidate brings 6+ years...SeniorClaims
- ...affecting cost, schedule, scope, and riskLead resolution of critical project issues and... ...years of leadership experience managing complex construction organizations and project teams... ...management.Expertise in contract negotiation, claims management, and commercial strategy....SeniorClaimsFull timeContract workFor contractorsFor subcontractorLocal area
- Sedgwick is actively seeking a Sr. Claims Specialist to analyze complex medical malpractice claims and manage high exposure cases with strong analytical... ...and negotiation skills. This role emphasizes timely resolutions and outstanding client service in a remote-capable...SeniorClaimsRemote job
$110k - $240k
...sophisticated expert services to resolve complex construction disputes. Our... ...on high-profile construction disputes, claims, and litigation matters, focusing on design... ...directly impact multi-million-dollar dispute resolutions by providing objective, credible, and defensible...SeniorClaimsFull timeFor contractorsWork at office- ...self! Anaplan is looking for a tenacious Sr. Solution Architect to join our Business... ...through leading expert interviews, handling complex data, leading partners, and guiding... ...telephone calls, emails and correspondence, claiming they are representatives of Anaplan. The...SeniorClaims
- Allergistsanantonio is seeking a full-time Medical Account Receivable Specialist (Level 3) to manage complex, high-dollar reimbursement issues. This role is... ...TX and will require expertise in medical billing and claims resolution. Candidates should have 5-7 years of relevant...SeniorClaimsFull time
- ...CPM scheduling, and construction dispute resolution for government and commercial clients... ...maintains a five-year undefeated record on claims involving billions of dollars in... ...time remote role responsible for leading complex project planning and scheduling activities...SeniorClaimsFull timeFor contractorsRemote workWorldwide
$95k - $125k
...Columbus, OH, United States; Philadelphia, PA, United States; Pittsburgh, PA, United... ...negotiating equitable adjustment and termination claims as well as providing strategic pricing... ...part of a team helping clients navigate complexity and move forward with clarity.We are...SeniorClaimsContract workFor contractorsWork at office
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