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- ...Technician - ASP is a professional in charge of receiving and processing medical prescriptions. They will attend to the patient with the... ...system to obtain patient and medication information to process claims to medical plans in a timely and efficient manner. Assist new...Claims
- ...needed. Help with backroom duties, i.e., auto-load, returns, stock, etc., as needed. Assist with customer labor claims, making sure they are processed quickly and efficiently. All other duties as assigned. Skills/Education/Knowledge/Experience/Abilities...ClaimsLocal areaFlexible hours
- ...closely with the Legal Department Director to help address legal claims and support the company's operations, escalating any matter... ...company operations. Manage, complete, and maintain compliance processes with federal agencies for programs such as SBA 8(a), SBA Women-...ClaimsContract workFor contractorsWork experience placementFor subcontractorMonday to Friday
- ...Must have a LinkedIn. Must have prior experience in the Insurance domain (Claims preferred). Mainframe and API Testing Lead end-to-end testing efforts for Claims E2E Transformation project implementations, enhancements, and upgrades across all applications and teams contributing...Claims
- ...the-counter merchandise. Updates patient records and inventory, processes invoices, and makes accounting entries using a computerized... ...direct pharmacist's supervision. Prepares third-party insurance claims, to the extent allowable by state law. Processes invoices and makes...SuggestedTemporary work
$12.1 per hour
...Identify and respond to potential fraud using training, account data, and internal tools; escalate complex cases as needed. Process fraud claims and disputes per client guidelines. Clearly explain account issues and resolutions, ensuring a professional, empathetic...ClaimsHourly payMinimum wageFull timeCurrently hiringRemote workWork from homeShift workNight shiftWeekend workConduent Business Solutions of Puerto Rico, Inc.
Puerto Rico12 hours agonew- ...Description Job Description Location: Guaynabo, PR PBM Claims Analyst is responsible for auditing, analyzing, and tracking accounts... ...claims that have been paid, partially paid, or unpaid, as processed in “View Response.” Review PBM remittances, reports, and electronic...ClaimsWork at office
- ...all back up. If payment center, make sure all is submitted as process in place. Revise BOL’s once the cargo is delivered or picked... ...short or damages cargo upon arrival. Notify cargo damage to claims department with corresponding backup. Responsible to manage...ClaimsImmediate start
- ...authorization requests, drug use review, among others, to ensure that claims are correctly and timely adjudicated. Essential Functions:... ...system overrides (e.g., prior authorization) on the PBM claims processing system to ensure that claims are correctly adjudicated. 5....Claims
$60k - $80k
...insurance companies, and guiding clients through the pre-litigation process with professionalism and empathy. This position is ideal for... ...Key Responsibilities: Manage a caseload of personal injury claims from intake through settlement. Evaluate cases for liability...ClaimsWork at office- ...Facilitate service failure investigation/complaint and ensure corrective and preventive actions are in place. Assist all claim processes within a timely manner. Tools For Success : Essential Traits & Skills To be considered candidates must have:...ClaimsFlexible hours
- ...pilots/ramp/operations using radio communications • Organize ticket and cash reports • Handle delayed or missing baggage and process claims • Assure compliance with FAA and airport security procedures • Meet and marshal aircraft • Fueling Cape Air aircraft, if...ClaimsWork experience placementRemote workNight shiftWeekend work
- ...Translate business problems into functional requirements, workflows, process models, and user stories Facilitate requirements workshops with... ...Integrity & Healthcare Domain Analysis Analyze healthcare claims, provider billing patterns, member utilization, and payment...ClaimsContract work
- ...may NOT be required. ~ Experience with Business workflow processes ~ Bachelor of Science in Nursing (BSN) or Associate Degree... ...~5+ years experience in policy remediation. ~5+ years claims processing systems experience. ~5+ years knowledge of Microsoft...ClaimsWork at officeImmediate startRemote workRelocation
- ...insurance platforms. This role will focus on model-based test automation, ensuring high-quality delivery across policy administration, claims, and digital systems. Key Responsibilities Design, develop, and maintain automated test assets using Tricentis Tosca,...ClaimsContract work
- ...may NOT be required. ~ Experience with Business workflow processes Required / Desired ~ Bachelor of Science in Nursing (BSN)... ...years' experience in policy remediation. Preferred ~5+ years claims processing systems experience. Preferred ~5+ years...ClaimsWork at officeImmediate startRemote workRelocation
- ...multiple business domains including Customer/Assured, Broker, Policy, Claims, Finance, Financials, GWP, Reinsurance, Submission, and HR.... ..., SMEs, and application owners to understand business processes, data requirements, and reporting needs. Assess existing SSIS...Claims
- ...Insurance Domain Knowledge: Familiarity with insurance concepts, processes, and regulations is beneficial for understanding business... ...plugins for pre/post submission logic, policy lifecycle events, and claim/policy sync. Guide and mentor development teams on integration...ClaimsContract work
- ...Position Overview We are seeking an experienced Process Consultant with strong expertise in Life Insurance operations, business process... ...including: New Business & Underwriting Policy Administration Claims Processing Customer Service Operations Policy Servicing Billing...Claims
- ...inventory management, supplier relationships, warranty equipment processing, and logistics operations. This role plays a critical part in... ...suppliers, couriers, and customs brokers. Process warranty claims and Return Merchandise Authorizations (RMAs) for equipment requiring...ClaimsWork at officeLocal areaMonday to FridayShift work
- ...plans, business rules, rates, and provider networks within the claims adjudication system. The ideal candidate will ensure configuration... .... Research and resolve benefit configuration and claims processing inquiries. Provide configuration support and consultation to...ClaimsTemporary workWork experience placement
- ...generate invoices, ensuring data accuracy through a verification process that minimizes data entry errors to the lowest possible level.... ..., Compliance, and Quality Department customer calls related to claims, returns, products not received, incorrectly invoiced products,...ClaimsImmediate start
- ...Responsibilities: Lead the development and delivery of healthcare and PBM products, with a focus on Medicare and Medicaid claims processing, eligibility, formulary management, pricing, and reimbursement Champion the design and implementation of scalable API...ClaimsImmediate startRemote work
- ...quality services & solutions on time all the time by transforming processes & technology into business advantages. ABOUT THE ROLE The... ...and the System Turnover Lead. Manage vendor change orders, claims, warranty terms, and spare-parts strategy. Ensure compliance...ClaimsContract workFor contractors
- ...product teams, and technical teams. The role focuses on business process analysis, requirements gathering, Agile delivery, system... ...Services, Enterprise Content Management, Risk Management Systems, Claims Management, Legal Systems, Compliance Systems, Safety Systems,...Claims3 days per week
- ...to patients. This involves managing the billing and collections process, resolving any billing issues, and ensuring compliance with... ...policies. Responsibilities 1. Accurately code and submit claims to insurance companies and government payers following industry...ClaimsLocal areaWorldwide
- Job Description Job Description Ubicación: Guaynabo, PR El Analista de Auditoría PBM es responsable de auditar, analizar y dar seguimiento a las cuentas por cobrar relacionadas con Pharmacy Benefit Managers (PBM) en una farmacia especializada. Este rol está enfocado...Claims
- ...Integrate B2C with web, mobile, and APIs. Implement claims transformation and token customization. Collaborate with dev... ...schema. Implement provisioning, synchronization, and lifecycle processes. Security & Risk Management: Implement MFA, session...Claims
- ...Auto Loader, and Delta Live Tables for batch and near real-time processing. Own architecture standards for data modeling, medallion... ...considerations, and analytics use cases relevant to underwriting, claims, pricing, or risk functions. For applications and...ClaimsPermanent employmentFull timeContract workRemote work
- ...PharmPix clients. The Benefit Configuration Specialist I will test claims and perform quality assurance reviews to ensure desired results... ...and take corrective action. # Research and respond to claims processing and system configuration inquiries from internal departments...ClaimsWork experience placementWork at officeImmediate startWeekend workAfternoon shift
