Medicaid Claims Processing Expert

About the PositionThis is an exciting opportunity to join our team as a Medicaid and Pharmaceutical Regulations Expert. You will work closely with cross-functional teams to ensure compliance with internal policies and SOX regulations.Responsible for supervision and oversight of Chargeback Processing, ensuring accurate and timely chargeback data entry into...

Clark Davis Associates is a world-leading Pharmaceutical company that improves the health of millions daily.We are seeking a talented individual with experience in Government Pricing to lead our Medicaid program.Duties:Maintain accurate Class of Trades assignments and ensure compliance with Internal Policies as well as processing state Medicaid claimsPerform...

Total Loss Claims Resolution ExpertiseWe are seeking an experienced Total Loss Claims Resolution Expert to join our team in Boston. As a key member of our Auto Claims Organization, you will be responsible for identifying, negotiating and settling total losses with both insureds and claimants. Your expertise in property and casualty claims handling, combined...

About the OpportunityAs a Pharmaceutical Pricing Expert at Teva Pharmaceuticals, you will play a crucial role in ensuring the seamless processing of Managed Care Commercial, Medicare Part D, Managed Medicaid, and Medical Agreement rebate claims. Your primary responsibility will be to analyze utilization data, apply rules to determine included and excluded...

Role DescriptionTeva Pharmaceuticals is seeking an experienced Medicaid Claims Processing Expert to join our team. The successful candidate will be responsible for Medicaid claims processing, including validation, verification, and payment remittance for assigned state Medicaid agencies.This role requires prior experience in Medicaid claim processing,...

Key ResponsibilitiesThe Total Loss Claims Representative will be responsible for:Negotiating and communicating total loss and diminished value settlements in accordance with company and state guidelines.Reviewing damage estimates to confirm vehicles are total losses.Documenting all settlements and actions in the claim file system.Working directly with...

Job Title: Medicaid and Government Programs ManagerWe are seeking an experienced Medicaid and Government Programs Manager to lead our team in government program regulations and share this knowledge with direct reports and peer groups.Key Responsibilities:Lead monthly and quarterly meetings on Government Pricing Calculations and ensure proper sign-off and...

Job OverviewWe are seeking a skilled Healthcare Pricing Specialist to join our team at Teva Pharmaceuticals. This role will be responsible for Medicaid claims processing, including validation, verification, and payment remittance for assigned state Medicaid agencies.The ideal candidate will have prior experience in Medicaid claim processing, preferably in...

NJM Insurance Group is seeking a skilled Personal Injury Protection Representative to join our team. As a key member of our claims department, you will be responsible for managing the entire claims process from start to finish. This role requires strong analytical and problem-solving skills, as well as excellent communication and interpersonal...

Key Responsibilities:This PIP Representative position involves investigating and analyzing loss events, injuries, and other relevant information to determine coverage and course of action. Key responsibilities include: Reviewing PIP coverages and identifying coverage issuesEvaluating claims for fraud indicators and potential underwriting issuesMaintaining...

The ideal candidate for this role will possess excellent analytical and problem-solving skills, with the ability to effectively communicate complex ideas and negotiate with various stakeholders.Responsibilities:Analyze policies to assess coverage and liability, providing advice on Excess and Primary coverage issues.Conduct field investigations, interviewing...

About the Job:Skanska is hiring a Process Improvement Expert to join our team in the United States. This role is responsible for analyzing, designing, and implementing business process improvements to increase efficiency and reduce costs.The ideal candidate will have a strong background in process mapping, data analysis, and automation tools. Experience with...

Skanska is a leading development and construction company shaping the way people live, work, and connect. We're seeking an experienced Business Process Automation Expert to join our team in the United States.About the Role:We estimate the salary for this position to be around $120,000 - $180,000 per year, depending on experience and qualifications. As a...

NJM Insurance Group, a leading insurance provider, is seeking an exceptional Personal Injury Protection Representative. With a strong focus on customer service and excellent communication skills, this individual will conduct thorough investigations on assigned claims, ensure accurate coverage determinations, and provide timely resolutions.Key...

NJM Insurance Group seeks part-time student associates for a General Claims Associate role. As a valued member of our team, you will assist with claims-related tasks, provide exceptional customer service, and participate in formal in-house training.Job ResponsibilitiesWork collaboratively with adjusters to resolve claims efficiently.Verify coverage on claims...

Job SummaryWe are seeking a highly skilled Statistical Process Monitoring Expert to join our team at Unicon Pharma Inc.About the Role:The successful candidate will have a strong background in statistics, process monitoring and advanced statistical data analysis. They will apply established commercial biologics Continued Process Verification (CPV) program...

About the JobWe're seeking a skilled Business Process Automation Expert to join our team at Skanska. As a key member of our organization, you'll play a crucial role in driving process improvements and implementing automation solutions that enhance efficiency and productivity.ResponsibilitiesAnalyze and design business processes to identify opportunities for...

Job Description SummaryWe're looking for a skilled Managed Care Rebate Analyst to join our team at Teva Pharmaceuticals. As a key member of our operations team, you'll be responsible for processing managed care commercial, Medicare Part D, managed Medicaid, and medical agreement rebate claims. Your expertise will help ensure compliance with contractual terms...

About the OpportunityOur team is seeking a highly skilled Pharmaceutical Rebate Operations Specialist to join our organization. As a key member of our team, you will play a critical role in processing Managed Care Commercial, Medicare Part D, Managed Medicaid, and Medical Agreement rebate claims.Key ResponsibilitiesAnalyze utilization data and apply rules to...

Job OverviewTeva Pharmaceuticals is a global leader in the development and manufacturing of generic medicines. As a Managed Care Rebate Analyst, you will play a crucial role in processing rebate claims for managed care commercial, Medicare Part D, managed Medicaid, and medical agreements.About YouWe're looking for a highly analytical individual with strong...