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Must have hands-on RWD/RWE experience with CMS data, large-scale administrative claims data sources (e.g., MarketScan, Optum, Medicare LDS SAF, Komodo claims), and EHR. Conduct queries to claims, EHR, and/or other real-world data sources.
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What Youll DoWe have an exciting opportunity for a Senior Litigation Specialist, EPL to join our team, responsibilities include: Claims Management:Oversee a caseload of 75 files, primarily litigated EPL and Professional Liability claims.
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ProBio proactively provides end-to-end CDMO service from drug discovery to commercialization with proactive strategies, professional solutions and efficient processes in cell and gene therapy (CGT), vaccine, biologics discovery and antibody protein drug to accelerate drug development for customers.
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Uses SAS, SQL, or other programming skills to create analytical datasets from health care claims, electronic health record, surveys, and other data sources by following protocols and statistical analysis plans.
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Claims QA – Liaise with the Global Claims QA Lead to ensure alignment of TPA audit plans on an annual basis and support the facilitation of each audit. Quarterly Relationship with our ‘strategic’ TPAs along with the Global Claims Vendor Lead. Claims QA - Liaise with Global Claims QA Lead to agree annual audit regime for TPAs. Risk/ Compliance – As it relates to Sanctions, Financial crime and Conduct risk.
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Examine equipment for possible warranty claims throughout warranty period. Process all claims and coordinate repairs. Minimum Requirements Candidate should have a minimum of 5 years of experience in Supermarket Refrigeration, HVAC & ElectricalM.E. or E.E. Preferred· Exceptional computer skills: Proficient in Lotus Notes, MS Word, Excel, and PowerPoint and Project.
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Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service. JOB DESCRIPTION :Essential Duties & Responsibilities:Performs a combination of duties in accordance with departmental guidelines:Manages an inventory of low to mid complexity and exposure Private D&O and EPL claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
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Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjuster? As a Licensed Claims Adjuster, you'll play a crucial role in helping individuals and businesses recover from unforeseen disasters and rebuild their lives.
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We are seeking a Senior Civil Engineer with broad expertise in land development and/or site/civil/heavy construction project management to perform investigations and analyses, prepare reports, and provide expert testimony where technical knowledge, skill, experience, training and/or education are needed to help resolve civil litigation and insurance claims.
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The SIU Supervisor will oversee the operation of a unit of SIU Investigators with varying levels of experience who handle investigations on suspect claim and underwriting matters.
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Serves as an impactful member of Product Development Team sub-teams (Clinical, Value Evidence, Commercial, Publications and Labelling) and Global Human Health commercialization teams. They are impactful members of Product Development Team and sub-teams and Global Human Health commercialization teams.
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We’re equipped to meet all our clients’ unique challenges including reorganizations, Ponzi schemes, fraud, contractual disputes, matrimonial claims, Intellectual Property disputes, valuation, and forensic investigations.
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This is a headquarters-based position in Our Company Research Laboratories, Global Medical and Scientific Affairs (GMSA). Contributes to the development of a single global scientific communications platform.
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Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. 5+ years reviewing and/or auditing ICD-10 CM, MS-DRG and APR-DRG claims preferred.
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The Associate Innovation Manager will be responsible for assisting in the development of innovation strategies, platforms, product ideas and claims within either Advil or CCF portfolio. During Development, effectively transfer to Brand Commercialization Leads for commercialization and launch.
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commercialization claims jobs Company: Genesis Research in Edison, NJ
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