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Strong knowledge of key laws and regulations impacting the pharmaceutical industry including the PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and federal and state transparency and disclosure laws.
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Communicate with University Development Office, Chief Investment Officer and/or Treasury Services regarding new endowment gifts, Charitable Gift Annuities or changes to University operating investment activity.
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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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The primary purpose of the Inpatient Coding Data Quality Auditor/Educator is to ensure the consistent processing of claims and collection of data to optimize DRG reimbursement and produce quality data that accurately reflects the severity and intensity of hospital inpatient services.
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The Trial Attorney will conduct examinations under oath of claimants asserting claims against the Company under their insurance policies and, acquire broad knowledge of the Company, your business area’s processes and procedures as well as best practices.
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We aim to provide comprehensive insurance solutions, use enhanced data and technology to make more informed decisions and rely on a field-based underwriting, claims and loss control model to be closer to our customers and brokers.
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If you are interested in the exciting, high paying and rewarding career of an Independent Claims Adjuster, apply now; and we will send you an immediate email with more details. Our focus is to assist you by training you for Success as a Licensed Independent Claims Adjuster.
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For 28 years, we have continued to commit ourselves to the utmost degree of integrity and professionalism specializing in all aspects of insurance defense investigations to include; claims investigations, SIU investigations and Vendor Management Programs.
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In addition, there will be a technical component that is required with a thorough understanding of relational databases, pharmacy and/or medical claims data, and writing SQL code. Skilled with data analysis tools and querying using tools such as SQL, Python, Alteryx, Tableau, Databricks, Hadoop or other big data platforms.
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Minimum of three (3) years of hospital inpatient coding experience in ICD-9 and ICD-10 diagnosis and procedure coding and DRG assignment, preferably in a tertiary care, teaching environment with complex surgical, transplant, trauma, neurosurgery, Ob/Gyn, and neonatology services.
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Actuary position in Risk Adjustment department: Requires deep analysis, data mining, and mathematical modeling for accurate claims/encounter data. Actuary position in Risk Adjustment department: Requires deep analysis, data mining, and mathematical modeling for accurate claims/encounter data.
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Requires a demonstrated progressive understanding of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, product pricing, network and provider contracting, and utilization management.
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File warranty claims. Job Summary:The Service Department Administrator will report directly to the Service Director, with additional responsibilities assigned to service and warranty managers.
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Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.
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Must have or be eligible to receive claims adjuster license. The primary purpose of this job is to investigate, evaluate, negotiate and settle assigned claims by collecting and analyzing data according to policy application and/or contract provisions.
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claims tpa endowment jobs Company: Metroplus Health Plan in Orange, NJ
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