1368 claims service specialist jobs found

Description Description Xylem (XYL) is a leading global water technology company committed to developing innovative technology solutions to the world's water challenges. The Company's products and services move, treat, analyze, monitor and return water to the environment in public utility, industrial, residential and commercial building services settings. Xylem also provides a leading portfolio of smart metering, network technologies and advanced infrastructure analytics solutions for water, electric and gas utilities. The Company's more than 16,500 employees bring broad applications expertise with a strong focus on identifying comprehensive, sustainable solutions. Headquartered in Rye Brook, New York with 2017 revenue of $4.7 billion, Xylem does business in more than 150 countries through a number of market-leading product brands. The name Xylem is derived from classical Greek and is the tissue that transports water in plants, highlighting the engineering efficiency of our...

The Imbruvica Field Access Specialist (FAS) acts as an alternative in-office resource that is available to address HCP questions about patient access. The FAS calls directly on HCP offices in their assigned, specific geography to answer questions about patient access & reimbursement in support of Imbruvica. The FAS provides expertise on coverage and common access and reimbursement challenges affecting Imbruvica. The FAS responsibilities include educating on the access and reimbursement support tools available from AbbVie, advising HCPs on patient prescription status and program eligibility, and educating HCP offices on payer processes and procedures. Specific Responsibilities: Educate HCPs on patient support programs, including access and reimbursement support tools and services Educate on product-specific acquisition and access options such as specialty pharmacy networks and specialty distribution Educate on resources available to address access issues...

Innovate to solve the world's most important challenges Working pattern: currently we are working in a pandemic-related hybrid mode. When you join Honeywell, you become a member of our global team of thinkers, innovators, dreamers and future shapers! We have an opportunity for a Senior Customer Experience Specialist with French language skills to join our multicompetence international team in Katowice, supporting key industrial Customers throughout Europe.     Join us at Honeywell. The future is what we make it! Senior Customer Experience Specialist responsibilities Serve as the primary customer contact for your assigned portfolio of accounts and ensure all customer needs and expectations are met. You will respond to inbound customer calls and email regarding order inquiry as to ship dates, order changes and returns. You will assist other customer service associates with administrative duties. You will communicate with other departments such as...

At Johnson & Johnson, the largest healthcare company in the world, we come together with one purpose: to profoundly change the trajectory of health for humanity. Diversity & Inclusion are essential to continue building our history of pioneering and innovation, which has been impacting the health of more than 1 billion patients and consumers every day for more than 130 years. Regardless of your race, belief, sexual orientation, religion or any other trait, YOU are welcome in all open positions at the largest healthcare company in the world. When You Join Johnson & Johnson, Your Next Move Could Mean Our Next Breakthrough At Johnson & Johnson Medical Devices Companies, we are using our breath, scale and experience to reimagine the way healthcare is delivered and to help people live longer, healthier lives. We are in this for life . We are changing the trajectory of human health, YOU CAN TOO . Please visit https://www.jnjmedicaldevices.com/es-419...

At Johnson & Johnson, the largest healthcare company in the world, we come together with one purpose: to profoundly change the trajectory of health for humanity. Diversity & Inclusion are essential to continue building our history of pioneering and innovation, which has been impacting the health of more than 1 billion patients and consumers every day for more than 130 years. Regardless of your race, belief, sexual orientation, religion or any other trait, YOU are welcome in all open positions at the largest healthcare company in the world. When You Join Johnson & Johnson, Your Next Move Could Mean Our Next Breakthrough At Johnson & Johnson Medical Devices Companies, we are using our breath, scale and experience to reimagine the way healthcare is delivered and to help people live longer, healthier lives. We are in this for life . We are changing the trajectory of human health, YOU CAN TOO . Please visit https://www.jnjmedicaldevices.com/es-419...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Receive, review and process Outpatient Treatment Requests (OTR) from providers as it relates to eligibility, benefits and authorization of services. Resolve issues and educate providers on policies and procedures. • Review OTR for accuracy and completeness of data and interact with providers • Perform research for OTR discrepancies as identified by providers • Create member authorizations for approved outpatient therapy services • Verify member eligibility and provider contracting/credentialing status prior to authorizing services • Coordinate outpatient treatment requests with Care Coordination staff for out-of-network providers • Coordinate with eligibility staff for member...

Innovate to solve the world's most important challenges Working pattern: currently we are working in a pandemic-related hybrid mode. When you join Honeywell, you become a member of our global team of thinkers, innovators, dreamers and future shapers! We have an opportunity for a Senior Customer Experience Specialist with French language skills to join our multicompetence international team in Katowice , supporting key industrial Customers throughout Europe.     Join us at Honeywell. The future is what we make it! Senior Customer Experience Specialist responsibilities Serve as the primary customer contact for your assigned portfolio of accounts and ensure all customer needs and expectations are met. You will respond to inbound customer calls and email regarding order inquiry as to ship dates, problems, order changes, repairs and RMA's. You will assist other customer service associates with administrative duties. You will communicate with other departments such as...

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform credentialing and related activities based on plan specifications • Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards • Communicate with professionalism with physicians, office managers, providers, and other third parties to secure needed information • Gather information for Credentialing Committee meetings • Process, track and file credentialing applications within established standards • Generate and utilize  reporting to support business functions • Ability to thrive in a fast-paced production environment while maintaining quality Education/Experience: Associate’s degree, or high...

Position Summary: Responsible for the maintenance and administration of Ryan Specialty Groups property catastrophe modeling technology infrastructure and implementation of data strategy including proper architecting of data storage systems, management of data intake and workflow, integration of data from independent systems / sources, and performance tuning of the environment for optimal efficiency. Work closely with RSG procurement and business teams to manage property catastrophe modeling vendor relationships, contracts, and licensing. Liaise between RSG Enterprise Data and IT Infrastructure teams to leverage corporate resources in the delivery of property catastrophe and non-catastrophe data analysis as part of businesses' competitive advantage. This role is focused solely on catastrophe and non-catastrophe property insurance and reinsurance; all casualty lines are out of scope. Essential Functions: Maintenance and Administration of RSG's property catastrophe modeling...

Join the industry leader to design the next generation of breakthroughs Working pattern: currently we are working in a pandemic-related hybrid mode. When you join Honeywell, you become a member of our global team of thinkers, innovators, dreamers and future shapers! We have an opportunity for a Senior Customer Experience Specialist with Spanish language skills to join our multicompetence international team in Katowice, supporting key industrial Customers throughout Europe.     Join us at Honeywell. The future is what we make it!   Senior Customer Experience Specialist (with Spanish) responsibilities   -           Customer relationship management of European B2B Customers -           Enabling continuous improvement and first-time quality -           Process maintenance and training -           Customer transition support -           Order Entry and claims management   What makes you the...

Design solutions to drive safe living and quality of life Working pattern: currently we are working in a pandemic-related hybrid mode. When you join Honeywell, you become a member of our global team of thinkers, innovators, dreamers and future shapers! We have an opportunity for a Senior Customer Experience Specialist with Italian language skills to join our multicompetence international team in Katowice, supporting key industrial Customers throughout Europe.     Join us at Honeywell. The future is what we make it!   Senior Customer Experience Specialist (with Italian) responsibilities   -           Customer relationship management of European B2B Customers -           Enabling continuous improvement and first-time quality -           Process maintenance and training -           Customer transition support -           Order Entry and claims management   What makes you the ideal...

Position: Marketing Specialist Job Description: Marketing Specialist will be working within the Marketing Department, responsible for Network and Security Solutions. Main accountabilities are the following: One of the main roles of the position will be looking after the marketing for two to three of our strategic networking and security vendors along with a couple of the smaller emerging vendors within the portfolio. These are vendors which have marketing funds to plan and spend on a quarterly basis. Marketing proposals and plans will be required to be produced and the execution of agreed marketing campaigns will have to be undertaken by the Marketing Manager. All ROI statistics and reports will have to be fed back to the vendors along with the invoice and other supporting information for claiming. You will also be required to manage the budget of these vendors, tracking the budget and ensure zero exposure to the business. Specific project or region based campaigns:...

Position: IMMEX Specialist Job Description: Join us at Arrow Nogales! We're looking for a IMMEX Specialist with knowledge on IMMEX for our import-export team in Nogales, Sonora. What You'll Be Doing: Responsible for the communication of information regarding the resolution of customer issues dealing with transportation pickups, claims, and the incorrect receiving of assets at a processing plant. Customer Service: Communicate shipping information to sales customer and PODS to Finance department, including obtaining shipping documents, tracking numbers, proof of deliveries, etc. Communicate with carriers. Manage routing guide. Assist in shipping requests by processing shipping report in order to set up and contact carriers for pickup. Process minor shipping requests including redirecting freight, changing freight terms, etc. Invoices and Account management: manage freight clearing account, charge back invoices to the branch, code and approve invoices....

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform day to day duties of assuring that providers (individual, group, ancillary, etc.) are set up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple state deliverables, network reporting and directories as well as claims payment resolution as it relates to provider set up. •    Provide support to the external provider representative to resolve provider data issues •    Research and effectively respond to provider related issues •    Submit provider data entries to resolve provider-related demographic information changes •    Initiate and process provider add, change and termination forms •...

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Monitor and oversee network development efforts including facilitating network transitions and developing and maintaining the network analysis and network development plans. Monitor network performance. • Develop and maintain all required State and health plan network reports including GeoAccess analysis, network readiness reports, etc. • Develop and maintain provider transition spreadsheets. • Review provider data reports and monitor network adequacy to provide recommendations for network enhancements  • Assist with the completion of annual and quarterly network analyses. • Track and monitor all activities of the network development plans. • Prepare network data for...

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Essential Functions: * Serves as the subject matter expert (SME) for the assigned product(s) or service area(s). * Drives assigned operational aspects of the product(s)/service(s). * Assesses operational performance and escalations by tracking, analyzing and researching performance level expectations. * Monitors assigned internal/external relationships to ensure compliance with contractual requirements. * Develops effective relationships with key partners and stakeholders to influence and drive operational enhancements. * Proactively identifies trends and root cause analysis to drive resolution of complex escalations; including communications and reporting. * Creates reports and supports...

*Note: this is an ongoing job posting, which means your resume will remain on file with us until openings arise. We will not actively provide an update on your application as this is not a formal job posting. If you submit an application, please note we reserve the right to reach out once an opening become available and if a good match. You are highly encouraged to also consider other opportunities in the meantime.* About the Role As a Trust and Safety Specialist within the Phoenix Center of Excellence (201 E. Washington St., Phoenix AZ), you will work with a high level of urgency - utilizing strong emotional intelligence as a first responder for our most critical incidents. Investigators will need to balance emotional self-regulation with empathy in all communications, while also coordinating case creation through fact gathering via phone outreach. Careful attention to following support logic and skilled case organization/documentation will be a vital part of the role. What...

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform day to day duties of assuring that providers (individual, group, ancillary, etc.) are set up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple state deliverables, network reporting and directories as well as claims payment resolution as it relates to provider set up. •  Provide support to the external provider representative to resolve provider data issues •    Research and effectively respond to provider related issues •    Submit provider data entries to resolve provider-related demographic information changes •    Initiate and process provider add, change and termination forms •    Create...

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform day to day duties of assuring that providers (individual, group, ancillary, etc.) are set up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple state deliverables, network reporting and directories as well as claims payment resolution as it relates to provider set up. • Maintain spreadsheets and collect, track, prepare, compile, and distribute statistical data for daily and monthly reports. • Maintain and report on the Health Plan(s) compliance with contract submission rules and exception requests and communicate to Manager on a monthly basis. • Support the contract submission process to...

Linde is a leading global industrial gases and engineering company with 2020 sales of $27 billion. We live our mission of making our world more productive every day by providing high-quality solutions, technologies and services which are making our customers more successful and helping to sustain and protect our planet. The company serves a variety of end markets including chemicals & refining, food & beverage, electronics, healthcare, manufacturing, and primary metals. Linde's industrial gases are used in countless applications, from life-saving oxygen for hospitals to high-purity & specialty gases for electronics manufacturing, hydrogen for clean fuels and much more. Linde also delivers state-of-the-art gas processing solutions to support customer expansion, efficiency improvements and emissions reductions. For more information about the company, please visit our website at www.lindeus.com . Linde Gas & Equipment Inc. is seeking a Gas Sourcing Specialist to...