119 jobs found in Baltimore, MD

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Under minimal supervision, the Claims Recovery Specialist II review and audits medical and/or dental claims to recover payments. Specialist will assist to maximize recovery amounts due to refund of payments made in error to members and/or providers, retro terms and/or focused provider audits. Specialist will provide day-to-day management of active overpayment recoveries. This position will work closely with the claims, service, finance, and vendor auditing departments to complete claims adjustments. ESSENTIAL FUNCTIONS: Under supervision, reviews, audits, and/or initiates recovery efforts for medical, and/or dental claims to recover overpayments, ensuring all parts of the process are documented properly. Contacts carriers, members and/or providers, via phone, email, and correspondence, to recover and settle overpaid and/or unpaid claims. Responds to carrier, customer and/or provider service inquiries...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Investigate and perform adjustment of complex claims and ensure that claims are handled properly within authority limits, and in line with standard procedures and guidelines. Verifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending changes in operating processes; completing reports, logs, and audit records. ESSENTIAL FUNCTIONS: Proactively investigate and perform adjustments of complex claims. Ensure claims are handled within authority limits, and in line with standard procedures and guidelines. Establishes insurance losses by evaluating reports and documentation. Documents insurance claim actions by completing logs and files; collecting, analyzing, and summarizing information in reports. Settles insurance claims by approving or denying claims and partnering with supervisor on progress...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Utilizes data analytics and contributes to a set of business initiatives designed to help business partners extract value from information. Develops data visualizations for analysis, problem-solving, and business solutions. We are not looking for generalists who may have an IT background and various credentials like Scrum, Agile, etc. We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week ESSENTIAL FUNCTIONS: Mines and extracts data and applies algorithms to derive insights. Contribute to the analytics, reporting and data governance activity related to Cost of Care Reporting, including Ideation support,...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Utilizes data analytics and contributes to a set of business initiatives designed to help business partners extract value from information. Develops data visualizations for analysis, problem-solving, and business solutions. We are not looking for generalists who may have an IT background and various credentials like Scrum, Agile, etc. We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week ESSENTIAL FUNCTIONS: Mines and extracts data and applies algorithms to derive insights. Contribute to the analytics, reporting and data governance activity related to Cost of Care Reporting, including Ideation support,...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: Provide validation and analysis of claims overpayments discovered by external claims overpayment recovery vendors, claims processing, audits, and customer service. Provide day-to-day management of active overpayment recoveries and/or overpayment recovery vendors. Responsibilities include validation and analysis of provider audits, and professional, institutional, member, and vendor recoveries. Works with the vendor(s) to approve and implement new recovery concepts. This position will also work closely with the claims, service, financial, and/or payment integrity units to facilitate the adjustment and analyze root causes of overpayment. This can also include third party liabilities, mass tort or class action lawsuit analysis. ESSENTIAL FUNCTIONS: Performs extensive analysis on medical policies, claim payment policies and contractual obligations for recovery inquiries and requests. Proactively...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Quality Specialist II is responsible for examining and evaluating the accuracy of transactions in accordance with regulations, and company guidelines. Fairly and consistently reviews team interactions with both internal and external parties to ensure accuracy and support success in executing superior service and quality. Acts as subject matter expert and actively participates in projects. FACETS Experiences is required. ESSENTIAL FUNCTIONS: Audits assigned function (service, claims, enrollment) for accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Identifies, documents and reports transaction errors utilizing departmental quality monitoring templates in a timely manner to ensure prompt resolution. Conducts structured coaching and feedback sessions. Provides feedback and recommends improvement action plans for areas of deficiency within the group or...

CareFirst BlueCross BlueShield Resp & Qualifications PURPOSE: The Quality Assurance Specialist I is responsible for examining and evaluating the accuracy of transactions in accordance with regulations and company guidelines. Fairly and consistently reviews team interactions with both internal and external parties to ensure accuracy and support success in executing superior service and quality. FACETS Experience is preferred. ESSENTIAL FUNCTIONS: Audits assigned function (service, claims, enrollment) for accuracy, benefit payment, contract interpretation, and compliance with policies and procedures. Identifies, documents and reports transaction errors utilizing departmental quality monitoring templates in a timely manner to ensure prompt resolution. Performs in the role of coach and mentor to less tenured associates and acts as a subject matter expert on the operations. Assist with cross-training and skill development activities with less experienced staff in...

Northrop Grumman RELOCATION ASSISTANCE: No relocation assistance availableCLEARANCE TYPE: SecretTRAVEL: Yes, 10% of the Time Description At Northrop Grumman, our employees have incredible opportunities to work on revolutionary systems that impact people's lives around the world today, and for generations to come. Our pioneering and inventive spirit has enabled us to be at the forefront of many technological advancements in our nation's history - from the first flight across the Atlantic Ocean, to stealth bombers, to landing on the moon. We look for people who have bold new ideas, courage and a pioneering spirit to join forces to invent the future, and have fun along the way. Our culture thrives on intellectual curiosity, cognitive diversity and bringing your whole self to work - and we have an insatiable drive to do what others think is impossible. Our employees are not only part of history, they're making history.Northrop Grumman Mission Systems has multiple openings for Staff...

Northrop Grumman RELOCATION ASSISTANCE: No relocation assistance availableCLEARANCE TYPE: NoneTRAVEL: No Description At Northrop Grumman, our employees have incredible opportunities to work on revolutionary systems that impact people's lives around the world today, and for generations to come. Our pioneering and inventive spirit has enabled us to be at the forefront of many technological advancements in our nation's history - from the first flight across the Atlantic Ocean, to stealth bombers, to landing on the moon. We look for people who have bold new ideas, courage and a pioneering spirit to join forces to invent the future, and have fun along the way. Our culture thrives on intellectual curiosity, cognitive diversity and bringing your whole self to work - and we have an insatiable drive to do what others think is impossible. Our employees are not only part of history, they're making history.At the heart of Defining Possible is our commitment to missions. In rapidly changing...

Northrop Grumman RELOCATION ASSISTANCE: No relocation assistance availableCLEARANCE TYPE: NoneTRAVEL: No Description At Northrop Grumman, our employees have incredible opportunities to work on revolutionary systems that impact people's lives around the world today, and for generations to come. Our pioneering and inventive spirit has enabled us to be at the forefront of many technological advancements in our nation's history - from the first flight across the Atlantic Ocean, to stealth bombers, to landing on the moon. We look for people who have bold new ideas, courage and a pioneering spirit to join forces to invent the future, and have fun along the way. Our culture thrives on intellectual curiosity, cognitive diversity and bringing your whole self to work - and we have an insatiable drive to do what others think is impossible. Our employees are not only part of history, they're making history.Northrop Grumman Mission Systems is a trusted provider of mission-enabling solutions...

Northrop Grumman RELOCATION ASSISTANCE: No relocation assistance availableCLEARANCE TYPE: NoneTRAVEL: No Description At Northrop Grumman, our employees have incredible opportunities to work on revolutionary systems that impact people's lives around the world today, and for generations to come. Our pioneering and inventive spirit has enabled us to be at the forefront of many technological advancements in our nation's history - from the first flight across the Atlantic Ocean, to stealth bombers, to landing on the moon. We look for people who have bold new ideas, courage and a pioneering spirit to join forces to invent the future, and have fun along the way. Our culture thrives on intellectual curiosity, cognitive diversity and bringing your whole self to work - and we have an insatiable drive to do what others think is impossible. Our employees are not only part of history, they're making history.Northrop Grumman Mission Systems is a trusted provider of mission-enabling solutions...

Northrop Grumman RELOCATION ASSISTANCE: No relocation assistance availableCLEARANCE TYPE: NoneTRAVEL: No Description At Northrop Grumman, our employees have incredible opportunities to work on revolutionary systems that impact people's lives around the world today, and for generations to come. Our pioneering and inventive spirit has enabled us to be at the forefront of many technological advancements in our nation's history - from the first flight across the Atlantic Ocean, to stealth bombers, to landing on the moon. We look for people who have bold new ideas, courage and a pioneering spirit to join forces to invent the future, and have fun along the way. Our culture thrives on intellectual curiosity, cognitive diversity and bringing your whole self to work - and we have an insatiable drive to do what others think is impossible. Our employees are not only part of history, they're making history.Northrop Grumman Mission Systems is a trusted provider of mission-enabling solutions...

Northrop Grumman RELOCATION ASSISTANCE: No relocation assistance availableCLEARANCE TYPE: NoneTRAVEL: No Description At Northrop Grumman, our employees have incredible opportunities to work on revolutionary systems that impact people's lives around the world today, and for generations to come. Our pioneering and inventive spirit has enabled us to be at the forefront of many technological advancements in our nation's history - from the first flight across the Atlantic Ocean, to stealth bombers, to landing on the moon. We look for people who have bold new ideas, courage and a pioneering spirit to join forces to invent the future, and have fun along the way. Our culture thrives on intellectual curiosity, cognitive diversity and bringing your whole self to work - and we have an insatiable drive to do what others think is impossible. Our employees are not only part of history, they're making history.Northrop Grumman Mission Systems is a trusted provider of mission-enabling solutions...

Northrop Grumman RELOCATION ASSISTANCE: No relocation assistance availableCLEARANCE TYPE: NoneTRAVEL: No Description At Northrop Grumman, our employees have incredible opportunities to work on revolutionary systems that impact people's lives around the world today, and for generations to come. Our pioneering and inventive spirit has enabled us to be at the forefront of many technological advancements in our nation's history - from the first flight across the Atlantic Ocean, to stealth bombers, to landing on the moon. We look for people who have bold new ideas, courage and a pioneering spirit to join forces to invent the future, and have fun along the way. Our culture thrives on intellectual curiosity, cognitive diversity and bringing your whole self to work - and we have an insatiable drive to do what others think is impossible. Our employees are not only part of history, they're making history.Northrop Grumman Mission Systems is a trusted provider of mission-enabling solutions...

American Red Cross Please use Google Chrome or Mozilla Firefox when accessing Candidate Home. By joining the American Red Cross you will touch millions of lives every year and experience the greatness of the human spirit at its best. Are you ready to be part of the world's largest humanitarian network? Join us-Where your Career is a Force for Good! Job Description: WHY CHOOSE US? Joining the American Red Cross is like nothing else - it's as much something you feel as something you do. You become a vital part of the world's largest humanitarian network. Joining a team of welcoming individuals who are exceptional, yet unassuming. Diverse, yet uncompromising in unity. You grow your career within a movement that matters, where success is measured in people helped, communities made whole, and individuals equipped to never stop changing lives and situations for the better. When you choose to be a force for good, you'll have mentors who empower your growth...

ALDI As a Store Associate, you'll be responsible for merchandising and stocking product, cashiering, and cleaning to keep the store looking its best. You'll enhance the customer shopping experience by working collaboratively with the ALDI team and providing exceptional customer service. Position Type: Full-Time Average Hours: 40 hours per week Starting Wage: $19.50 per hour Wage Increases: Year 2 - $20.00 | Year 3 - $20.50 | Year 4 - $20.50 | Year 5 - $21.50 Duties and Responsibilities: Must be able to perform duties with or without reasonable accommodation. * Consistently demonstrate the Mindsets, ALDI Acts Competencies and Professional Skills as outlined for the role. * Processes customer purchases, perform general cleaning duties, stocks shelves and merchandise displays neatly * Provide exceptional customer service, assisting customers with their shopping experience * Collaborate with team members and communicate clearly to the store management team *...

ALDI Enhance the ALDI customer shopping experience in a collaborative team environment as an ALDI Cashier or Stocker. As a member of our team, you'll be operating the registers or other machinery, stocking our shelves, keeping our stores looking their best, and serving our customers. Start a job that offers up something new each day. Position Type: Part-Time Average Hours: Fewer than 30 hours per week Starting Wage: $19.50 per hour Wage Increases: Year 2 - $20.00 | Year 3 - $20.50 | Year 4 - $20.50 | Year 5 - $21.50 Duties and Responsibilities: Must be able to perform duties with or without reasonable accommodation. * Collaborates with team members and communicates relevant information to direct leader * Upholds the security and confidentiality of documents and data within area of responsibility * Other duties as assigned Cashier Responsibilities: * Processes customer purchases, performs general cleaning duties, stocks shelves and merchandise displays...

Transamerica Job Family Finance - General About Us At Transamerica, hard work, innovative thinking, and personal accountability are qualities we honor and reward. We understand the potential of leveraging the talents of a diverse workforce. We embrace an environment where employees enjoy a balance between their careers, families, communities, and personal interests. Ultimately, we appreciate the uniqueness of a company where talented professionals work collaboratively in a positive environment - one focused on helping people look forward and plan for the best life possible while providing tools and solutions that make it easier to get there. Who We Are We believe everyone deserves to live their best life. More than a century ago, we were among the first financial services companies in America to serve everyday people from all walks of life. Today, we're part of an international holding company, with millions of customers and thousands of...

Transamerica Job Family Finance - General About Us At Transamerica, hard work, innovative thinking, and personal accountability are qualities we honor and reward. We understand the potential of leveraging the talents of a diverse workforce. We embrace an environment where employees enjoy a balance between their careers, families, communities, and personal interests. Ultimately, we appreciate the uniqueness of a company where talented professionals work collaboratively in a positive environment - one focused on helping people look forward and plan for the best life possible while providing tools and solutions that make it easier to get there. Who We Are We believe everyone deserves to live their best life. More than a century ago, we were among the first financial services companies in America to serve everyday people from all walks of life. Today, we're part of an international holding company, with millions of customers and thousands of...

Transamerica Job Family Market Research and Intelligence About Us At Transamerica, hard work, innovative thinking, and personal accountability are qualities we honor and reward. We understand the potential of leveraging the talents of a diverse workforce. We embrace an environment where employees enjoy a balance between their careers, families, communities, and personal interests. Ultimately, we appreciate the uniqueness of a company where talented professionals work collaboratively in a positive environment - one focused on helping people look forward and plan for the best life possible while providing tools and solutions that make it easier to get there. Who We Are We believe everyone deserves to live their best life. More than a century ago, we were among the first financial services companies in America to serve everyday people from all walks of life. Today, we're part of an international holding company, with millions of customers and...