342 senior claims vendor specialist jobs found

CareFirst BlueCross BlueShield Resp & Qualifications Candidate must reside in the CareFirst service area (MD, DC & VA) PURPOSE: This role is responsible for the building, management, oversight and negotiation of Institutional, Ancillary, Vendor, Dental and Professional contracts as well as the contracting of more complex high-performance provider networks. Performs duties to coordinate and support all types of provider contracting in accordance with guidelines in order to maintain and enhance the provider network and to meet accessibility, quality and financial goals. ESSENTIAL FUNCTIONS: Successfully negotiates cost effective, competitive and complex contracts in focused regions that will produce savings to clients. Ensures the economic details in the contracts meet the need of key stakeholders. Manages the provider contract including negotiations, level of network participation, rates, payment levels, reimbursement methodologies, financial...

CareFirst BlueCross BlueShield Resp & Qualifications ***Must Reside in the CareFirst Service area (MD-DC-VA)*** PURPOSE: This role is responsible for the building, management, oversight and negotiation of Institutional, Ancillary, Vendor, Dental and Professional contracts as well as the contracting of more complex high-performance provider networks. Performs duties to coordinate and support all types of provider contracting in accordance with guidelines in order to maintain and enhance the provider network and to meet accessibility, quality and financial goals. ESSENTIAL FUNCTIONS: Successfully negotiates cost effective, competitive and complex contracts in focused regions that will produce savings to clients. Ensures the economic details in the contracts meet the need of key stakeholders. Manages the provider contract including negotiations, level of network participation, rates, payment levels, reimbursement methodologies, financial feasibility, performance...

CSAA Insurance Group CSAA Insurance Group (CSAA IG), a AAA insurer, is one of the top personal lines property and casualty insurance groups in the U.S. Our employees proudly live our core beliefs and fulfill our enduring purpose to help members prevent, prepare for and recover from life's uncertainties, and we're proud of the culture we create together. As we commit to progress over perfection, we recognize that every day is an opportunity to be innovative and adaptable. At CSAA IG, we hire good people for a brighter tomorrow. We are actively hiring for an Auto Field Specialist (DRN) in our Contra Costa County Area territory! (Territory includes: Tracy, Concord, Walnut Creek, and Pittsburg) Your Role: An Auto Field Specialist (DRN) is a virtual and field-based employee responsible for Direct Repair Network (DRN) performance, management and relationships to ensure financial and customer-driven results, including service level agreements, contract compliance and due...

Hess Corporation ABOUT HESS CORPORATION Hess is a leading international independent energy company engaged in the exploration and production of crude oil and natural gas. We have an industry leading position in the Bakken in North Dakota - a key U.S. shale play. Hess is also one of the largest producers in the deepwater Gulf of Mexico and a key natural gas producer and supplier to Peninsular Malaysia and Thailand. The company is engaged in exploration and appraisal activities offshore Guyana, participating in one of the industry's largest oil discoveries in the past decade, as well as the Gulf of Mexico, Suriname and Nova Scotia. Hess aims to attract, retain and energize the best people by investing in their professional development and providing them with challenging and rewarding opportunities for personal growth. We are always looking for talented professionals who share our values and are passionate about making a difference in the world and in their careers. We strive...

Wabtec It's not just about your career or job title... It's about who you are and the impact you will make on the world. Because whether it's for each other or our customers, we put People First. When our people come together, we Expand the Possible and continuously look for ways to improve what we create and how we do it. If you are constantly striving to grow, you're in good company. We are revolutionizing the way the world moves for future generations, and we want someone who is ready to move with us. It's not just about your career or job title... It's about who you are and the impact you will make on the world. Because whether it's for each other or our customers, we put People First. When our people come together, we Expand the Possible and continuously look for ways to improve what we create and how we do it. If you are constantly striving to grow, you're in good company. We are revolutionizing the way the world moves for future generations, and we want someone who is...

Novartis Job Description Summary The Key Account Specialist will be responsible for representing Sandoz as a leader in the generic injectable institutional marketplace and other assigned settings appropriate to the Sandoz product portfolio, implementing strategic initiatives with selected complex accounts, while ethically and compliantly meeting and exceeding objectives. The Key Account Specialist will maintain and generate new business, enforce GPO contract compliance, develop current and new account relationships, and help achieve Sandoz's corporate sales goals. In the assigned territory, the associate will utilize all marketing and contract materials, designed for the respective audience, with a focus on the economic/business decision makers in institutions, hospitals, and clinics. The associate will align closely with other members of the Sandoz Key Accounts and Sales organizations, as well as other cross-functional colleagues, to plan and organize activities to ensure...

Apex Systems, Inc. Job#: 2067832 Job Description: Apex Systems, a World-Class Technology Solutions Provider, is currently hiring for a Junior Business Application Support Specialist to join a remote Digital Banking Support & Operations Team. Ideal candidates will have the experience below; please note only qualified candidates will be contacted. Position: Junior Business Application Support Specialist Duration: 6-18 month W2 contract with high potential for FTE conversion Rate Range: TBD, expecting W2 $30-40/hr on contract Location: Remote in the US, team works CST/EST hours, Monday-Friday 40 hrs Job Summary: This position serves as a point of contact for all incoming application requests, incidents, or problems within the scope of the department, largely related to money movement within a digital banking platform. Responsible for providing application support to business users inclusive of investigating data discrepancies, reviewing...

Hess Corporation ABOUT HESS CORPORATION Hess is a leading international independent energy company engaged in the exploration and production of crude oil and natural gas. We have an industry leading position in the Bakken in North Dakota - a key U.S. shale play. Hess is also one of the largest producers in the deepwater Gulf of Mexico and a key natural gas producer and supplier to Peninsular Malaysia and Thailand. The company is engaged in exploration and appraisal activities offshore Guyana, participating in one of the industry's largest oil discoveries in the past decade, as well as the Gulf of Mexico, Suriname and Nova Scotia. Hess aims to attract, retain and energize the best people by investing in their professional development and providing them with challenging and rewarding opportunities for personal growth. We are always looking for talented professionals who share our values and are passionate about making a difference in the world and in their careers. We strive...

Merck Job Description Job Title: Senior Raw Material Planner Specialist Location: Research and Development Division Bioprocess Clinical Manufacturing and Technology (BCMT), Planning and Manufacturing Systems (PAMS) Overview: We invite applications for the position of Senior Raw Material Planner Specialist. This role is critical in supporting pilot-scale campaigns for the Good Manufacturing Practice (GMP) production of bulk biological clinical supplies, including vaccines, therapeutic proteins, and monoclonal antibodies. Key Responsibilities: Establish and prioritize raw material (RM) procurement needs for GMP manufacturing. Source raw materials from internal divisions (Manufacturing Division, Research and Development Division network) and external vendors. Coordinate the manufacturing of culture media (CM) and buffers. Collaborate with internal and external partners to benchmark and implement best practices in RM management. Manage the logistics...

Merck Job Description Job Title: Senior Raw Material Planner Specialist Location: Research and Development Division Bioprocess Clinical Manufacturing and Technology (BCMT), Planning and Manufacturing Systems (PAMS) Overview: We invite applications for the position of Senior Raw Material Planner Specialist. This role is critical in supporting pilot-scale campaigns for the Good Manufacturing Practice (GMP) production of bulk biological clinical supplies, including vaccines, therapeutic proteins, and monoclonal antibodies. Key Responsibilities: Establish and prioritize raw material (RM) procurement needs for GMP manufacturing. Source raw materials from internal divisions (Manufacturing Division, Research and Development Division network) and external vendors. Coordinate the manufacturing of culture media (CM) and buffers. Collaborate with internal and external partners to benchmark and implement best practices in RM management. Manage the logistics...

King County Summary **This opportunity is open to current King County employees only. We are not accepting external applications at this time.** Lead Grant Administration to Support Environmental Initiatives! Are you passionate about making an impact through strategic grant administration? Do you thrive in a collaborative environment where your expertise can shape best practices and drive meaningful change? This is your opportunity to build and lead a newly created Grant Administration Unit within the Finance and Administration Section, supporting critical environmental programs. About the Role This Grants Unit Supervisor leadership position is an exciting opportunity for someone who enjoys establishing best practices and driving continuous improvement in grant administration. You'll build and oversee a new Grant Administration Unit, guiding teams across the Division on federal, state, and local grant processes. You'll also play a key role in ensuring...

Wilbur-Ellis Investing in You, join a 100-year-old, family-owned leader in Ag - and grow with us! Wilbur-Ellis invests heavily in our employees by offering skill development and training, competitive compensation and benefits, and a tradition of promoting from within for a broad range of career opportunities. And we foster a supportive, people-first work environment. "We know the confidence gap can get in the way of meeting spectacular candidates, so please don't hesitate to apply - we'd love to hear from you." General Purpose & Scope This role is critical in managing the purchasing, sourcing, and logistics of fertilizer and related inputs for agricultural operations. They aim to ensure that the right types and quantities of fertilizers are procured at the best possible prices, within the necessary timelines, and in compliance with industry regulations. Key Skills and Abilities Include: Negotiation Skills: Ability to negotiate favorable terms...

Conagra Brands Reporting to the Director of Supply Chain Sustainability you will support execution of corporate projects affecting the Conagra Brands product portfolio and helps build the business case for sustainability across company functions. You'll collaborate with stakeholders on projects addressing climate change, water use, sustainable sourcing, packaging, end-to-end waste, animal welfare and other material topics. You'll work as a member of the Sustainability Team and will understand sustainability strategies, goals and objectives, and have subject matter expertise in at least one material environmental topics outlined in our annual CSR report. You Will: Support corporate sustainability goals under the direction of supervisor, including project management, research and analysis, communications materials development, and internal and external presentation. Facilitate collaboration between Procurement, R&D, supply chain, brand and other departments to promote the...

Baylor Scott & White Health JOB SUMMARY The Patient Services Specialist 2 provides administrative help in a physician office, clinic or other operational area that assists patients, to ensure high quality, patient-centered care. Duties include patient relations, check-in or check-out, scheduling, insurance verification and answering phones. May assist in training and mentoring junior Patient Services Specialists. ESSENTIAL FUNCTIONS OF THE ROLE Assists patients and other visitors by performing patient related duties to include check-in or check-out, scheduling, insurance verification and answering and responding to phones inquiries. Arranges follow-up visits and referral appointments. Registers patients by collecting and verifying insurance information. Verifies patient demographics and enters changes into computer system. Directs patients to appropriate waiting areas. Accepts payments for physician/clinic services according to established guidelines. Posts payments...

Baylor Scott & White Health JOB SUMMARY The Patient Services Specialist 2 provides administrative help in a physician office, clinic or other operational area that assists patients, to ensure high quality, patient-centered care. Duties include patient relations, check-in or check-out, scheduling, insurance verification and answering phones. May assist in training and mentoring junior Patient Services Specialists. ESSENTIAL FUNCTIONS OF THE ROLE Assists patients and other visitors by performing patient related duties to include check-in or check-out, scheduling, insurance verification and answering and responding to phones inquiries. Arranges follow-up visits and referral appointments. Registers patients by collecting and verifying insurance information. Verifies patient demographics and enters changes into computer system. Directs patients to appropriate waiting areas. Accepts payments for physician/clinic services according to established guidelines. Posts...

Baylor Scott & White Health JOB SUMMARY The Patient Services Specialist 2 provides administrative help in a physician office, clinic or other operational area that assists patients, to ensure high quality, patient-centered care. Duties include patient relations, check-in or check-out, scheduling, insurance verification and answering phones. May assist in training and mentoring junior Patient Services Specialists. ESSENTIAL FUNCTIONS OF THE ROLE Assists patients and other visitors by performing patient related duties to include check-in or check-out, scheduling, insurance verification and answering and responding to phones inquiries. Arranges follow-up visits and referral appointments. Registers patients by collecting and verifying insurance information. Verifies patient demographics and enters changes into computer system. Directs patients to appropriate waiting areas. Accepts payments for physician/clinic services according to established guidelines. Posts payments...

The Coca-Cola Company Requisition ID: 217883 Posting Locations: Charleston Pay Range: $61,000 - $62,000/year, depending on experience Rate Frequency: Daily Click here to view a Day in the Life of our Teammates! Our Secret Ingredient is our Teammates. We offer great rewards , competitive pay , career advancement and growth opportunities . Full Time Teammates are also eligible for: Paid Training Paid Time Off plus paid holidays 401(k) with Company matching on a dollar-for-dollar basis Employee Stock Purchase Plan (ESPP) Group Health Insurance - Medical, Dental, Vision & Disability Basic and Supplemental Life Insurance Refresh and Grow your Career with Us! Job Overview The Route Specialist will cover the routes of teammates when they are away and maintain their established routes, including orders, delivery, and, or unloading our products at customer locations on designated routes, in a courteous, professional, compliant, safe, and...

Wells Fargo About this role: Wells Fargo is seeking a Lead Analytics Consultant for the Global Sanctions Office (GSO)'s Model Governance, Analytics, and Data Quality staff within Financial Crimes Risk Management (FCRM). The GSO is the business owner for the enterprise platform used to screen transactions and customer records for sanctions targets, politically exposed persons, and other parties. The Model Governance, Analytics, and Data Quality staff has primary responsibility for model risk over the sanctions screening ecosystem at Wells Fargo. Learn more about our career areas and business divisions at wellsfargojobs.com. In this role, you will: Manage existing quantitative models with peer analytical consultants and contribute to the development of new quantitative models that govern the sanctions screening platforms' configurations in use by Wells Fargo. Become an expert in the details of the platforms' capabilities and provide insight into possible enhancements as...

Walgreens Job Description Responsible for executing, monitoring, and training inventory best practices and standard operating procedures for the entire store, including both front end and pharmacy. Supports pharmacy inventory management activities, including receiving, counting, ordering, and facilitating returns. Champions On-Shelf Availability and is responsible for receiving, counting, pricing, returns, and all in-store inventory processes. Validates and ensures accuracy of planograms. Responsible for reviewing and coordinating the proper use of reports and system applications, which have an impact on the accuracy of front end and pharmacy on-hand balances and pricing. Responsible for executing and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), shortages (merchandise billed, but not received), order errors or damaged goods including prescription drugs. In...

Walgreens Job Description Responsible for executing, monitoring, and training inventory best practices and standard operating procedures for the entire store, including both front end and pharmacy. Supports pharmacy inventory management activities, including receiving, counting, ordering, and facilitating returns. Champions On-Shelf Availability and is responsible for receiving, counting, pricing, returns, and all in-store inventory processes. Validates and ensures accuracy of planograms. Responsible for reviewing and coordinating the proper use of reports and system applications, which have an impact on the accuracy of front end and pharmacy on-hand balances and pricing. Responsible for executing and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), shortages (merchandise billed, but not received), order errors or damaged goods including prescription drugs. In...