Claims Jobs in Charleston

Description The Senior Business Intelligence Engineer (Claims Strategy) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Engineer ..

Description The Associate Actuary analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes unit cost metrics, provides competitive data and ..

Description The Lead Data Scientist uses mathematics, statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions. The Lead Data Scientist works on problems ..

Description The Senior Installation Administration Professional establishes and manages relationships with internal and external clients. Coordinates end to end process from the point of sale to members loaded in system, ID ..

Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..

Description The Network Strategy Business Intelligence Analyst work assignments will vary by system and frequently require interpretation and independent determination of the appropriate courses of action. How We Value You Benefits ..

Description The Senior Business Intelligence Engineer (Claims Strategy) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Engineer ..

Description The Experience Strategy & Transformation Lead enhances the consumer experience by architecting experiences and building capabilities that will positively impact our customers. The Experience Strategy & Transformation Lead works on ..

Description Responsibilities This position can be in office or work at home in EST or CST and will provide coverage for eastern time zone hours. Weekend work required. Schedules will be ..

Description The Learning Facilitation Professional 2 conducts or facilitates training courses for organization employees or external audiences. The Learning Facilitation Professional 2 work assignments are varied and frequently require interpretation and ..

Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..

Description The Data and Reporting Professional 1 generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The ..

Description The Claims Research & Resolution Representative 2 ... & Resolution Representative 2 manages claims operations that involve customer contact, ... contact, investigation, and settlement of claims for and against..

Description The Actuary role on the Medical Modeling and Specialty Strategies team within Pharmacy Analytics and Consulting (PAC) is an opportunity to provide analytics in support of Humana Pharmacy Solutions infusion ..

... accurate and timely information for claims reserve valuation, financial forecasting, and ... and executing necessary processes for claims reserving and claims analytics. They will have access ... have access..

Job OverviewA law firm seeks an Associate Attorney in Charleston, WV, with over one year of defense litigation experience. This role offers an opportunity to join a collaborative team dedicated to ..

Description The Senior Business Intelligence Analyst (Claims Strategy) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Analyst ..

Description Business Intelligence Engineers on the Provider Intelligence and Claims Analytics (PICA) team solve complex business problems and issues using data from internal and external sources to provide insights to decision-makers. ..

Description The Actuary, Valuation is responsible for the calculation of reserves required for unpaid claim liability, including incurred but not reported (IBNR), for a portion of Humana's fully insured medical lines ..

Description The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further request ..

Description The Business Intelligence 2 - Provider Intelligence and Claims Analytics (PICA) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The ..

Description The Clinical Trend and Analytics team leverages advanced scientific techniques, forecasting, and machine learning to predict financial and clinical outcomes in order to guide investments that improve health outcomes and ..

Description The Subrogation Professional 2 iIdentifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health ..