Claims Jobs in Dover

Description The Provider Insights & Claims Analytics (PICA) team is a blend of technology, data, and consulting professionals leveraging the latest tools and methods to solve complex business problems. In this ..

Description The Senior Medical/Financial Risk Evaluation Professional is responsible for supporting the development, implementation and monitoring of medical/financial risk. The Senior Medical/Financial Risk Evaluation Professional work assignments involve moderately complex to ..

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 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 Bilingual Claims Research and Resolution Representative 2 ... you Come In The Bilingual Claims Research & Resolution Representative 2 ... services in the settlement of claims. Comprised of..

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

Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..

Description This opening will support the Humana Clinical Pharmacy Review organization performing a variety of analytical tasks including forecasting clinical review volume, identifying opportunities for automated decision making in the clinical ..

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 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 Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

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 What Humana Offers We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development ..

Description The Business Intelligence Lead solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Lead works on problems of ..

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 The Provider Insights & Claims Analytics (PICA) team is a blend of technology, data, and consulting professionals leveraging the latest tools and methods to solve complex business problems. In this ..

Description The Informaticist 2 coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Informaticist 2 work assignments are ..

Job Information Humana Claims Research & Resolution Representative 2 ... Dover Delaware Description The Bilingual Claims Research and Resolution Representative 2 ... for well-being Responsibilities The Bilingual Claims Research &..

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 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 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 ..

Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..