Claims Jobs in Troy

Senior Claims Paralegal The candidate under direct supervision, provides professional legal support service to attorneys in the form of basic legal research, drafting of legal and business communications and general file ..

Description The Pharmacy Claims Lead - Overpayment works on ... moderate to substantial. The Pharmacy Claims Lead will lead the development ... D and review of pharmacy claims containing invalid..

Troy office of our client seeks an associate attorney with 2-5 years of private practice experience, preferably general liability and 1st and 3rd party claims. The candidate will support the insurance ..

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 Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..

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 ..

Troy office of our client seeks a partner-level attorney with 3+ years of experience in federal government contracts, with some experience in U.S. export controls, including OFAC sanctions. The candidate must ..

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 ..

Job OverviewA law firm seeks an Associate Attorney for its offices based in Troy, MI, with hybrid or remote options available. The attorney must be licensed in the state of Michigan ..

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

Troy office of our client seeks commercial litigation/trucking industry associate attorney with 3-10 years of legal experience. The candidate will support the firm’s commercial litigation practice and will be provided with ..

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 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 ..

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 ..

Job OverviewA law firm seeks an experienced Civil Litigation Attorney in Troy, MI, to manage a diverse caseload of civil matters from inception through resolution. The ideal candidate will possess strong ..

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

Job OverviewA law firm seeks a Social Security Attorney in Troy, Michigan. This role involves managing a high-volume caseload and representing clients in disability claims and hearings. The position offers independence, ..

Job Information Humana Claims Research & Resolution Representative 2 ... Troy Michigan 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 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 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 ..