Claims Specialist Jobs in Philadelphia, PA

Join a dynamic team to analyze big data and develop cutting-edge fraud solutions. Utilize advanced analytics and machine learning to uncover fraud patterns, optimize rule sets, and deliver impactful i...

Empower project success by leading Project Controls on diverse projects. Oversee cost, schedule, risk, and change management while collaborating with teams to ensure informed decision-making and optim...

Join a team that's leading human risk initiatives to enhance information security awareness through targeted training and engaging communication efforts, ensuring team members effectively spot and rep...

Engage with clients as a Senior Communications Consultant, crafting impactful materials across platforms while managing projects and collaborating with teams to enhance employee benefits communication...

Join a dynamic team to analyze and enhance Personal Insurance strategies, driving growth and compliance across multiple states through collaboration and data-driven recommendations...

Unlock potential by leveraging data to shape product strategies that enhance growth and profitability across multiple states, collaborating with diverse teams to deliver high-impact insights and recom...

Drive strategic revenue growth by leading the billing operations team, optimizing processes, and enhancing cross-functional collaboration. Ensure compliance and efficiency in contracting and credentia...

Shape the future of care by assessing member needs and coordinating personalized plans. Interact with multidisciplinary teams to ensure optimal service delivery while advocating for member outcomes th...

Lead the charge in driving strategic initiatives for the Surety Underwriting Group, ensuring profitable growth while managing resources and fostering strong partnerships with stakeholders in a dynamic...

Analyze and manage complex underwriting portfolios, driving profitable relationships with brokers while mentoring peers. Collaborate cross-functionally to improve decision-making and client outcomes i...

Transform channel partner strategies by managing portfolios, aligning business plans, and delivering revenue goals while driving market growth through effective training and operational support...

Lead the charge in underwriting complex pharmacy benefit deals, optimizing pricing strategies with cross-functional teams. Leverage automation and insights to enhance underwriting capabilities while m...

Tackle challenges by leading sales initiatives, mentoring teams, and executing tailored insurance solutions. Drive growth by building strong client relationships and optimizing the sales process for m...

Bring your expertise to elevate our commercial systems, owning and optimizing tools like Salesforce and HubSpot while leveraging AI for automation and improved workflows, ensuring seamless connections...

Bring your expertise to lead investigations into healthcare fraud, waste, and abuse. You'll develop anti-fraud programs, conduct audits, and coordinate with law enforcement to ensure compliance and re...

Elevate clinical outcomes by serving as the key pharmacist liaison among partners, translating real-world issues into actionable insights, driving resolution of clinical concerns, and enhancing produc...

Build impactful contracting processes by providing strategic legal support throughout the contracting lifecycle. Collaborate with business partners and drive efficiencies in an innovative, hybrid role...

Lead the charge in SPP Settlements, partnering cross-functionally to ensure compliance and enhance product features. Use your expertise to drive solutions and deliver exceptional support that meets cu...

Join a team that's dedicated to enhancing healthcare efficiency by analyzing the revenue cycle. Your expertise will drive improvements in billing operations, perform detailed assessments, and ensure s...

Join our team to lead in Physical Medicine and Rehabilitation, providing oversight, improving utilization, and guiding medical policy. Collaborate with staff and external partners to enhance healthcar...

Unlock your potential by providing leadership in medical policy development, overseeing staff, analyzing data, and conducting research in physical medicine. Collaborate with healthcare professionals t...

Elevate your underwriting career by managing a complex portfolio of nonprofit and educational organizations. Collaborate with agents, analyze risks, and ensure competitive pricing while providing expe...

Help us elevate quality in clinical audit processes through oversight, mentorship, and strategic recommendations. Collaborate with teams and uphold standard accuracy in DRG coding while ensuring compl...

Unlock potential by leading the effective management of Insurance Broking Accounts, ensuring compliance, improving cash collection, and fostering collaboration across finance and operations for optima...

Transform clinical research by applying your monitoring expertise in a dynamic environment. Collaborate with teams to ensure participant safety and data integrity while managing site monitoring and co...