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Investigator Senior - Pharmacy

Elevance Health
Mason, OH
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**Investigator Senior - Pharmacy****Location:** _Hybrid 1_ _:_ This role ...
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Summary
About the job:
requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered.The I **nvestigator Senior - Pharmacy** position is responsible for the independent identification, investigation and development of complex cases against perpetrators of healthcare...
Location:
Mason, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
US.jobs
Certifications / Licenses:
Certified Fraud Examiner
Certified Financial Examiner
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

APPEALS ANALYST

Highmark Health
Columbus, OH
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**Company :**Highmark Inc.**Job Description :****JOB SUMMARY**This job ...
Details
Summary
About the job:
reviews inquiries to determine if they meet the definition of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals; initiates a case file for each grievance and appeal; ensures compliance with organizational and regulatory requirements for member or provider issues; independently coordinates the resolution with internal/external parties as required; and documents and summarizes to all parties involved in the case the investigation results.**ESSENTIAL RESPONSIBILITIES**+ Review...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Claims Examiner - Workers Compensation (OH exp required)

Sedgwick
Dublin, OH
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By joining Sedgwick, you'll be part of something truly meaningful. It’s what ...
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Summary
About the job:
our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation (OH exp required) Are you looking for an opportunity to...
Location:
Dublin, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
Sedgwick
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Eligibility Analyst - REMOTE

Prime Therapeutics
Columbus, OH
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Our work matters. We help people get the medicine they need to feel better ...
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About the job:
and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.**Job Posting Title**Eligibility Analyst - Remote**Job Description**The Eligibility Analyst is responsible for representing commercial or government programs' eligibility and acts as a subject matter expert for department projects, Run functions and escalated client issues. This role is responsible for mentoring and training the Eligibility Specialist.**Responsibilities**+ Serves as subject matter expert representing...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Claims Team Lead, Liability

Sedgwick
Seven Hills, OH
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By joining Sedgwick, you'll be part of something truly meaningful. It’s what ...
Details
Summary
About the job:
our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead, Liability PRIMARY PURPOSE : To supervise the operation of multiple teams of...
Location:
Seven Hills, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
Sedgwick
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Claims Team Lead, Liability

Sedgwick
Columbus, OH
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By joining Sedgwick, you'll be part of something truly meaningful. It's what ...
Details
Summary
About the job:
our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top CompaniesCertified as a Great Place to Work®Fortune Best Workplaces in Financial Services & InsuranceClaims Team Lead, Liability**PRIMARY PURPOSE** : To supervise the operation of multiple teams of...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Claims Team Lead, Liability

Sedgwick
Cleveland, OH
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By joining Sedgwick, you'll be part of something truly meaningful. It's what ...
Details
Summary
About the job:
our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top CompaniesCertified as a Great Place to Work®Fortune Best Workplaces in Financial Services & InsuranceClaims Team Lead, Liability**PRIMARY PURPOSE** : To supervise the operation of multiple teams of...
Location:
Cleveland, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Claims Team Lead, Liability

Sedgwick
Dayton, OH
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By joining Sedgwick, you'll be part of something truly meaningful. It's what ...
Details
Summary
About the job:
our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top CompaniesCertified as a Great Place to Work®Fortune Best Workplaces in Financial Services & InsuranceClaims Team Lead, Liability**PRIMARY PURPOSE** : To supervise the operation of multiple teams of...
Location:
Dayton, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Claims Team Lead, Liability

Sedgwick
Cincinnati, OH
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By joining Sedgwick, you'll be part of something truly meaningful. It's what ...
Details
Summary
About the job:
our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top CompaniesCertified as a Great Place to Work®Fortune Best Workplaces in Financial Services & InsuranceClaims Team Lead, Liability**PRIMARY PURPOSE** : To supervise the operation of multiple teams of...
Location:
Cincinnati, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Claims Team Lead, Liability

Sedgwick
Toledo, OH
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By joining Sedgwick, you'll be part of something truly meaningful. It's what ...
Details
Summary
About the job:
our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top CompaniesCertified as a Great Place to Work®Fortune Best Workplaces in Financial Services & InsuranceClaims Team Lead, Liability**PRIMARY PURPOSE** : To supervise the operation of multiple teams of...
Location:
Toledo, OH
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
High Income Jobs ($80K-$99K)
From:
US.jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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Salary: High Income Jobs ($80K-$99K)
Occupation: Claims Adjusters, Examiners, and Investigators
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