Analyze and audit complaints to ensure the integrity of claims, authorization processes, and business operations. Perform root cause analysis to identify trends and recommend change management to reduce redeterminations and rework.
Remote Jobs across various categories (53,351)
Job category = Others
Manage relationships with investigator sites to support engagement and performance across clinical studies. Coordinate site activation tasks, regulatory documentation, and operational issue resolution to ensure study success.
Responsible for the preparation, review, and management of informed consent forms in compliance with protocols and regulations. Coordinates ethics committee approvals and manages document translations and version control across multiple sites.
Manage a portfolio of franchisees to achieve operational and business performance goals through strategic coaching and annual planning. Monitor data and analytics to drive sales, profitability, and brand consistency while supporting new store openings and remodels.
Manage a portfolio of franchisees to achieve operational and business performance goals through strategic coaching and annual planning. Monitor data and analytics to drive sales, profitability, and network growth while ensuring a consistent brand experience.
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Perform administrative tasks including data entry and database maintenance to support the Results Reporting team. Coordinate with genetic counselors and clients to ensure the timely distribution of genetic testing results to patients.
Vertriebsmitarbeiter im Außendienst (m/w/d) Ansbach / Schwabach / Treuchtlingen
Lyreco Group
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Full Time
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3 Days Ago
Lyreco Group
Proactively acquire new B2B customers and maintain long-term relationships through a comprehensive solution and service portfolio. Manage the assigned sales territory independently by analyzing customer needs and achieving revenue, margin, and growth targets.
Coordinate daily activities and prioritize work for the technical team while managing employee recruitment, onboarding, and performance. Act as the primary point of contact for clients and internal teams to ensure service quality and operational consistency across product lines.
Conseiller technique - Technicien informatique
Harris Computer
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Full Time
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3 Days Ago
Harris Computer
The role involves analyzing and resolving technical software and environment issues for clients to ensure effective and sustainable solutions. Responsibilities include performing remote installations, configurations, and contributing to the improvement of support documentation and tools.
Conduct thorough reviews of healthcare billing and claims documentation to ensure accuracy, compliance, and medical necessity. Analyze claim denials, identify root causes, and collaborate with providers and coding teams to resolve discrepancies and prevent fraud.
The specialist is responsible for processing documents for client Defined Contribution plans while ensuring compliance with Service Level Agreements. Key tasks include performing data entry, researching complex participant benefit issues, and collaborating with third-party vendors.
Prior Authorization Specialist I - Patient Access Services 25 APPLICANTS
BMC Software
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Full Time
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3 Days Ago
BMC Software
Responsible for screening and processing prior-authorization requests for inpatient, outpatient, and ancillary services to ensure cost-effective healthcare delivery. Coordinates financial clearance activities, including insurance verification and obtaining precertification numbers to maximize hospital reimbursement.
The Hotline Operator serves as the primary point of contact for callers, managing incoming calls using a harm reduction framework. They engage individuals who use drugs in meaningful conversations to provide support and save lives through prompt action.
The role focuses on driving network performance and operational excellence by analyzing operational data and preparing insights for leadership. Key duties include tracking strategic deliverables, coordinating resources, and producing executive messaging to keep stakeholders aligned.
Oversee the strategic and operational execution of Free Commercial Goods, Trial, and Product Replacement programs to ensure compliant patient access. Manage vendor relationships, pharmacy partners, and internal supply chain logistics while maintaining rigorous quality and regulatory standards.
The Commissioning Manager is responsible for verifying and closing out all MEP and fire/life safety scopes for large technical projects. This includes deploying full commissioning plans, managing the commissioning team, and ensuring validation certification of project systems.
The specialist is responsible for reviewing patient orders and documentation to obtain necessary health insurance authorizations. They act as a primary point of contact to ensure patients receive care quickly while improving the overall patient experience.
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Senior Oncology Account Specialist Breast Cancer Las Vegas, NV
Pfizer
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Full Time
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3 Days Ago
Pfizer
Promote Pfizer's oncology product portfolio to healthcare providers and specialists while educating the medical community on appropriate product use. Develop strategic account plans to increase brand value and improve patient care quality within the assigned territory.
Auto Damage Consultant - Good Hands Repair Network - Remote
Allstate
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Full Time
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3 Days Ago
Allstate
Independently manages complex auto repair issues and evaluates the quality of claim handling and estimating work within the Good Hands Repair Network. Serves as a liaison between repair shops, customers, and internal partners to resolve escalated issues and ensure service expectations are met.
The Order Quality Coordinator validates high-volume customer orders for medical equipment to ensure accuracy and compliance. They resolve order discrepancies and collaborate with cross-functional teams to maintain service quality and operational goals.
The Order Quality Coordinator validates high-volume customer orders for medical equipment to ensure accuracy and compliance. They collaborate with cross-functional teams to resolve order discrepancies and identify process improvement opportunities.
The Application Coordinator acts as a subject matter expert for Sunquest LIS workflows and configurations to ensure high-quality support. Responsibilities include managing daily operations, coordinating with offshore teams, and aligning system capabilities with client business needs.
Configure and support Epic Patient Access applications to ensure system stability and manage releases. Lead cross-functional teams to gather requirements and implement innovative solutions for application performance.
Global Site Start Up II - Spain/Poland/Serbia/Romania - FSP
Parexel
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Full Time
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3 Days Ago
Parexel
Accountable for the global execution of site activation for clinical trials, ensuring efficiency and compliance with SOPs and ICH/GCP. Develops site start-up strategies, manages regulatory packages, and oversees CRO performance and TMF documentation.
Provide on-site technical leadership and hands-on service for the installation, commissioning, and maintenance of utility and industrial facilities. Perform troubleshooting and routine maintenance on power transformers, switchgear, and control systems while managing technical documentation.
The Third Party Quality Lead manages quality risk and compliance for clinical trial vendors and site entities. This includes overseeing quality systems, conducting risk assessments, and ensuring adherence to GCP and sponsor policies.
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Provide technical and non-technical customer support via phone, online chat, or text. Analyze and resolve customer issues while acting as a liaison between customers and distribution departments.
Team Leader - Tires as a Service
The Goodyear Tire & Rubber Company
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Full Time
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3 Days Ago
The Goodyear Tire & Rubber Company
Lead and develop a team of remote field technicians to ensure high-quality delivery of Tires as a Service (TaaS). Coordinate daily operations, manage stakeholder partnerships, and optimize processes to improve customer satisfaction and safety compliance.
Responsible for the end-to-end design, configuration, and deployment of Workday Absence and Time Tracking solutions for external clients. This includes leading discovery sessions, managing system testing, and providing post-production optimization support.
Director, Portfolio Management
NTT Global Data Centers
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Full Time
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3 Days Ago
NTT Global Data Centers
Lead the structuring and management of third-party investments in U.S. greenfield data center assets across the full development lifecycle. Act as a strategic partner to investors and internal functions to oversee financial performance, financing packages, and board-level reporting.
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