Manager Financial Planning and Cost Analysis Highmark IncManager Financial Planning and Cost AnalysisPittsburgh, PAThese facets include but are not limited to: reporting, financial analysis, variance analysis, bid process support, administrative cost allocations, forecast model enhancement, and the period to period risk and opportunities process. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Underwriter Highmark IncUnderwriterPAWork with the sales team and underwriting peers and leaders to manage a portfolio of clients, including all rating methods and owning the underwriting engagement from initial identification through documentation of final sold-contract details. The incumbent will collaborate with cross-functional team members on client-level quotes and function as a trusted advisor by providing financial and risk management support to sales as well as strategic insight.
Director Capital and Business Development Planning Highmark IncDirector Capital and Business Development PlanningPAInteract with a wide array of internal and external customers at all levels of the business including finance, actuarial, cost and budgeting, membership and information technology departments to discuss model assumptions, model methodology and financial modeling findings. The result of the modeling will be integrated with capital planning efforts which includes working with internal business units, treasury and others to understand the current risk composition of the of the Enterprise portfolio of companies to calculate risk adjusted financial returns under various scenarios.
NewMedical Case Manager - Workers' Compensation ForzaCareMedical Case Manager - Workers' CompensationPittsburgh, PAPart timeThis role is ideal for licensed nurses or certified rehabilitation counselors with prior experience working in a role where the primary responsibility was coordinating medical care and case management for individuals with active workers' compensation claims. ABOUT US:Founded in 2022, ForzaCare is a purpose-driven organization that helps injured individuals recover faster and return to work safely through coordinated, clinically appropriate care.
Patient Access Coordinator I - Emergency Department - Jefferson - Full Time (Evening Shift) Highmark IncPatient Access Coordinator I - Emergency Department - Jefferson - Full Time (Evening Shift)Jefferson Hills, PAConducts scheduling, registration, and admitting functions independently at bedside, validates patient demographic data, identifies and verifies insurance information through payor contacts via telephone, online resources, or electronic verification systems utilizing accurate plan code and COB order. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Companys Handbook of Privacy Policies and Practices and Information Security Policy.
LOCK AND DAM OPERATOR United States ArmyLOCK AND DAM OPERATORPittsburgh, PA$32.90–$38.41 / hourHowever, you must be able to demonstrate, through experience shown in your written application materials that you possess the sufficient knowledge, skills, and abilities to successfully perform the work of this position without more than normal supervision including operating lock and dam equipment where lock and dam gates and valves are electrically or hydraulically controlled, as directed; making minor repairs to lock and dam equipment; apply locking procedures, policies, and laws regarding traffic right-of-way, sequence of operations and safe passage of hazardous commodities and damaged crafts; and comply with governing safety practices and procedures. I can apply locking procedures, policies, and laws regarding traffic right-of-way, sequence of operations and safe passage of hazardous commodities and damaged crafts; provide locking instructions to tow boat captains and other craft operators; operate electrically or hydraulically controlled lock and dam equipment; determine the specific actions to take during breakdowns of equipment, delays in operation, and accidents; recognize and avoid potential work hazards; perform repairs necessary to keep the lock in operation.
Professional Coding Specialist III - Cardiothoracic Surgery West Virginia University MedicineProfessional Coding Specialist III - Cardiothoracic SurgeryPAAccurately codes and/or audits complex surgical procedures as part of daily workload (85%-95% of workload) including but not limited to: Bariatric surgery, Cardiothoracic surgery, Gynecologic surgery, Oncology surgery, Orthopaedics surgery, Thoracic surgery, Transplant surgery, Trauma and burn surgery, and Open Vascular surgery. Reviews and accurately interprets medical record documentation from all accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified.
Independent Insurance Claims Adjuster in Gibsonia, Pennsylvania MileHigh Adjusters Houston IncIndependent Insurance Claims Adjuster in Gibsonia, PennsylvaniaGibsonia, PAWHAT WE OFFER: • Adjuster licensing assistance• Xactimate training• Property inspection & scoping training• Claims-writing workflow training• Online and in-person training options• Resume guidance• Access to industry staffing firm contacts and resources WHY PEOPLE CHOOSE MILEHIGH ADJUSTERS HOUSTON: • Over 500 Five-Star Google Reviews• Over 1,750 students trained since 2020• Hands-on, real-world training approach• Flexible online and in-person programs IMPORTANT: Requirements for roster consideration vary based on experience, licensing status, certifications, and client needs. Independent adjusting is a certification-based career field that often requires:• State licensing• Xactimate estimating knowledge• Property claims training• Real-world claims workflow understandingIf additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Psychiatric Nurse Practitioner- Pennsylvania SonderMindPsychiatric Nurse Practitioner- PennsylvaniaPittsburgh, PennsylvaniaOur most successful providers treat their practice as their primary professional priority and view these investments as essential steps toward building a thriving, sustainable practice. Guaranteed Pay & Billing: Bi-weekly payment for completed sessions, regardless of claim status we guarantee pay for no-shows.
NewComplex Claim Director - Mass Tort Unit CNA Financial CorpComplex Claim Director - Mass Tort UnitPittsburgh, PA$97,000–$189,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Leads the work activities of medium to high severity specialized Claims Professionals, has full management responsibility for setting and communicating expectations, providing direction and situational coaching, and facilitating ongoing training. Leads a team of Claims Consultants and Consulting Directors that are responsible for the handling of complex, high exposure mass tort and environmental claims, including social media addiction, PFAS, talc, sexual molestation, and other long tail general liability and pollution related matters.
NewEmployee Benefits Coordinator System OneEmployee Benefits CoordinatorPittsburgh, PAThis role serves as a primary point of contact for employee benefit inquiries, ensuring accurate and timely resolution of issues while supporting compliance, data integrity, vendor coordination, and benefits communication initiatives. Associate's or Bachelor's degree in Human Resources, Business Administration, or a related field preferred; equivalent combination of education and experience will be considered.
Customer Service Representative Monica Conroy - GEICO Local OfficeCustomer Service RepresentativePittsburgh, PAFull timeThe Monica Conroy GEICO Local Office is seeking a motivated and friendly Customer Service Representative to join our growing team in South Hills Pittsburgh. As a Customer Service Representative, you'll be the trusted point of contact for our customers, helping them understand their coverage, service their policies, and protect what matters most.
Senior Medical Stop Loss Underwriter Highmark IncSenior Medical Stop Loss UnderwriterPAActively pursuing a professional designation related to the healthcare industry and be willing to complete one course within twelve months in either Life Office Management Association (LOMA) Certified Employee Benefit Specialist (CEBS), or America"s Health Insurance Plans (AHIP). Analyzes data such as financial conditions of the organization, participation percentage, type of industry, characteristics of employee groups, or past claim experience to determine what benefits can be offered and to set the rates.
NewAccounts Receivable Specialist CFSAccounts Receivable SpecialistSewickley, PA$50,000–$60,000 / yearThe AR Specialist will monitor incoming payments, post transactions, and reconcile payments against submitted claims. Join a growing nonprofit organization dedicated to supporting individuals and strengthening the community.
Commercial Counsel Sargent ElectricCommercial CounselPittsburgh, PAFull timeWHAT YOU'LL DO: Serve as a legal advisor for three U.S. operating companies engaged in the electrical construction, telecommunication, power, utilities, infrastructure, mission critical, and renewable energy markets, providing strategic and day-to-day commercial legal support across the full project lifecycle, including project development, contracting, execution, change management, claims, disputes, and closeout. ADDITIONAL QUALIFICATIONS: Experience advising business and project teams - whether in-house or in private practice - on legal and commercial risk allocation, contract administration, claims, disputes, and project execution issues in the electrical construction, telecommunications, power, utilities, infrastructure, mission critical, renewable energy, or other complex project-based businesses.
Pharmacy Intern- Fisher Heights Giant Eagle Giant Eagle IncPharmacy Intern- Fisher Heights Giant EagleMonongahela, PAModel excellent patient care by respecting, engaging and enthusiastically meeting or exceeding all patient needs including processing orders in person and by phone, directing patients to products and merchandise and referring appropriate questions concerning prescriptions and over the counter medicine to the pharmacist. Alert pharmacists appropriately for drug utilization reviews, calling and resolving third party rejections and rebilling claims, entering and processing refills and adding patients to Refills on Time Program.
VP Reserving Forecasting & Trend Analytics Highmark IncVP Reserving Forecasting & Trend AnalyticsPARemoteStrategic Actuarial & Financial Leadership: Serve as a trusted advisor to Senior Management and cross-functional teams, proactively identifying opportunities and advocating for strategic and tactical changes and best practices that align with Highmark"s enterprise-wide goals. Advanced Trend Analytics & Insights: Lead and empower the Trend Analytics team to identify, analyze, and interpret key trend drivers, developing early indicators that inform medical economics strategies and support proactive intervention.
Independent Insurance Claims Adjuster in New Kensington, Pennsylvania MileHigh Adjusters Houston IncIndependent Insurance Claims Adjuster in New Kensington, PennsylvaniaNew Kensington, PAWHAT WE OFFER: • Adjuster licensing assistance• Xactimate training• Property inspection & scoping training• Claims-writing workflow training• Online and in-person training options• Resume guidance• Access to industry staffing firm contacts and resources WHY PEOPLE CHOOSE MILEHIGH ADJUSTERS HOUSTON: • Over 500 Five-Star Google Reviews• Over 1,750 students trained since 2020• Hands-on, real-world training approach• Flexible online and in-person programs IMPORTANT: Requirements for roster consideration vary based on experience, licensing status, certifications, and client needs. Independent adjusting is a certification-based career field that often requires:• State licensing• Xactimate estimating knowledge• Property claims training• Real-world claims workflow understandingIf additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Independent Insurance Claims Adjuster in Allison Park, Pennsylvania MileHigh Adjusters Houston IncIndependent Insurance Claims Adjuster in Allison Park, PennsylvaniaAllison Park, PAWHAT WE OFFER: • Adjuster licensing assistance• Xactimate training• Property inspection & scoping training• Claims-writing workflow training• Online and in-person training options• Resume guidance• Access to industry staffing firm contacts and resources WHY PEOPLE CHOOSE MILEHIGH ADJUSTERS HOUSTON: • Over 500 Five-Star Google Reviews• Over 1,750 students trained since 2020• Hands-on, real-world training approach• Flexible online and in-person programs IMPORTANT: Requirements for roster consideration vary based on experience, licensing status, certifications, and client needs. Independent adjusting is a certification-based career field that often requires:• State licensing• Xactimate estimating knowledge• Property claims training• Real-world claims workflow understandingIf additional licensing or training is needed, MileHigh Adjusters Houston offers career-entry training programs designed to help qualified individuals prepare for the industry.
Business Information Analyst II - HEDIS Quality Analytics Elevance Health IncBusiness Information Analyst II - HEDIS Quality AnalyticsSeven Fields, PAMay require taking business issues and devising the best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.