Outside Property Associate Claim Representative The Travelers Companies IncOutside Property Associate Claim RepresentativeWestchester, NY$52,600–$86,800 / yearThis position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). As an Associate Claim Rep, Outside Property, you will receive comprehensive training in claim handling, customer service, and policy interpretation while working alongside experienced claim professionals.
Product Manager IV SS&C Technologies Holdings IncProduct Manager IVNJRemoteLeads medium to large initiatives or complex, high‑visibility product efforts requiring broad business perspective, conceptual thinking, and in‑depth analytical problem solving. Partners closely with cross‑functional teams-including technical architecture, engineering, development, analytics, operations, and commercial teams-to ensure solutions meet financial, timing, and customer expectations.
NewCPC Investigator Blue Cross and Blue Shield AssociationCPC InvestigatorNewark, NJ$70,500–$94,395 / yearThe Certified Professional Coder (CPC) is responsible for performing reviews, audits and coding oversight of medical records to ensure the appropriate CPT codes, diagnosis codes and modifiers according to Generally Accepted Medical Coding Guidelines, CPT-4; HCPCS; ICD-10 Guidelines; and, CMS Correct Coding. The incumbent will also be responsible for handling low level investigative activities (external) related to claims, enrollment, accounting, receive and review suspected fraud and to complete cases with all information and analysis for resolution, as the manager and prior approved guidelines may direct.
FT Pharmacy Technician MEDI TECH RX LLCFT Pharmacy TechnicianScotch Plains, NJFull timeCurex Pharmacy in Scotch plains is on the lookout for a motivated and detail-oriented Pharmacy Technician to become a vital part of our dynamic team! Provide outstanding customer service by assisting patients with inquiries and resolving concerns.
Pharmacy Technician MEDI TECH RX LLCPharmacy TechnicianScotch Plains, NJFull timeProvide outstanding customer service by assisting patients with inquiries and resolving concerns. Curex Pharmacy is on the lookout for a motivated and detail-oriented Pharmacy Technician to become a vital part of our dynamic team!
Member Revenue Analyst Progyny, Inc.Member Revenue AnalystNew York, NY$65,000–$75,000 / yearHeadquartered in New York City, Progyny has been recognized for its leadership and growth as a TIME100 Most Influential Company, CNBC Disruptor 50, Modern Healthcare's Best Places to Work in Healthcare, Forbes' Best Employers, Financial Times Fastest Growing Companies, Inc. 5000, Inc. Our benefits solution empowers patients with concierge support, coaching, education, and digital tools; provides access to a premier network of fertility and women's health specialists who use the latest science and technologies; drives optimal clinical outcomes; and reduces healthcare costs.
Data Exchange Analyst - Claim Ops TPA Capital Rx LLCData Exchange Analyst - Claim Ops TPANew York, NY$96,800–$121,000 / yearKey Responsibilities: Data Integration & Mapping: Design, develop, and maintain data mappings and transformations for incoming and outgoing healthcare data files: 837/835 - claims & remittance, 270/271 - eligibility and responses, 278 - Prior Auth, 276/277 - claim status, 999/TA1 - file level acknowledgement as well as proprietary formats. Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and.
Revenue Cycle Systems Manager The Dermatology SpecialistsRevenue Cycle Systems ManagerLong IslandOversee all EDI enrollment activities, including clearinghouse connectivity, payer enrollments (ERA/EFT/EDI), troubleshooting rejections, and maintaining enrollment status tracking. The Supervisor ensures data integrity, system optimization, and alignment between system build and operational workflows to support efficient billing, claims processing, and cash flow.
OON Mandate Negotiation Analyst-1 Blue Cross and Blue Shield AssociationOON Mandate Negotiation Analyst-1Newark, NJ$58,029–$77,074 / yearPrepares written responses including negotiation outcomes by completing a written justification on how Horizon BCBSNJ adjudicated the initial and adjusted claim, but not limited to, benefits, contracts, payment and pricing methodology, proof of plan and providing explanation of benefits within regulated timeframes. This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.
Pharmacist Unlimited Drugs IncPharmacistPaterson, NJFull timeWe are looking for a professional who can dispense medications accurately, provide excellent pharmaceutical care, and ensure compliance with all relevant laws and regulations. - Controlled Substances Management: Maintain accurate records and manage controlled substances responsibly.
Pharmacy Technician Unlimited Drugs IncPharmacy TechnicianPaterson, NJFull timeCustomer Service: Provide outstanding customer service by assisting patients with their inquiries, processing transactions, and addressing concerns professionally. - Inventory Management: Maintain accurate inventory levels, order supplies, and manage stock to ensure availability of medications.
Account Executive MLabsAccount ExecutiveNew York, NY$100,000–$200,000 / yearThe position requires a player-coach mentality: owning high-stakes enterprise sales cycles from prospecting to close with Managing General Agents (MGAs) and global insurers, while establishing the scalable infrastructure and sales processes needed to hire and lead a world-class team as the company scales toward $1B in managed premiums. Product & Industry Fit: Background selling mission-critical B2B core infrastructure/software (not "nice-to-have" tools) into highly regulated or complex sectors: InsurTech (carriers, MGAs, TPAs), B2B FinTech, RegTech, PropTech, ConstructionTech, Legal, Government, Logistics, or Manufacturing .
Director, Restructuring Alvarez & Marsal North America, LLCDirector, RestructuringNew York, NYFull timeYou will be leading a team overseeing a diverse range of projects involving turnaround management, restructuring, performance improvement and corporate advisory services, helping underperforming businesses navigate their restructuring process and creating a lasting positive impact on organizations. Additionally, employees are eligible for paid time off including vacation, personal days, seventy-two (72) hours of sick time (prorated for part time employees), ten federal holidays, one floating holiday, and parental leave.
NewManager Benefits Maintenance [Hybrid- PA, DE, NJ) Blue Cross and Blue Shield AssociationManager Benefits Maintenance [Hybrid- PA, DE, NJ)New Jersey, NJResponsible for extensive downstream impacts; including but not limited to claims processing, costs to self-funded customers, cost to modify coding, compliance with state and federal regulations, adherence to filed benefits, client and member dissatisfaction. Demonstrated effective communication skills required to address and present most complex ideas and concepts to staff, management, vendor and external customers (as needed).
ServiceNow Developer Pyramid, IncServiceNow DeveloperNew York, NY$130,000 / yearFull timeProven experience in at least one design, development and implementation of FSO solutions involving Financial Data Model, Dispute management, Customer life cycle management, Treasury Operation, Payment operations, Card operations, Loan operation, Claims processing. By applying to our jobs, you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners.
ServiceNow Architect Pyramid, IncServiceNow ArchitectNYC, NY$140,000–$150,000 / yearFull timeProven experience in at least one design, architect and implementation of FSO solutions involving Financial Data Model, Dispute management, Customer life cycle management, Treasury Operation, Payment operations, Card operations, Loan operation, Claims processing. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners.
Provider Partnership Associate Blue Cross and Blue Shield AssociationProvider Partnership AssociateCranbury, NJDevelops and delivers provider education and issue resolution in pursuit of network strategies (product portfolio and product changes, payment policy changes, reimbursement methodologies, PEAR/other provider tools, clinical initiatives, etc.). Attends onsite, face-to-face, or virtual visits with all provider types and administrators when necessary to communicate changes and provide issue resolution that assists participating providers in the efficient administration of our benefit plans.
Principal Solution Engineer - Strat FINS Salesforce IncPrincipal Solution Engineer - Strat FINSNew York, NY$157,640–$210,910 / yearKey Responsibilities: As a Solution Engineer in Strat FINS, your core focus will be driving technical alignment and showing concrete value through hands-on execution: Lead AI & AgentForce Workshops: Create, deliver, and manage high-impact, interactive customer workshops. Hands-on Builder: Proven experience building with modern AI tools, low-code/pro-code AI builders, and specifically AgentForce or equivalent autonomous agent frameworks.
Account Manager IV (National Large Group) Blue Cross and Blue Shield AssociationAccount Manager IV (National Large Group)Newark, NJ$125,100–$151,095 / yearThis compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. The Account Manager acts as a trusted advisor to the client and consultants while coordinating across internal Horizon teams to ensure service delivery, compliance, and performance expectations are met.
Trainer II Blue Cross and Blue Shield AssociationTrainer IINewark, NJ$63,000–$84,420 / yearThis compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. Skills and Abilities: Current industry trends, learning solution Best Practices, technology based training administration systems helpful, healthcare industry knowledge, claims processing experience helpful.