Benefits Manager Jobs

Benefit Specialist — VA - Norfolk. Apply via Workday.

Claim Benefit Specialist — 52 Locations. Apply via Workday.

Claim Benefit Specialist — 51 Locations. Apply via Workday.

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider refunds and returned checks. May handle customer service inquiries and problems. Perform adjustments across all dollar amount level on customer service platforms by using technical and claims processing expertise. Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process. Performs claim re-work calculations. Follow through completion of claim overpayments, underpayments, and any other irregularities. Process complex non-routine Provider Refunds and Returned Checks. Review and interpret medical contract language using provider contracts to confirm whether a claim is overpaid to allocate refund checks. Handle telephone and written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals. Ensures all compliance requirements are satisfied and that all payments are made following company practices and procedures. Review and handle relevant correspondences assigned to the team that may result in adj

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines. Functions as a subject matter expert by providing coaching, and offering guidance on escalated or technically challenging issues. Supports customer service operations by addressing inquiries and resolving issues to ensure a positive member experience. Additional Responsibilities - Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication. - Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures. - Identifies and reports potential overpayments, underpayments, and other claim irregularities. - Performs claim rework calculations as needed. - Trains and mentors as needed to enhance team performance and technical proficiency. - Conducts outbound calls to obtain required information for claims or reconsideration requests. Required Qualifications - Minimum of 18 months of medical claim processing experience with a health insurance payor or third‑party administrator. - Proven

About the Team The Personal AGI team seeks to empower all of humanity to benefit from frontier intelligence in whatever way they choose. We are responsible for training models to deploy to millions of users globally via ChatGPT, the API, and future products. We aim to evolve ChatGPT from a chatbot to an infinitely capable and personalized superassistant supporting human flourishing. We work on defining, measuring, and improving capabilities across the training stack. Our focus areas include but are not limited to model behavior, personalization, safety, factuality, instruction following, personality, interactivity, multilingual fluency, world interaction, and bringing agents to everyone. We chart the course for what to strive towards. We partner closely with research and product teams across the company ensuring that our models are safe, efficient, and reliable. About the Role You’ll work as a Research Engineer / Scientist on the North Stars team within the broader Personal AGI research org. You will work on bringing the next generation of AI-enabled experiences to all of humanity by closing the capability overhang between power users and the average consumer, including areas like tool-use, feature discovery, connectors, and instruction following. You will think deeply about the current bottlenecks in model behavior, translate these insights into robust evals, training data, reward signals, and model and harness improvements. We're looking for individuals with strong ML engineering skills and research experience passionate about creative, product-driven research. This role is based in San Francisco, CA. We use a hybrid work model of 3 days in the office per week and offer relocation assistance to new employees. In this role, you will: Own and pursue a research agenda to improve model capability and performance. Collaborate closely with the other research and product teams, allowing customers to optimize their own models. Build robust evaluations for tracking modelin

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with a high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Opportunity The Molecular Account Executive is a field sales role. This position is part of the Molecular Diagnostic Division, which sells the full stack selling of Molecular products to healthcare fac

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with a high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Opportunity The Molecular Account Executive is a field sales role responsible for covering the North Florida territory. This position is part of the Molecular Diagnostic Division, which sells th

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: About Abbott Abbott is a global healthcare leader, creating breakthrough science to improve people’s health. We’re always looking towards the future, anticipating changes in medical science and technology. Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and family, be your true self and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with high employer contribution. Tuition reimbursement, the Freedom 2 Save student debt program and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companie

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with a high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Opportunity The Molecular Account Executive is a field sales role responsible for covering the North Florida territory. This position is part of the Molecular Diagnostic Division, which sells th

About the Team OpenAI’s Network Engineering team within IT and Security advances the mission of deploying artificial general intelligence (AGI) for the benefit of all by delivering secure, scalable, and resilient network services. We build and operate the connectivity that supports OpenAI’s offices, labs, campuses, cloud environments, people, and devices. By combining strong network fundamentals with security, reliability, automation, and user-centered design, we enable impactful AI research, corporate operations, and product innovation. About the Role As a Network Engineer at OpenAI, you will design, operate, and continuously improve the global networks that connect our offices, labs, campuses, PoPs, cloud environments, people, and devices. The role spans strategic platform engineering and responsive production operations: you will shape architecture, standards, roadmaps, lifecycle plans, and automation while supporting incidents, escalations, and time-sensitive delivery. Operational signals will inform what we stabilize, simplify, standardize, or automate next. We work backward from user needs, investigate root causes, own outcomes end-to-end, and move quickly without compromising security. We are looking for a versatile engineer who can make pragmatic reliability and security tradeoffs, communicate clearly, and turn recurring operational work into durable platforms, tooling, and standards. You will partner across IT, Security, AppEng, Research, Applied, workplace teams, carriers, and vendors. In this role, you will: Design, implement, and operate secure, scalable enterprise networks across offices, labs, campuses, PoPs, cloud connectivity, and hybrid environments. Set strategic direction for network services through architecture, standards, roadmaps, lifecycle planning, capacity strategy, and measurable reliability outcomes. Own production operations, including on-call, incident response, escalations, and time-sensitive delivery, while protecting user experience,

About the Team OpenAI’s Platform and Infrastructure Engineering organization advances the mission of deploying artificial general intelligence (AGI) for the benefit of all by delivering secure, scalable, and resilient technology solutions. Our team builds and maintains robust infrastructure that safeguards OpenAI’s data and systems while ensuring employees are well-equipped and seamlessly connected. By prioritizing security, reliability, and user-centric solutions, we empower OpenAI employees to drive impactful AI research, corporate operations, and product innovation. About the Role As a Software Engineer: Internal Applications, Enterprise, you will build internal products that make technology support and administration safer, faster, and less dependent on manual intervention. You will help reduce reliance on broadly privileged human actions, turn recurring technology problems into paved paths, and build agentic systems that can help resolve tickets end to end. A core part of the role is building the interfaces that bring employees, AI agents, and human responders together in a shared ITSM experience, with the right context, controls, and handoffs at each step. We are seeking engineers who enjoy working across frontend and backend layers on ambiguous, high-leverage enterprise problems. You should bring strong product judgment, solid backend engineering fundamentals, and an interest in building software that changes how technology support, system administration, and agent-assisted operations are delivered. The best fit will care as much about the quality of the operator and employee experience as the correctness of the backend systems behind it. In this role, you will: Build frontend experiences that let employees request help, let agents gather context and take safe actions, and let human responders review, approve, or take over without losing the thread. Reduce reliance on broadly privileged manual actions by replacing them with narrow, auditable, policy-aware aut

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with a high employer contribution. Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Opportunity This position works out of our Phoenix, AZ location in the Cancer Diagnostic Di

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with a high employer contribution. Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired com

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: · Career development with an international company where you can grow the career you dream of. · Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. · An excellent retirement savings plan with a high employer contribution. · Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. · A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired com