Claims Trainer Jobs

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 The growing DSNP business has created an opportunity for an individual with claims experience, who is familiar with the 837 standard claims format. This individual will own 837 file transmissions to the states, manage and act on state response files, ensuring that all transactions transmitted are complete and error free. Manage and complete error corrections to meet state requirements. Required Qualifications 1&#43; year of experience with encounter data, medical claims, or Medicare/Medicaid. 1&#43; year of experience using FTP and data transfer software. 1&#43; year of data management experience. Preferred Qualifications Experience with Microsoft Access Databases. Analytical skills with the ability to identify and resolve data discrepancies. Working knowledge of the 837 claims files. Education Bachelors degree or equivalent work experience Anticipated Weekly Hours 40 Time Type Full time Pay Range <p s

Who we are About Stripe Stripe's mission is to increase the GDP of the internet. We build the most powerful and flexible tools for running an internet business — handling billions of dollars each year and enabling millions of businesses worldwide to scale faster by building on Stripe. That means you have an unprecedented opportunity to put the global economy within everyone’s reach while doing the most important work of your career. About the team Our tax team works with Stripes across the company to develop an efficient operating model as our international business scales and expands into new markets and launches new products. EMEA Tax supports Stripe’s growth across the region by helping the company meet its tax obligations, manage tax risk, and make well-supported decisions as Stripe’s products, systems, and operations evolve. You will be based in Dublin and report to the EMEA Tax lead, who is located in Dublin. This role will develop and lead a best-in-class global R&D incentives programme. What you’ll do You will be Stripe’s European R&D incentives lead, responsible for developing and leading Stripe’s R&D incentives programmes in Ireland and the UK. You will support Stripe’s US federal and state research-credit programme and will explore new opportunities as Stripe continues to expand globally. You will build trusted relationships with engineering and product teams, establish repeatable processes for identifying and documenting qualifying work, and ensure Stripe can support its global R&D incentives claims with contemporaneous evidence. You must be able to work effectively with cross-functional teams and independently lead complex, high-impact work. You will translate complex technical activity into clear documentation, and help Stripe enhance its global R&D incentives processes. Responsibilities Act as Stripe’s European lead and technical expert for R&D incentive and grant claims. Support the annual US fed

Why Jencap? We are one of the largest wholesale insurance intermediaries in the United States with expertise in wholesale brokerage, binding authority, and program management. The common thread woven throughout our success story is our collaborative and driven team of people. Our teams are empowered and work together to find solutions. We have a passion culture – with teamwork, collaboration and a focus on growing individuals and giving them the tools & development opportunities to have a successful career. MiniCo has nearly 50 years of experience in program management, underwriting, binding authority, and claims, offering a portfolio of exclusive programs to address even the most unique risk exposures. Our dedicated program teams provide niche underwriting process and flexibility, industry specialization, and unparalleled customer service. Today, MiniCo is a member of the Jencap Program Administrators division, offering multiple specialty property and casualty insurance products for a variety of unique industries and exposures. The Team Lead Underwriting Operations will work a hybrid schedule from our Phoenix AZ office Lead MiniCo’s Underwriting Support Team and operational workflows, with responsibility for team development, ConceptOne (C1) subject-matter expertise, New Business and Renewal support processes, agency-operations coordination, vendor/BPO governance, system testing, and cross-functional process improvement. Responsibilities : People Leadership & Service Management Lead, coach, and develop the Underwriting Support team, including cross-training, workload management, and performance expectations. Monitor team capacity, address bottlenecks, and recommend staffing or workflow improvements. Conduct regular team meetings, coaching, goal setting, and performance reviews. Systems & Process Ownership Serve as the primary ConceptOne SME and liaison across Underwriting, IT, Accounting, and vendors. Troubles

Why Jencap? We are one of the largest wholesale insurance intermediaries in the United States with expertise in wholesale brokerage, binding authority, and program management. The common thread woven throughout our success story is our collaborative and driven team of people. Our teams are empowered and work together to find solutions. We have a passion culture – with teamwork, collaboration and a focus on growing individuals and giving them the tools & development opportunities to have a successful career. MiniCo has nearly 50 years of experience in program management, underwriting, binding authority, and claims, offering a portfolio of exclusive programs to address even the most unique risk exposures. Our dedicated program teams provide niche underwriting process and flexibility, industry specialization, and unparalleled customer service. Today, MiniCo is a member of the Jencap Program Administrators division, offering multiple specialty property and casualty insurance products for a variety of unique industries and exposures. The Administrative and Operations Specialist will work from our Phoenix, Arizona office. Responsibilities : Serve as MiniCo’s primary day-to-day Phoenix office operations and admin resource, to handle front-office/reception duties, mail and shipping, facilities/vendor coordination, trade-show logistics, and general administrative support. Coordinate reception/phone coverage, messages, deliveries, and general correspondence; escalate insurance-specific questions appropriately. Own incoming/outgoing mail, post-office retrieval, UPS/FedEx/shipping, physical document routing, scanning, storage, and related record-handling procedures. Liaise with building management and external vendors for facilities, maintenance, access, service requests, and office needs. Manage office/kitchen supplies, deliveries, storage areas, shared office records, and general organization. Coordinate employee meetings, office events, celebr

Data Scientist II, Cohere Health, Inc., Boston, Massachusetts (Remote) Duties: Gather business requirements and apply trend analysis to identify actionable insights using analytic tools. Analyze healthcare claims and authorization data to identify outliers, interpret patterns, and assess trends and opportunities. Apply large language models (LLMs), stochastic optimization methods, and related technologies to support decision-making. Monitor industry trends, regulatory changes, and emerging fraud schemes to support detection strategy development, maintain methodology documentation, and present findings to leadership. Train, fine-tune, and implement LLMs and deep learning models for tasks such as anomaly detection, classification, and automated analysis of security-related or operational data. Analyze datasets to assess expected impacts and return on investment, including effects on medical expense, administrative cost, and clinical outcomes. Develop data models, algorithms, and simulations to support analytical objectives. Build visualizations and dashboards to communicate analytical findings and support business workflows. This is a fully remote position and may be performed from anywhere within the United States. Occasional travel to company headquarters in the U.S. for onboarding, team meetings, and company events may be required. Requirements: Must have a Master’s degree in Data Science, Statistics, Biostatistics or related field (willing to accept foreign education equivalent) and 36 months of experience as Analyst or related position analyzing datasets. Must possess three (3) years of experience (may be gained concurrently with above experience) in the following skills: Analyzing healthcare datasets, including EMR/EHR data, medical and pharmacy claims data, and Social Determinants of Health (SDoH) data; Performing data quality analysis to identify data quality issues, gaps, or inconsistencies; Building scalable AWS Airflow pipelines to ingest, integrate, and tr

End to end responsible for: • budget governance and cost predictability by driving planning, reforecasting and variance controls across SBUs/projects. • cost-to-complete and contingency discipline with early-warning insights to protect margins and cashflows. • financial impact assessment of changes, claims and VE decisions to enable faster approvals and risk control. • standardized MIS and corrective action tracking for leadership reviews. Source: Adani Group | Job ID: 59137

The Lead - Billing (MEP) will be responsible for end-to-end billing, quantity surveying, contract administration, and commercial management for Mechanical, Electrical, Plumbing (MEP), Fire Fighting, HVAC, ELV, and Utility works. The role involves preparation and certification of RA bills, contractor and subcontractor billing, client billing, variation management, claims administration, BOQ reconciliation, and cost monitoring for large-scale construction projects including high-rise buildings, industrial plants, data centers, commercial developments, and infrastructure projects. Source: Adani Group | Job ID: 59172

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 The Senior Manager, Project Management is responsible for leading and overseeing Coordination of Benefits projects and operational initiatives that improve payment accuracy, reduce overpayments, enhance compliance, and drive process efficiency across the organization. This role manages a portfolio of complex, cross-functional projects and collaborates with stakeholders across Claims, Enrollment, Provider Services, Operations, Technology, Analytics, and Vendor Management to ensure successful delivery of strategic business objectives. The Senior Manager is accountable for defining project scope, objectives, timelines, resource requirements, and success measures while ensuring initiatives are delivered on time, within budget, and aligned with organizational goals. This role leverages data analytics and business intelligence to identify trends, assess risks, develop solutions, and implement process improvements that enhance operational performance and the provider and member experience. In addition to project leadership, the Senior Manager directly manages staff, providing day-to-day leadership, coaching, performance management, and professional development. Responsibilities include establishing team priorities, allocating resources, managing workload distribution, fostering collaboration, and creating a culture of accountability, innovation, and continuous improvement. The role

Job Description: A Licensed Surveyor assesses damaged property (primarily vehicles, equipment, or commercial assets) to determine the cause, extent, and financial cost of loss for insurance claims. An active Insurance Regulatory and Development Authority of India (IRDAI) License is mandatory for this role to legally sign off on survey reports. Job Overview •Position: Licensed Insurance Surveyor & Loss Assessor •Required Certification: Valid IRDAI License (SLA Number required) •Objective: Inspect insured losses, verify damage authenticity, negotiate repair costs, and submit final assessment reports for claim settlement. Key Responsibilities •Site & Physical Inspection: Inspect damaged assets, vehicles, or property directly on-site or at workshops. •Loss Assessment: Evaluate the extent of damage, identify cause of loss, and verify coverage against the insurance policy terms. •Cost Estimation: Review repair estimates, negotiate labor/parts costs with workshops, and calculate depreciation and salvage value. •Report Submission: Draft and submit clear, accurate, and compliant Survey & Loss Assessment reports within regulatory timelines. •Fraud Detection: Spot discrepancies, pre-existing damages, or misrepresentations in claim submissions. Qualifications & Requirements •License: Valid IRDAI Surveyor & Loss Assessor License is preferable. •Education: B.E., B.Tech, or Diploma in Mechanical, Electrical, or Civil Engineering •Experience: 2 5+ years in field surveying, loss assessment, or automobile/property insurance •Skills: Strong technical knowledge of repairs and estimation, thorough understanding of IRDAI guidelines, and excellent communication skills What's App Number: 8897534176

End to end responsible for: • project design integration under D&B by converting product intent into organization’s Requirements and coordinated deliverables. • stage-gate reviews and interface management across Arch–Str–MEP to ensure buildability, compliance and cost alignment. • design change governance with quantified impacts, protecting baselines and reducing claims and rework. • construction-stage design assurance via submittal reviews, mockups and deviation control without duplicating PMC. • Ensures transparent MIS, audit-ready records and SLA-driven closures across stakeholders. Source: Adani Group | Job ID: 54250

Help leading insurers rethink how underwriting, claims and operations work The Role Capco is growing its Insurance practice in Hong Kong and is looking for a Principal Consultant to lead transformation initiatives with major Life, Health and General Insurance clients across Hong Kong and APAC. This is an opportunity to work directly with senior insurance leaders to redesign operating models, transform underwriting and claims capabilities, modernise customer journeys, and unlock value through digital, automation, data and AI-enabled solutions. You will play a key role in shaping client outcomes, developing market propositions, and contributing to the continued growth of Capco’s Insurance practice. What You’ll Do Lead end-to-end transformation programmes across Life, Health and General Insurance clients throughout Hong Kong and APAC. Design future-state operating models, process improvements, and customer, underwriting and claims journey enhancements. Partner with senior stakeholders including COOs, Heads of Claims, Heads of Underwriting, Operations Leaders and Transformation Executives to deliver strategic change. Lead multidisciplinary teams across consulting, technology, operations, data and third-party vendors to achieve successful outcomes. Contribute to business development activities, market propositions, thought leadership and the growth of Capco’s Insurance capability. What We’re Looking For 8–12+ years of experience within consulting, insurance operations, underwriting, claims, transformation, or a related discipline. Strong understanding of insurance operating models, process optimisation, underwriting operations, claims operations and policy servicing. Proven experience delivering large-scale transformation programmes within regulated insurance environments. Ability to engage senior stakeholders and translate strategic objectives into practical, measurable delivery plans. Professional fluency in English; Cantonese and/or Mandarin language ski

The Ops Sup Lead Analyst is a senior-level operations professional responsible for managing transaction exception processing, including payment network claims, adjustments, disputes, settlement exceptions, and reconciliation activities for internal Citi business partners. The role is accountable for ensuring the accurate and timely resolution of operational exceptions, maintaining a strong control environment, and overseeing third-party vendors that support these functions. This individual serves as the primary liaison between Operations, Business, Technology, Risk & Control partners, payment networks, and external vendors to ensure operational issues are resolved effectively, controls are maintained, and processes continue to evolve to support business growth and regulatory expectations. The successful candidate will act as a subject matter expert in payment network operations, transaction routing, settlements, reconciliations, and exception management. Responsibilities Lead the end-to-end management and resolution of transaction exceptions, including payment network claims, adjustments, disputes, settlement discrepancies, and other operational exceptions. Oversee settlement and reconciliation processes to ensure the timely identification, investigation, and resolution of breaks, variances, and outstanding items. Monitor operational performance and service level adherence, ensuring all activities are completed accurately, timely, and in compliance with applicable policies and procedures. Serve as the primary operational liaison with internal Citi business partners, Technology, Risk & Control, Compliance, Finance, payment networks, and third-party vendors. Manage vendor relationships supporting claims, adjustments, settlement, and reconciliation functions, including performance monitoring, issue escalation, service delivery oversight, and process improvements. Act as the b

Job Title Global Product Manager- IVP & Launch Excellence Job Description As a Global Product Manager (GPM)- IVP & Launch Excellence , you will build integrated value propositions and standardized launch approaches across Sleep & Respiratory segments ; improve launch planning, commercial readiness, and execution consistency Your role: Develop value propositions, business cases, and product claims (clinical, economic, technical) to support strategic investments, pricing, and product success. Define and maintain product, software, and lifecycle specifications aligned with portfolio strategy and customer needs. Drive product strategy execution with regional teams , ensuring commercial viability, technical simplicity, and margin optimisation. Own the claims roadmap, prioritising validated claims based on market, customer, competitor, and regulatory insights. Engage Key Opinion Leaders (KOLs) through advisory boards and educational initiatives to strengthen product credibility and market influence. Partner with cross-functional teams to develop channel strategies and go-to-market plans that accelerate adoption and revenue growth. Analyse market trends, competitive activity, customer behaviour, and product performance to inform data-driven decisions and roadmap priorities. Ensure regulatory compliance and quality standards throughout the product lifecycle. Support development and refinement of testing protocols to ensure accurate product evaluation. Lead end-to-end product lifecycle management, from concept through launch, ensuring quality, timely delivery, and alignment with business objectives. Drive continuous improvement and innovation initiatives to enhance product performance and maintain market competitiveness. You're the right f

Job Title Global Product Manager- Accelerators Job Description Global Product Manager- Accelerators will lead the incubation of early-stage products and technologies, including internally developed and partnered solutions; translate emerging concepts into scalable new-product opportunities Your Role Own the end-to-end product lifecycle, including portfolio strategy, roadmap development, value propositions, and business case execution. Lead new product development and PDLM governance, ensuring timely, profitable, and compliant product launches. Develop portfolio positioning, claims strategies, and customer segmentation based on market insights, competitive analysis, and regulatory requirements. Partner with R&D, Innovation, Sales, Marketing, Manufacturing, and regional teams to deliver commercially successful solutions. Build and manage KOL relationships to strengthen product credibility, thought leadership, and market adoption. Drive global launch readiness and support regional go-to-market execution. Provide strategic guidance and product expertise to regional marketing and sales teams to accelerate growth and market penetration. Ensure achievement of commercial objectives, portfolio profitability, and Annual Operating Plan (AOP) targets. Oversee product validation and testing activities to ensure quality, performance, and customer satisfaction. You're the right fit if: You’ve acquired 10&#43; years of experience in an international business environment in the field of product management, marketing, or related commercial/strategic role in medical devices or health technology. Exposure to Regulatory frameworks (FDA, EU MDR) and Reimbursement considerations You have a Bachelor's/ master’s degree in business

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 Inspects and provides accurate claim information to support savings optimization for claims. Responds to customers on benefit inquiries. Maintains customer service standards. Administers policies and procedures for medical cost management. Coordinates support functions for claim adjudication. Required Qualifications Executes both routine and non-routine business support tasks for the Medical Claims area under limited supervision, referring deviations from standard practices to managers. Follows area protocols, standards, and policies to provide effective and timely support. Reviews provider billing practices to identify trends and cost savings opportunities. Conducts training programs related to claim billing appropriateness and health plan guidelines for claim processors. Tests automated code review programs. Takes direction to execute techniques, processes, and responsibilities Preferred Qualifications Working knowledge of problem solving and decision making skills 5&#43; years work experience Education High school diploma or equivalent required. Anticipated Weekly Hours 40 </p