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. A Brief Overview Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills. What you will do Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy, efficiency, and strict adherence to policies and guidelines. Determines the eligibility and coverage of benefits for each claim based on the patient's insurance plan and policy guidelines and scope. Assesses claims for accuracy and compliance with coding guidelines, medical necessity, and documentation requirements. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims. Conducts reviews and investigations of claims that require additional scrutiny or validation to ensure proper claim resolution. Communicates with healthcare providers, patients, or other stakeholders to resolve any discrepancies or issues related to claims.</sp
Jobs in United States
Claim Benefit Specialist Commercial Operations in United States
15 active opportunities · Updated September 2026
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Explore current claim benefit specialist commercial operations jobs across United States. Filter by work mode, employment type, experience, department, date posted and distance.
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. A Brief Overview Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills. What you will do Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy, efficiency, and strict adherence to policies and guidelines. Determines the eligibility and coverage of benefits for each claim based on the patient's insurance plan and policy guidelines and scope. Assesses claims for accuracy and compliance with coding guidelines, medical necessity, and documentation requirements. Documents claim information in the company system, assigning appropriate codes, modifiers, and other necessary data elements to ensure accurate tracking, reporting, and processing of claims. Conducts reviews and investigations of claims that require additional scrutiny or validation to ensure proper claim resolution. Communicates with healthcare providers, patients, or other stakeholders to resolve any discrepancies or issues related to claims.</sp
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
About the Team OpenAI’s mission is to ensure that artificial general intelligence benefits all of humanity. Our Communications team supports that mission by explaining our technology, our values, and how we safely build powerful AI. We help business leaders see what AI can make possible for their organizations, show how customers use OpenAI’s products, and explain how AI is changing the way people work. About the Role We are looking for a senior product communications leader to own OpenAI’s B2B product story across business, trade, and nontraditional media. You will lead B2B communications for major product and platform moments, translate technical capabilities into clear business value, and build a sustained editorial program grounded in customer proof. Your work will help business leaders understand the problems our products solve and the outcomes they can enable using frontier intelligence. This is an exceptionally fast-paced, hands-on role that spans every altitude of communications. You will move from setting strategic positioning and shaping executive narratives to writing launch materials, developing media pitches, and delivering the details that make a story land. Working closely with Product, Research, Marketing, Sales, and our central Product Communications team, you will identify buyer needs, substantiate our claims, and carry a clear, consistent B2B story into the market. This role reports to the Head of Business Communications. In this role, you will: Set the positioning for OpenAI’s business products, connecting new capabilities to customer needs, the work they enable, and the evidence behind our claims. Lead business storytelling for priority launches across Codex, ChatGPT Work, API and developer capabilities, agents, and other enterprise products, in partnership with central Product Communications and product owners. Build a sustained editorial program between launches, using customer stories, explainers, and executive perspectives to show how our pr
Be at the forefront of innovation with NVIDIA! Our CUDA Libraries & Frameworks Product Marketing Manager role offers an outstanding opportunity to build the future of accelerated computing. This is your chance to join an elite team in Santa Clara, where your contributions will have a lasting impact on technology and society! We are looking for a technical, AI-first CUDA Product Marketing Manager. This is a hands-on PMM role for someone who uses AI coding agents and automation as part of daily execution, not as an occasional productivity aid. Come help craft the story for CUDA, core NVIDIA acceleration libraries like cuDNN, NCCL, NIXL, and AI frameworks like PyTorch, JAX, vLLM, and SGLang. What you'll be doing: Own positioning and messaging for CUDA as a developer platform, including the CUDA programming model, compilers, and core libraries. Make technical capabilities clear, credible, and useful for developers and technical decision-makers. Translate technical features for core libraries such as cuDNN, NCCL, CUTLASS, and TensorRT-LLM into data-driven developer narratives, release messages, proof points, ecosystem informed claims, and field-ready assets. Describe how NVIDIA speeds up AI frameworks and runtimes such as PyTorch, JAX, vLLM, and SGLang, linking low-level platform features to benefits for developers. Use AI coding agents daily to build PMM operating systems: competitive-intelligence agents, automated research pipelines, content auditing, reporting, and partner mapping. Turn documentation, performance benchmarks, GitHub issues, customer signals, and roadmap updates, into messaging assets. Lead go-to-market execution for CUDA launches and core library releases. What we need to see: Bachelor's degree in Computer Science or relevant field (or equivalent experience).
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 : This Underwriting role is for Meritain Health, an independent subsidiary of Aetna and CVS, and one of the nation's largest employee benefits administrators. We have the resources of a national carrier coupled with the unique flexibility and devoted service of a third-party administrator (TPA). The Meritain Health underwriting department supports the attainment of organizational goals through the issuance of prospective and existing business quotations and proposals. Including administrative fee pricing, stop loss, RFP questionnaire responses, and plan consultation. This fully-remote position will have the opportunity to work on a diversified book of business including Mid-Market and our Captive/Alternate channels. Responsibilities Include: Provide guidance and consultation to our Sales and Client Management teams on pricing and stop loss strategies Prepares and issues quotations and other financial deliverables for prospective and existing business while meeting established departmental TAT goals. Prepares financial projections on prospects utilizing financial models in Excel and Salesforce. Marketing and placement of stop loss policies, negotiating terms based upon claims data, strategy, relationships. and cost avoidance/reduction efforts. Works with leaders from key functional areas to understand p
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 As the Senior Lead Coordinator you will be responsible for implementing and maintaining comprehensive billing review processes. You will identify and quantify trends/issues and effectively communicate/report them to the appropriate members of the management team and payer business partners along with the potential impact. You will assist leadership in building and maintaining a high performing highly engaged team. In this role you will also provide excellent mentorship and support to your colleagues as well as design and implement training classes. The key responsibilities of the Medical Revenue Cycle Senior Lead Coordinator are: Review and analyze patient profiles, benefits, and prior authorizations to identify potential issues affecting clean claims. Collaborate with clinical and administrative teams to ensure accurate documentation is maintained and available for claims processing. Monitor claims submissions and follow up on pending claims to expedite resolution and payment. Identify trends in claims denials and develop strategies for improvement. Conduct training sessions for staff on best practices for claims submissions and compliance. Maintain up-to-date knowledge of insurance policies, regulations, and healthcare trends that impact claims
For over 20 years, Smartsheet has empowered teams to manage work seamlessly and scale solutions smarter. Now, in our most ambitious chapter yet, we are uniting human teams with AI agents. By orchestrating the work agents do best, automating manual tasks and uncovering insights at scale, we create the space for people to focus on what truly matters: judgment, creativity, and big thinking. That is magic at work, and it’s what we show up for every day. Smartsheet targets industries where workflow specificity is essential. As a Principal Product Marketing Manager, Vertical Industries, you will lead the strategic development of industry-specific value narratives, use case positioning, and sales-ready content for priority vertical, Manufacturing. In this role, you will own the GTM narrative, ensuring positioning is grounded in quantified, defensible value claims. This role requires deep industry curiosity, methodological discipline, and the ability to drive multiple complex workstreams in parallel to maintain Smartsheet’s competitive edge. This full-time position reports to the Sr. Director, Customer Value and can be located in our Bellevue, WA office, or you may work remotely from anywhere in the US where Smartsheet is a registered employer. What You Will Own: Value Strategy Execution — Vertical Industries Lead the team's execution of the Smartsheet Value Strategy process for priority verticals. Define positioning scope, including target segments, industry-specific buyer roles, KPIs, and competitor sets. Validate buyer value levers and map them to Smartsheet's capabilities to demonstrate differentiated, quantified benefits. Build vertical Value Impact Models and define the problem Smartsheet owns within each industry. Develop cross-functional Adoption Plans and validate position hypotheses through direct buyer sessions. ICP & CAPDB for Vertical Segments: Own ICP definition and target account prioritization for each priority vertical. Ensure each vertical ICP sp
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 Waste & Error Certified Coding Manager is responsible for leading the Certified Coding Analyst and W&E Team Lead roles that conduct medical claim reviews and coding audits to identify billing errors, waste, abuse, fraud, and payment integrity opportunities. The Manager provides direct people leadership, establishes operational priorities, ensures consistent application of coding and billing requirements, and is accountable for team productivity, quality, service levels, compliance, and employee development. This role partners closely with the W&E team lead, who provides day-to-day technical guidance and subject matter support to the coding team. The Manager retains accountability for staffing, performance management, workload oversight, escalations, audit readiness, process improvement, and delivery of business outcomes. The position also represents the team in discussions with senior leadership, Medical Directors, Legal, Compliance, Analytics, Operations, and other Payment Integrity partners. Primary Responsibilities People Leadership & Team Development Lead, coach, and develop a team of Certified Coding Analysts and Senior Certified Coding Analysts. Establish clear role expectations, performance goals, productivity standards, quality requirements, and accountability measures. Conduct regular perfor
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 We are seeking a highly skilled Automation Developer & Revenue Cycle Systems Analyst to support operational efficiency initiatives within our Revenue Cycle organization. This role will be responsible for developing, maintaining, and enhancing automated solutions that improve workflows, reduce manual effort, and support front-line operations. The ideal candidate will have strong technical expertise in automation technologies, programming, and healthcare revenue cycle processes. Key Responsibilities Design, develop, test, and maintain automation solutions using Visual Basic (VB) scripting and related technologies. Create, modify, and support complex Microsoft Excel macros and VBA-based automation tools. Develop and maintain automations within Boston Workstation to improve operational performance and productivity. Review claim data and quality assure claim examples in Athena Health Utilize Python and coding to implement automation via web-based platforms & applications. Selenium experience preferred to automate web-based processes and interactions with websites and application interfaces. Experience with application programming interface (API). Troubleshoot automation issues, identify root causes, and implement sustainable solutions. Partner with re
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 Lead Director, Stop Loss Relationship Management will serve as the single accountable owner for enterprise stop loss relationship strategy, governance, escalation management, and operational performance. This role is responsible for creating a more disciplined, scalable, and consistent operating model across stop loss carriers, internal business partners, and cross-functional stakeholders. This leader will address current gaps in ownership, decision rights, escalation pathways, and carrier performance that are contributing to delays, disputes, reimbursement challenges, and financial exposure. The role will centralize accountability for stop loss-related funding decisions, risk acceptance, issue resolution, and carrier engagement, ensuring clearer governance, faster resolution of high-cost claim issues, and improved predictability across the stop loss ecosystem. The ideal candidate is a strong enterprise relationship leader with deep experience managing complex, cross-functional programs, executive-level stakeholders, financial risk, operational escalations, and external partner performance. This individual must be highly effective at driving alignment, establishing governance, improving processes, and influencing outcomes across matrixed teams. What You Will Do Serve
From $95.2K/yr
GitLab is the intelligent orchestration platform for DevSecOps. GitLab enables organizations to increase developer productivity, improve operational efficiency, reduce security and compliance risk, and accelerate digital transformation. More than 50 million registered users and more than 50% of the Fortune 100* trust GitLab to ship better, more secure software faster. The same principles built into our products are reflected in how our team works: we embrace AI as a core productivity multiplier, with all team members expected to incorporate AI into their daily workflows to drive efficiency, innovation, and impact. GitLab is where careers accelerate, innovation flourishes, and every voice is valued. Our high-performance culture is driven by our values and continuous knowledge exchange, enabling our team members to reach their full potential while collaborating with industry leaders to solve complex problems. Co-create the future with us as we build technology that transforms how the world develops software. * Fortune 500® is a registered trademark of Fortune Media IP Limited, used under license. Claim based on GitLab data. Fortune 100 refers to the top 20% ranked companies in the 2025 Fortune 500 list, published in June 2025. Fortune and Fortune Media IP Limited are not affiliated with, and do not endorse products or services of GitLab. An overview of this role At GitLab, we’re looking for a Talent Brand Manager to shape how current and prospective team members understand what it means to work here. You’ll bring GitLab’s employer value proposition to life through storytelling, recruitment marketing, candidate education, and experiences that connect our external reputation to our internal culture. You’ll partner across GitLab to turn talent brand strategy into campaigns and content throughout the candidate journey. This role is a strong fit for a brand, recruitment marketing, employer brand, or content professional who can move between strategy and execution. You
From $115.2K/yr
GitLab is the intelligent orchestration platform for DevSecOps. GitLab enables organizations to increase developer productivity, improve operational efficiency, reduce security and compliance risk, and accelerate digital transformation. More than 50 million registered users and more than 50% of the Fortune 100* trust GitLab to ship better, more secure software faster. The same principles built into our products are reflected in how our team works: we embrace AI as a core productivity multiplier, with all team members expected to incorporate AI into their daily workflows to drive efficiency, innovation, and impact. GitLab is where careers accelerate, innovation flourishes, and every voice is valued. Our high-performance culture is driven by our values and continuous knowledge exchange, enabling our team members to reach their full potential while collaborating with industry leaders to solve complex problems. Co-create the future with us as we build technology that transforms how the world develops software. * Fortune 500® is a registered trademark of Fortune Media IP Limited, used under license. Claim based on GitLab data. Fortune 100 refers to the top 20% ranked companies in the 2025 Fortune 500 list, published in June 2025. Fortune and Fortune Media IP Limited are not affiliated with, and do not endorse products or services of GitLab. An overview of this role As a Senior Talent Brand Manager, you'll shape how current and prospective team members understand what it means to work at GitLab. You'll bring our employer value proposition to life through talent brand strategy, recruitment marketing, and integrated campaigns across the candidate journey. You'll combine editorial judgment, performance data, cross-functional influence, and artificial intelligence tools to create clear, inclusive, and authentic candidate experiences. What You’ll Do Lead GitLab's talent brand strategy, translating our employer value proposition and company direction into clea
From $152.8K/yr
GitLab is the intelligent orchestration platform for DevSecOps. GitLab enables organizations to increase developer productivity, improve operational efficiency, reduce security and compliance risk, and accelerate digital transformation. More than 50 million registered users and more than 50% of the Fortune 100* trust GitLab to ship better, more secure software faster. The same principles built into our products are reflected in how our team works: we embrace AI as a core productivity multiplier, with all team members expected to incorporate AI into their daily workflows to drive efficiency, innovation, and impact. GitLab is where careers accelerate, innovation flourishes, and every voice is valued. Our high-performance culture is driven by our values and continuous knowledge exchange, enabling our team members to reach their full potential while collaborating with industry leaders to solve complex problems. Co-create the future with us as we build technology that transforms how the world develops software. * Fortune 500® is a registered trademark of Fortune Media IP Limited, used under license. Claim based on GitLab data. Fortune 100 refers to the top 20% ranked companies in the 2025 Fortune 500 list, published in June 2025. Fortune and Fortune Media IP Limited are not affiliated with, and do not endorse products or services of GitLab. An overview of this role As Engineering Manager for the Agent Execution group , you'll lead more than 10 engineers who build foundations for AI agents to run safely and effectively across GitLab. You'll give the group clarity, remove obstacles, and help teams move quickly while protecting what matters. You'll contribute to design reviews on sandboxing and agent observability, work alongside staff engineers, and use modern AI coding tools and agent harnesses in your work. What you’ll do Lead the Agent Tools, Agent Observability, and Runner Execution teams across frontend, backend, and AI engineering, with each team anchored by a s
GitLab is the intelligent orchestration platform for DevSecOps. GitLab enables organizations to increase developer productivity, improve operational efficiency, reduce security and compliance risk, and accelerate digital transformation. More than 50 million registered users and more than 50% of the Fortune 100* trust GitLab to ship better, more secure software faster. The same principles built into our products are reflected in how our team works: we embrace AI as a core productivity multiplier, with all team members expected to incorporate AI into their daily workflows to drive efficiency, innovation, and impact. GitLab is where careers accelerate, innovation flourishes, and every voice is valued. Our high-performance culture is driven by our values and continuous knowledge exchange, enabling our team members to reach their full potential while collaborating with industry leaders to solve complex problems. Co-create the future with us as we build technology that transforms how the world develops software. * Fortune 500® is a registered trademark of Fortune Media IP Limited, used under license. Claim based on GitLab data. Fortune 100 refers to the top 20% ranked companies in the 2025 Fortune 500 list, published in June 2025. Fortune and Fortune Media IP Limited are not affiliated with, and do not endorse products or services of GitLab. An overview of this role Join us at a pivotal moment as we scale our revenue operations globally. As Chief of Staff to the CRO, you'll serve as a strategic partner and force multiplier to our revenue leadership team, driving operational excellence and orchestrating high-impact initiatives. As part of the Office of the CRO, you'll also manage our Communications lead and CRO Initiatives Program Manager, giving you direct ownership over how the CRO's key initiatives get built and run. This highly visible role offers a unique opportunity to shape strategy at the executive level while developing your path to senior leadership. Y
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