Claim Health jobs

Safety & Occupational Health Specialist Window Rock, Arizona Summary This position is part of the Education Facilities, Bureau of Indian Education (BIE), Department of the Interior (DOI). As a Safety & Occupational Health Specialist you will be responsible for managing the safety program to include implementation, oversite and evaluations, and performance serving as the technical expert regarding safety to management, safety staff and committees. Duties As a Safety & Occupational Health Specialist, GS-0018-12, your typical work assignments will include the following under supervision: Conducts annual workplace inspections in an appropriate frequency and program evaluations to assess conformance with Indian Affairs, adopted safety and health codes and mandated standards. Investigates accidents involving employees when necessary and ensures that all accidents are reported immediately and properly. Serves as Tort Claim Officer, and as such, thoroughly conducts special investigations of all accidents which might result in a claim against the Government. Coordinates with other safety organizations including the Occupational Safety and Health Administration (OHSA), Department of the Interior (DOI), Office of Inspectors General (OIG), and others. Provides safety and health training and Bureau wide safety outreach to employees using a variety of methods such as training sessions, videos, web page updates, electronic and other written communications. Education This position does not have a positive education requirement at this grade level. Therefore, no transcripts are required. Evaluation Once the announcement has closed, your resume and supporting documentation will be used to determine if you meet the qualifications listed on this announcement. To determine if

Public Benefit Specialist 2 Locations posted: Posted Yesterday

Patient Access Executive - Singapore Singapore posted: Posted Yesterday

Business Analyst, Misleading Claims Bengaluru, Karnataka, IND Misleading Claims is part of the Regulatory Intelligence Safety and Compliance (RISC) organization. We are on a mission to protect customers from false and deceptive claims on products, enabling trustworthy shopping experiences at Amazon. We are seeking an experienced Business Analyst to drive the metrics strategy and data infrastructure for Amazon's Misleading Claims program. This role will define, build, and own the key performance metrics that measure program effectiveness in protecting customers from deceptive product claims across our marketplace. The ideal candidate will independently identify underlying data sources, design new metrics frameworks where none exist, and deliver actionable insights that shape program direction. You will partner with Risk Management, Tech, Science, and Ops teams to translate complex enforcement outcomes into measurable business indicators. Strong analytical judgment, deep SQL proficiency, and experience working with trust and safety or compliance programs are essential. This role requires the ability to operate independently in ambiguous, fast-moving environments where data definitions and measurement approaches must be built from the ground up. Key job responsibilities The successful candidate will: - Define and own the end-to-end metrics framework for the Misleading Claims program, including identifying gaps in existing measurement, creating new metrics, and establishing baselines and targets for program performance - Independently identify, evaluate, and onboard underlying data sources across enforcement, detection, and seller behavior systems to build a comprehensive data foundation for program analytics - Design and build dashboards and reporting mechanisms that provide real-time visibility into program health,

HR Manager – Leave Management, Worker’s Compensation & Occupational Health Towson - Dulaney Center The HR Manager - Leave Management, Workers' Compensation & Occupational Health is responsible for the strategic oversight and day-to-day administration of employee leave programs, workers' compensation claims, and occupational health initiatives. This role ensures regulatory compliance, supports employee wellbeing, mitigates organizational risk, and partners with leaders to promote a safe, healthy, and productive workplace.

Supervisor, Billing Downers Grove, IL At Accendra Health, we understand that healthcare is complex, and we're here to make it easier. We help deliver care beyond traditional settings, making essential products and services more accessible through every stage of life. As part of the care team, our teammates play a critical role in delivering personalized, long-term care for the patients we serve. With deep expertise promoting health outside the hospital and a presence in communities nationwide through our Apria and Byram Healthcare brands, Accendra Health does more than just deliver the essentials. If you're interested in meaningful work with impact, explore our career opportunities and join us in our purpose of Bringing Care To Life™. The anticipated range for this position is $65-75k annually The role is Hybrid, attending to the office 1-2 times at a week and the schedule required is M-F from 8.30 to 4 pm Qualifications EDUCATION & EXPERIENCE REQUIRED: High School Diploma 1 year of experience as a supervisor or related Excel skills KNOWLEDGE SKILLS & ABILITIES: Strong leadership and team management skills. Excellent attention to detail and organizational skills. Ability to analyze reports and identify root causes of billing issues. Effective communication and problem‑solving skills. Ability to manage multiple priorities in a fast‑paced environment. Proficiency with Microsoft Office applications, particularly Excel. Supervise daily billing workflows, including electronic and paper claim submission. Ensure claims are billed accurately and in compliance with payer, CMS, and internal billing requirements. Monitor unbilled, held, or rejected claims and ensure appropriate

Client Relations Associate - Health (new) Lima Testing Health Islamabad Job Description

Medical Representative_CVRM (North) Taiwan posted: Posted 30+ Days Ago

Customer Claims Executive Country Australia Position Summary ( 12 month's contract role) Join one of the world's most recognised FMCG brands and play a key role behind the scenes of major commercial decisions. At Nestlé, this isn't just a claims processing role - it's an opportunity to work at the heart of Sales, Finance, and Trade Operations, where your insights, accuracy, and stakeholder partnerships directly influence business performance. If you enjoy connecting the dots between numbers, commercial strategy, and customer outcomes, this role offers plenty of variety and visibility. You'll work closely with Sales teams, validating claims or deductions from customers, analyse trade spend performance, solve complex claims issues, and help ensure commercial agreements are executed accurately and compliantly. Why Nestle Work in a high-performing, collaborative team Grow through real career development and internal mobility Be part of a business focused on nutrition, health and wellness Competitive salary + benefits + product perks Inclusive culture where your ideas are heard Ready to step up your impact? If you're ready to move beyond reporting into a role where you support the financial management of one of the largest lines in the profit and loss account leading to the right decisions and outcomes, we'd love to hear from you. A day in the life If you enjoy fast-paced environments where your analysis directly shapes business outcomes, this role will keep you challenged and engaged every day. Reporting to the Sales Contr

Medical Representative_GP (North) Taiwan posted: Posted 30+ Days Ago

Lead Software Engineer, Agentic AI Systems Lehi, UT | Plano, TX At Collective Health, we're transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design. The Claims AI Automation team is currently evolving from traditional rule-based adjudication to an intelligence-driven platform. We are seeking a Lead Software Engineer who excels at high-level technical execution. This role is focused on the development and delivery of our Agentic AI strategy, turning architectural blueprints into production-ready systems. The ideal candidate will be the primary engine for building Python-based AI agents using the Google Cloud (GCP) ecosystem to automate complex claims workflows. You will be responsible for implementing sophisticated LLM behaviors using Gemini. What you will do: - Execute Agentic Workflows: Build and deploy sophisticated AI agents using Google Vertex AI and the Google Agent SDK (ADK) based on provided architectural specifications. - Develop and optimize agent behaviors using Gemini (Pro/Flash) with a focus on reliable tool-calling and multi-step reasoning; implement RAG and grounding strategies to ensure AI agents provide factual, data-driven responses derived from internal claims databases and policy documents. - Design and implement complex system instructions, few-shot prompting, and Chain-of-Thought reasoning to ensure agents handle claims logic with high precision, performing Supervised Fine-Tuning on Gemini models to improve domain-specific performance in adjudication and medical coding - Data & Messaging: Expert in SQL/PostgreSQ/AlloyDB/BigQueryUnderstand architectural decisions and actively drive reusable patterns for cloud-native, AI-enabled backend systems. - Design and implement Stateful

Senior Group Manager, Customer Success United States About Lyra Health Lyra Health is a leading provider of evidence-based mental health care, serving more than 20 million people globally in partnership with employers and more than 100 million through health plan and partner relationships. The company has delivered more than 15 million sessions of mental health care, published more than 35 peer-reviewed studies, and delivered unmatched outcomes in terms of access, clinical effectiveness, and cost efficiency. Extensive peer-reviewed research confirms Lyra's transformative care model helps people recover twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra Empower, the only fully integrated, AI-powered platform combining the highest-quality care and technology solutions. About Lyra Health Lyra Health is a leading provider of evidence-based mental health care, serving more than 20 million people globally in partnership with employers and more than 100 million through health plan and partner relationships. The company has delivered more than 15 million sessions of mental health care, published more than 35 peer-reviewed studies, and delivered unmatched outcomes in terms of access, clinical effectiveness, and cost efficiency. Extensive peer-reviewed research confirms Lyra's transformative care model helps people recover twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra Empower, the only fully integrated, AI-powered platform combining the highest-quality care and technology solutions. Responsibilities - Hire, develop, and

Community Health Worker AZ - Tucson posted: Posted 30+ Days Ago

Community Health Navigator 2 Locations posted: Posted 30+ Days Ago

Sr. Data Analyst United States About Lyra Health Lyra Health is a leading provider of evidence-based mental health care, serving more than 20 million people globally in partnership with employers and more than 100 million through health plan and partner relationships. The company has delivered more than 15 million sessions of mental health care, published more than 35 peer-reviewed studies, and delivered unmatched outcomes in terms of access, clinical effectiveness, and cost efficiency. Extensive peer-reviewed research confirms Lyra's transformative care model helps people recover twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra Empower, the only fully integrated, AI-powered platform combining the highest-quality care and technology solutions. About Lyra Health Lyra Health is a leading provider of evidence-based mental health care, serving more than 20 million people globally in partnership with employers and more than 100 million through health plan and partner relationships. The company has delivered more than 15 million sessions of mental health care, published more than 35 peer-reviewed studies, and delivered unmatched outcomes in terms of access, clinical effectiveness, and cost efficiency. Extensive peer-reviewed research confirms Lyra's transformative care model helps people recover twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra Empower, the only fully integrated, AI-powered platform combining the highest-quality care and technology solutions. Responsibilities - Collaborate closely with Lyra's Technology,

Food Service Worker PRN Banner Payson Med Ctr (807 S Ponderosa St) posted: Posted Today

Enterprise Sales Director - Health Remote This is a fully remote opportunity. Gradient AI: Gradient AI is revolutionizing Group Health and P&C insurance with AI-powered solutions that help insurers predict risk more accurately, improve profitability, and automate underwriting and claims. Our SaaS platform taps into one of the industry's largest data lakes-tens of millions of policies and claims-to deliver deep, actionable insights. Trusted by leading carriers, MGAs, TPAs, and self-insured employers, Gradient AI has grown rapidly since our founding in 2018. Backed by $56M in Series C funding, we're scaling fast-and it's an exciting time to join the team. About the Role: We are searching for a results-driven Enterprise Sales Director - Health to join our growing team and lead enterprise sales efforts across the health insurance ecosystem. This individual will own the full sales cycle, selling our AI-powered SaaS underwriting and analytics solutions to health insurance and benefits organizations. This role requires someone who understands the nuances the health insurance landscape and can credibly speak the language of underwriting, actuarial, and clinical leadership. The ideal candidate brings deep relationships across the health insurance ecosystem and a proven track record of closing complex, multi-stakeholder enterprise deals. They are equally comfortable presenting to a Chief Actuary and negotiating with key leadership across large enterprise organizations, and they thrive in a high-growth startup environment where they can build something meaningful. How you will make an impact: - Own and grow a pipeline of enterprise opportunities across the group health ecosystem through strategic

Medical Representative (ETC - Nutrition) - Thanh Hoa Vietnam - Ho Chi Minh City posted: Posted 2 Days Ago

Senior Software Engineer in Test (AI Agentic Systems) Lehi, UT At Collective Health, we're transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design. This is not a traditional QA role . You will be the quality owner for an LLM-based multi-agent pipeline that autonomously adjudicates health insurance claims for self-funded plan sponsors. You are building a Three-Tier Evaluation Framework to ensure our Gemini-powered agents reason correctly, call tools accurately, and produce DOL-ready outcomes. You will work at the intersection of Vertex AI, healthcare compliance, and high-scale data engineering. Your work directly determines whether claims are paid correctly and whether the company can withstand a Department of Labor (DOL) or state DOI audit. The stakes are real, the domain is hard, and the problems are genuinely novel. What you'll do: - Outcome Evaluation (The "What") - Golden Set Governance: Build and maintain a versioned library of "Grounding Data" results by working with senior claims examiners to define "Ground Truth." - Model-as-a-Judge Automation: Design automated "LLM-grading-LLM" workflows using custom rubrics to score factual grounding and policy compliance. - Semantic Assertion Framework: Develop testing libraries that move beyond string matching to validate semantic equivalence and numerical accuracy in agent outputs. - Trajectory Evaluation (The "How") - Function-Call Auditing: Use Vertex AI traces to programmatically verify that mandatory tools (via MCP) were invoked with correct arguments. - Orchestration Logic Validation: Assert that agents respect defined priorities across the four architectural

Senior Examiner, Claims FL, United States Senior Examiner, Claims

Mental Health Professional (Affiliate) Singapore About Lyra Lyra Health is the leading provider of mental health solutions for employers supporting more than 20 million people globally. The company has delivered 13 million sessions of mental health care, published more than 20 peer-reviewed studies, and delivered unmatched outcomes in terms of access, clinical effectiveness and cost efficiency. Extensive peer-reviewed research confirms Lyra's transformative care model helps people recover twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra Empower, the only fully integrated, AI-powered platform combining the highest-quality care and technology solutions. About Lyra Lyra Health is the leading provider of mental health solutions for employers supporting more than 20 million people globally. The company has delivered 13 million sessions of mental health care, published more than 20 peer-reviewed studies, and delivered unmatched outcomes in terms of access, clinical effectiveness and cost efficiency. Extensive peer-reviewed research confirms Lyra's transformative care model helps people recover twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra Empower, the only fully integrated, AI-powered platform combining the highest-quality care and technology solutions. Mental Health Professional (Affiliate) - A Masters degree in Psychology, Counselling or related field. - A minimum of 5 years of Clinical Psychology experience. - Mandate requirement - Should have permission to work and reside in Singapore. - Registration with the

Senior Quality Specialist Work at Home, Minnesota, United States Join our team as a Senior Quality Specialist and drive excellence in healthcare operations. Leverage your expertise in quality audits, claims processing, and medical terminology to ensure compliance and customer satisfaction. Collaborate cross-functionally and make a real impact on healthcare outcomes at CVS Health®. Grow your career in a dynamic, purpose-driven environment.

RN II HM Clear Lake - Main Hospital Building posted: Posted Yesterday

Front Office Patient Financial Representative Multispecialty BUMC South Tucson (2800 E Ajo Way) posted: Posted Yesterday