7 claims operations technician jobs found in Remote, Remote

AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology. Join us in improving health care outcomes for all!  We promise to do what’s right, always. Position Summary: The Senior Pharmacy Technician, Utilization Management leads the non-clinical administration of pharmacy utilization management (UM) programs by receiving, processing, and conducting non-clinical review of prior authorization requests, in accordance with established workflows, coverage criteria, and regulatory requirements, and escalating non-standard or ambiguous situations to a pharmacist. The role obtains required clinical and...

AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology. Join us in improving health care outcomes for all!  We promise to do what’s right, always. Position Summary: The Client Manager serves as the primary day-to-day operational contact for assigned employer and health plan clients, ensuring a high level of service and support. Working within a cross-functional account team, this role collaborates closely with internal partners to deliver a seamless client experience. The position manages the operational aspects of client accounts, including benefit administration, plan changes, eligibility...

Senior Data Engineer Insurance underwriting runs on human judgment, manual workflows, and knowledge locked in someone's head. It breaks when that person leaves and doesn't scale when the book doubles. Sixfold is building AI agents that understand risk the way a 20-year veteran underwriter does. Not summaries or flags, but systems that make real decisions on billions in premium for some of the world's largest carriers. AI is the product and the workflow. The Senior Data Engineer makes sure the data powering those decisions is trusted, governed, and built to scale. If you live and breathe Data and AI tools, understand how models work under the hood, and can translate that into business outcomes for a room full of skeptical underwriters, this role was written for you. Who We Are 🏔 Product: Sixfold is the AI brain for underwriting. Our platform handles submissions at scale, assessing risk against appetite, surfacing cited insights, and deploying AI agents to handle...

At Swyfft, we're reshaping the way home insurance and commercial package products are priced and bound. We've created an insurance experience that's smart, instant, and designed to deliver unparalleled customer service.   Our focus on lightning-fast quotes and seamless claims servicing is powered by cutting-edge technology and an Agent and Customer-centric approach that sets us apart in the industry.   Joining Swyfft means becoming part of a dynamic team of forward-thinkers who thrive on moving fast and delivering exceptional products. We pride ourselves on fostering an environment where creativity and positive energy thrive.   As we continue to grow and expand, we're on the lookout for experienced professionals like you to join us in transforming the insurance landscape. If you're passionate about leveraging technology to provide the best customer service experience and are ready to be a part of our journey, we welcome you to explore opportunities at Swyfft!...

At Swyfft, we're reshaping the way home insurance and commercial package products are priced and bound. We've created an insurance experience that's smart, instant, and designed to deliver unparalleled customer service. Our focus on lightning-fast quotes and seamless claims servicing is powered by cutting-edge technology and an Agent and Customer-centric approach that sets us apart in the industry. Joining Swyfft means becoming part of a dynamic team of forward-thinkers who thrive on moving fast and delivering exceptional products. We pride ourselves on fostering an environment where creativity and positive energy thrive. As we continue to grow and expand, we're on the lookout for experienced professionals like you to join us in transforming the insurance landscape. If you're passionate about leveraging technology to provide the best customer service experience and are ready to be a part of our journey, we welcome you to explore opportunities at Swyfft!...

- The Commercial Surety Regional Manager is responsible for the underwriting, marketing, production, profitability, and overall management of a regional Commercial Surety portfolio. This position serves as the senior underwriting leader for the assigned territory and is accountable for achieving premium growth, underwriting profitability, agency development, and portfolio management objectives. The Regional Manager will develop and maintain strong relationships with agents, brokers, principals, indemnitors, and other business partners while exercising significant underwriting authority and ensuring compliance with company underwriting guidelines and risk appetite. The position is highly market-facing and focused on profitable business development, agency management, and underwriting execution. Key Accountabilities/Deliverables: Underwriting Leadership Serve as lead underwriter for the assigned territory. Analyze, evaluate, and approve commercial surety...

- The Commercial Surety Regional Manager is responsible for the underwriting, marketing, production, profitability, and overall management of a regional Commercial Surety portfolio. This position serves as the senior underwriting leader for the assigned territory and is accountable for achieving premium growth, underwriting profitability, agency development, and portfolio management objectives. The Regional Manager will develop and maintain strong relationships with agents, brokers, principals, indemnitors, and other business partners while exercising significant underwriting authority and ensuring compliance with company underwriting guidelines and risk appetite. The position is highly market-facing and focused on profitable business development, agency management, and underwriting execution. Key Accountabilities/Deliverables: Underwriting Leadership Serve as lead underwriter for the assigned territory. Analyze, evaluate, and approve commercial surety...