ICONMA

Location: USA- Job Description: Our client, a Business Solutions company, is looking for a Claims Examiner - Workers Compensation for their Remote in CA location. Responsibilities: - To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. - Primary Purpose: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. - Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. - Negotiates settlement of claims within designated authority. - Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. - Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. - Prepares necessary state fillings within statutory limits. - Manages the litigation process; ensures timely and cost effective claims resolution. - Coordinates vendor referrals for additional investigation and/or litigation management. - Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. - Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. - Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner. - Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. - Ensures claim files are properly documented and claims coding is correct. - Refers cases as appropriate to supervisor and management. - Performs other duties as assigned. - Supports the organization's quality program(s). Requirements: - Minimum 3years of relevant CA WC claims experience is mandatory - California WC Claims handling experience - Must have OSIP certificate - Education & Licensing: Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. - Experience: Five (5) years of claims management experience or equivalent combination of education and experience required. Why Should You Apply? - Health Benefits - Referral Program - Excellent growth and advancement opportunities

Title: SAP Finance - S/4HANA RTR Lead /Architect#26-16551 Location: Princeton, NJ $87.86-$92.86 per hour Job Description: Our client, is a IT Services company, is looking for a SAP Finance - S/4HANA RTR Lead /Architect for their Princeton, NJ/Hybrid location. Responsibilities: - Design integrated SAP FICO architectures that align finance processes with enterprise objectives and enable consistent and reliable financial data flows across multiple systems and regions. - Drive end to end SAP FICO testing strategies that validate core finance functionalities including general ledger postings asset accounting and cost center accounting to ensure robust and accurate system behavior. - Coordinate with functional and technical teams to refine business requirements into detailed SAP FICO solution designs that reduce complexity and improve maintainability for long term platform evolution. - Develop comprehensive test plans and reusable test cases for SAP FICO modules ensuring traceability to business requirements and full coverage of critical finance scenarios. - Review and refine configurations in SAP FICO with emphasis on cost center structures internal orders and allocations to optimize transparency and control of operational costs for stakeholders. - Guide defect triage and resolution activities during testing cycles by prioritizing issues based on business impact and ensuring that remediation maintains the integrity of finance processes. - Establish reusable test automation approaches for SAP FICO where feasible to shorten regression cycles and support frequent change releases without compromising financial accuracy. - Collaborate with controllers finance analysts and auditors to validate that SAP FICO designs and testing outcomes comply with internal policies and external regulatory expectations. - Prepare clear documentation for solution architecture configurations and test evidence so that audit and compliance reviews can be completed efficiently and confidently. - Support cutover planning and post go live validation by defining finance specific checks such as opening balances reconciliation and cost center reporting to secure stable operations. - Mentor project team members on SAP FICO concepts cost center modeling and structured testing practices fostering continuous improvement in delivery quality. - Engage in performance assessment of SAP FICO processes identifying bottlenecks in postings or reporting and recommending design or configuration optimizations that enhance user productivity. - Partner with program management to estimate effort and risk for SAP FICO changes providing realistic inputs that help balance delivery timelines with financial system reliability. - This hybrid role seeks a seasoned senior architect with deep hands on expertise in SAP FICO testing and cost center accounting, bringing 15 to 18 years of experience to design resilient finance solutions, optimize enterprise processes, and ensure high quality SAP delivery that supports sustainable business growth for a global client focused organization. Requirements: - This hybrid role requires 15–18 years of SAP Finance experience, with deep expertise in Record-to-Report (RTR) processes and hands-on S/4HANA implementation. - The ideal candidate will lead Fit-to-Standard workshops, translate business requirements into best-practice SAP solutions, and own the end-to-end RTR workstream. - This role is critical in delivering scalable, compliant, and high-performing finance systems for a global, client-focused organization. - Strong expertise in SAP S/4HANA Finance (FI) and Controlling (CO) - Proven ability to lead RTR workstreams independently - Experience running Fit-to-Standard / Explore workshops Deep knowledge of: - General Ledger (GL) - Accounts Payable (RTR scope) - Asset Accounting (AA) - Controlling (Cost Center Accounting, Profit Center Accounting, Internal Orders) - Hands-on experience in S/4HANA system configuration - Strong understanding of: - Universal Journal (ACDOCA) - New Asset Accounting - Fiori Finance applications - Expertise in translating business requirements into SAP best-practice solutions - Experience with SAP Activate methodology - Strong stakeholder management and communication skills Experience with: - Group Reporting - Central Finance - S/4HANA Public Cloud - Knowledge of data migration tools (LSMW, BAPI, Syniti, SAP Data Services) - Familiarity with integrations across: - MM (GR/IR) - SD (Revenue Recognition) - HR (Payroll Posting) - Background in Big 4 / global SI / SAP consulting firms - Technology: SAP S/4HANA, SAP FI/CO, SAP Activate, Fiori Apps - Experience : 15to18Yrs - Possess extensive hands on experience of 15 to 18 years in SAP FICO with a strong portfolio of projects covering general ledger accounts payable accounts receivable asset accounting and controlling. - Demonstrate deep practical knowledge of cost center accounting including planning allocations assessments and reporting to support informed decision making by finance stakeholders. - Exhibit proven expertise in SAP FICO testing across unit integration user acceptance and regression phases using structured test design techniques and defect management practices. - Show experience working in hybrid work models collaborating with distributed teams through virtual tools while maintaining high levels of coordination and accountability. - Display strong analytical and problem solving skills with the ability to interpret complex financial requirements and convert them into clear SAP FICO configurations and test scenarios. - Bring familiarity with adjacent SAP modules such as materials management and sales distribution to ensure end to end process coverage in finance related testing. -Communicate complex SAP FICO concepts in simple language for finance and technology stakeholders enabling shared understanding of solution choices and potential risks. - Apply sound documentation discipline creating detailed configuration narratives test scripts and status reports that support sustainment teams and knowledge retention. - Years of Experience: 15 Years of Experience Skills: - Category Name Required Importance Experience - EPS_NEW SAP Accounts Payable Yes 9 6 + Years - SAP FICO SAP FICO Yes 9 6 + Years - SAP S/4HANA  S/4 HANA Finance Yes 9 6 + Years Why Should You Apply? - Health Benefits - Referral Program - Excellent growth and advancement opportunities

Title: Pharmacist - Prior Authorizations Location: Remote, CA $50-$55 per hour Fully Remote Our Client, a Retail Pharmacy company, is looking multiple Pharmacists with prior authorization experience to work remotely. Responsibilities: - Evaluate and review all prior authorization requests and render coverage determinations based on clinical criteria and plan design. - Includes verifying insurance coverage and eligibility, interpreting clinical guideline criteria, consulting physicians and other healthcare providers, and appropriately utilizing clinical knowledge and resources while complying with department protocols. - One of the crucial responsibilities is to guarantee that the decisions regarding cases are conveyed promptly and efficiently to all the healthcare providers, health plans/employers, patients, and other healthcare professionals following agreed-upon approval & denial management processes. - Collaborate with the technicians and prior authorization team members to process referrals, including answering clinical questions and collecting appropriate clinical/medical data needed to perform clinical assessments and reviews as per the health plan/employer- agreed criteria within the designated service level agreements. - Performs and handles in bound and outbound phone calls with technicians, prior authorization team members, physicians, healthcare providers, and/or patients to facilitate prior authorization requests, answer inquiries, and/or resolve escalations. - Maintain professional and technical knowledge of drug and disease states for the Specialty and Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review Unit (CRU) line of business. - Perform other related projects and duties as assigned, including attending training sessions and development meetings, and providing on-call and after-hours pharmacist avail ability as needed. - Demonstrated experience using clinical resources, e g., Micromedex, Lexicomp, Clinical Pharmacology - Ability to prioritize, quickly assess, manage multiple tasks and adapt to constantly changing situations. Requirements: - Excellent organizational skills. Strong detail orientation. - Strong Microsoft Office skills. - Ability to receive phone calls from prior authorization pharmacy technicians and/or providers for clinical information. - Minimum 2 years’ recent experience reviewing and processing prior authorizations against health plan criteria for a determination in a specialty/skilled clinical setting i.e., specialty medical office or Pharmacy Benefits Manager (PBM) - Bachelor’s degree in pharmacy or PharmD Why Should You Apply? - Health Benefits - Referral Program - Excellent growth and advancement opportunities ICONMA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to any status protected by applicable law. #alljobs