- HomeSafe Alliance (San Juan, PR)
- **Title:** Assistant Claims Manager (Military Move) **HomeSafe Alliance** is the single global household goods movement manager of over 300,000 Military Household ... motivated **Assistant** **Cl** **aims Manager** to assist in all aspects of claims management, to support and promote process improvement methodologies and best… more
- Sedgwick (San Juan, PR)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Surety Claims Specialist **PRIMARY PURPOSE** **:** To analyze complex or technically difficult ... surety and surety bond claims ; to provide resolution of highly complex nature and/or...coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned… more
- Sedgwick (San Juan, PR)
- …mainly Australia. If this does not apply to you please use the 'Apply' option.** Claims Examiner - Liability IF YOU CARE, THERE'S A PLACE FOR YOU HERE For a ... Sedgwick supports and resolves property, general, auto, product and professional liability claims . We help our clients maintain brand protection in times of crisis.… more
- InnovaCare (San Juan, PR)
- …and providers in a timely and courteous manner. Assist pharmacies in the claims payment process. May educate the provider, beneficiary or the pharmacy and if ... follow-up history in the Pharmacy Application and Prescription Benefit Manager (PBM) claims processing system. Provide all relevant clinical information of a CDR to… more
- Mathematica (San Juan, PR)
- …predictions with a large multiyear sample of Medicare beneficiaries with detailed claims data about millions of people. Mathematica's team reached the second round ... involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources...obtain work outside CMS. Staff will work with their supervisor to get re-staffed, however if they are unable… more
- Mathematica (San Juan, PR)
- …large secondary data sources such as Medicaid (T-MSIS, TAF) administrative claims data to effectively answer research questions and guide decision-making about ... and practical knowledge of administrative healthcare data (eg commercial claims , hospital claims , and Medicare or Medicaid...obtain work outside CMS. Staff will work with their supervisor to get re-staffed, however if they are unable… more
- Walgreens (Toa Baja, PR)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Mathematica (San Juan, PR)
- …include: * Assisting with quantitative analyses using Medicaid enrollment, claims /encounter, financial and program data to support program monitoring, improvement, ... high attention to detail * Familiarity with Medicaid enrollment, claims , financial, or program data is preferred * Excellent...obtain work outside CMS. Staff will work with their supervisor to get re-staffed, however if they are unable… more
- Mathematica (San Juan, PR)
- …and maintaining clinical quality measures, supporting states with implementing all-payer claims databases, alternative payment models, or tools to support analytics, ... policy issues. * Familiarity with Medicare or Medicaid enrollment, claims , financial, or program data is preferred. * Excellent...obtain work outside CMS. Staff will work with their supervisor to get re-staffed, however if they are unable… more
- Walgreens (Caguas, PR)
- …the unique communities we serve as requested by Store Manager, Healthcare Supervisor , or District Manager. Operations + Counsels' patients and answers their ... ways to further promote productivity. + Ensures the accurate processing of insurance claims to resolve patient issues and prevent payment rejections. Follows up with… more
- Oriental Bank (San Juan, PR)
- …to fully satisfy the customer's needs, referring them to another officer/ supervisor only when different skills/knowledge are required, ensure the customer ... of payment book to customer's request. + Assume and resolve payment claims ensuring customer provides sufficient payment evidence for investigation. Determining if… more
- Walgreens (Dorado, PR)
- …the unique communities we serve as requested by Store Manager, Healthcare Supervisor , District Manager or Pharmacy Manager. Operations + Counsels' patients and ... ways to further promote productivity. + Ensures the accurate processing of insurance claims to resolve patient issues and prevent payment rejections. Follows up with… more
- Humana (San Juan, PR)
- …years or more years of equivalent work experience in Grievance and Appeals, Claims , Authorizations, CMS, Provider Disputes and/or healthcare industry + 1 or more ... insights/findings to Senior Leadership + 2 or more years of leadership ( Supervisor , Manager or above) experience + Strong knowledge of Medicare and Medicaid… more
- Sunrun (San Juan, PR)
- …driver's license + Three years of this experience must be as a manager, supervisor , or equivalent position of leadership + Strong knowledge of safety regulations for ... risk assessment + Familiarity with the insurance industry, specifically Workers' Compensation claims + Working knowledge of the Microsoft Office Suite and common… more
- Oriental Bank (San Juan, PR)
- …fraud patterns through the monitoring of varied data sources including customer claims , red flag indicators, and vendor-generated alerts to quickly establish counter ... + fraud related matters. + Report risk information and findings to the immediate supervisor in a timely manner. + Support and may lead the implementation of digital… more