- Prime Therapeutics (Columbus, OH)
- …and drives every decision we make. **Job Posting Title** Customer Care Associate - Philadelphia PACE Application Center **Job Description Summary** This position is ... Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers. Responsibilities… more
- CVS Health (Charleston, WV)
- …care more personal, convenient and affordable. **Position Summary** The Care Management Associate (CMA) role is a full time remote telework position. Qualified ... population health members, and carries a caseload. The Care Management Associate supports comprehensive coordination of medical services including Care Team intake,… more
- Magellan Health Services (San Diego, CA)
- …information regarding a variety of services including: educating providers on claims , member eligibility, benefits, EAP services, claim status, and authorization ... crisis calls with appropriate resource. + Facilitates routine referrals and triage decisions not requiring clinical judgment. + Comprehensively assembles and enters… more
- Travelers Insurance Company (Overland Park, KS)
- …Under general supervision, this position is responsible for assigning claims to appropriate claim professionals. Coordinating and monitoring claim professional ... and maximization of adjuster resources. **What Will You Do?** + Assigns claims to appropriate claim professionals and independent adjusters as required to maintain… more
- Gentiva (Atlanta, GA)
- …resources to ensure coordinated and efficient program management + Participate in " triage " process to determine whether claims warrant additional investigation, ... claims review meetings and makes recommendations for on-going claims handling **About You** + Associate degree...for on-going claims handling **About You** + Associate degree required, Bachelors a plus + Related work… more
- Humana (Richmond, VA)
- …(ACT, MST, FFT, Homebuilders) + Ensure prompt responsiveness and appropriate triage of provider inquiries, concerns, or problems, including those associated with ... claims payment, prior authorizations, and referrals, as well as...(collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and… more
- Leidos (Alexandria, VA)
- …and maintain SharePoint services, including load balancing, PKI authentication, and claims -based authentication as well as support site setup, permission management, ... for 24/7/365 IT Operations Center personnel to assist with after-hours triage and troubleshooting of common SharePoint problems. **Basic Qualifications** + Extensive… more
- Doosan Bobcat (Chicago, IL)
- …to work with Dealer Accounts service groups with product warranty and service management. Triage warranty claims at the Dealer Accounts level They resolve the ... activities to the general manager * Review all high dollar warranty claims with warranty department * Provide updated technical information to Dealer Accounts… more
- Russell Sage College (Albany, NY)
- …The Administrative Assistant is a ten month position that reports to the Associate Vice President for Student Life for Student Wellness and supports all Health ... Wellness Center. + Schedule and verify patient appointments. + Triage for health and counseling while checking patients in...patient arrival. + Manage the complex schedule of the Associate Vice President for Student Life for Student Wellness… more
- Veterans Affairs, Veterans Health Administration (Cleveland, OH)
- …(OIG), Office of General Counsel (OGC), Government Accountability Office (GAO), Tort Claims , Non-Protected Clinical Reviews and internal issues not resolved at the ... level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a… more
- CareFirst (Baltimore, MD)
- …including configuration setup, system and integration testing, production issues triage and resolution, and interface monitoring/ resolution. The position will ... technologies, systems, and business processes supported by the department (eg, claims processing, enrollment and billing, financial, etc.). + Experience in industry… more
- CareFirst (Washington, DC)
- …including configuration setup, system and integration testing, production issues triage and resolution, and interface monitoring/ resolution. The position will ... technologies, systems, and business processes supported by the department (eg, claims processing, enrollment and billing, financial, etc.). + Experience in industry… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …mitigations. + Manage end-to-end incident management process, from initial ticket triage to prioritization and resolution. + Develop and update comprehensive ... of monolithic apps. + Understanding of EDI transactions (Eligibility, Claims , enrollment, authorization etc), standards (X12, EDIFACT) and experience troubleshooting… more
- South Middlesex Opportunity Council (Framingham, MA)
- …entire management team. + Monitor caseloads and work with the clinic intake specialist to triage and assign cases from a waitlist. + Work with the front office and ... as required by payors and state agencies. Monitor weekly claims reports and assist in correcting billing issues. +...As part of the responsibilities of this position, the Associate Clinic Director will have direct or incidental contact… more
- Humana (Harrisburg, PA)
- …+ Contacts the hospice to verify or obtain necessary information, can appropriately triage incoming calls and provide excellent and complete documentation. + Able to ... client / prescriber interaction + Assist local pharmacies in adjudication of claims for emergent need medications + Ability to appropriately escalate urgent requests… more
- HUB International (Riverside, CA)
- …provide critical support to our customers through account management, claims management, day-to-day client oversight, and underwriting services that make ... document retrieval from carrier websites + May perform a triage role on behalf of the team: review incoming...individual queues based on priority and skill level of associate _The expected salary range for this position is_… more