- TEKsystems (Columbia, SC)
- Description Candidate would handle provider service calls, responding and answering any questions providers may have Responsible for responding to customer ... procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay … more
- The Cigna Group (Bloomfield, CT)
- …Ancillary Lead Analyst - ARM** provides advanced professional input to complex Provider Relations assignments/projects. Supports and provides direction to more ... knowledge and acumen to develop models and procedures, and monitor trends, within Provider Relations . **DUTIES AND RESPONSIBILITIES:** + Serves as a key member… more
- Molina Healthcare (Santa Fe, NM)
- …New Mexico _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...ABILITIES** : * 3 - 5 years customer service, provider service, or claims experience in a… more
- Molina Healthcare (Los Angeles, CA)
- …Angeles County _** **Job Description** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...ABILITIES** : * 2 - 3 years customer service, provider service, or claims experience in a… more
- Centene Corporation (Harrisburg, PA)
- …to identify and strategizes opportunities for provider improvement. + Collaborates with Provider Relations to improve provider performance in areas of ... THE STATE OF PENNSYLVANIA WITH 25% TRAVEL TO VISIT PROVIDER OFFICES. MILEAGE IS REIMBURSED AT THE CURRENT IRS...health information. + Acts as a liaison and member advocate between the member/family, physician and facilities/agencies. + Acts… more
- Kelly Services (Columbia, SC)
- **Job Title: Customer Service Advocate II - Call Center Position** **Job Summary:** Join our dynamic team as a Customer Service Advocate II, where you will play ... **Shift:** 8-hour shift between 8am and 8pm **Roles and Responsibilities:** - Provide prompt, accurate, and courteous responses to customer inquiries across various… more
- County of Blair (Altoona, PA)
- Under general supervision, the advocate will work in a department of four who deliver a wide array of assigned services to victims and witnesses of juvenile and ... adult crimes as cases progress through court proceedings. An advocate , specialized case managers, and the coordinator perform responsibilities as allocated within… more
- TEKsystems (Columbia, SC)
- …research as needed to resolve inquiries. *60% Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, ... our customers through the details of their benefit plan, claims processes, and their rights as customers of our...- easy. During a typical day, a Customer Service Advocate may assist one customer with scheduling a doctor… more
- MTA (Jamaica, NY)
- … - Railroad Operations and Director - Labor Relations on current labor relations issues. Provide consultation and expert advice to management or other groups ... within time limits. Calculate the cost or liability of claims . Negotiate stipulations of settlement where appropriate. Analyze cases...Relations - Railroad Operations and Director - Labor Relations at various meetings as needed. Provide … more
- TEKsystems (Columbia, SC)
- …research as needed to resolve inquiries. *60% Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, ... *5% Assist with the training of new employees and cross training of coworkers. Please provide a few sentences describing what a typical day would like in this role:… more
- TEKsystems (Columbia, SC)
- …research as needed to resolve inquiries. *60% Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, ... Education: High School Diploma or equivalent Required Work Experience: 1 year of claims processing or customer service experience OR Bachelor's Degree in lieu of… more
- University of Utah Health (Murray, UT)
- …and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient ... to perform the essential functions as outlined above. + Demonstrated human relations and effective communication skills. + Demonstrated knowledge of commercial or… more
- McLaren Health Care (Flint, MI)
- … for the Provider , supplying information and education, working with Provider Relations to handle issues. Also responsible for assisting members with ... risk arrangements and actuarial precepts). + In-depth understanding of claims administration as it pertains to provider ...of claims administration as it pertains to provider payments, including CPT-4 codes, revenue codes, HCPCS codes,… more
- Molina Healthcare (Milwaukee, WI)
- …WI and must reside in Wisconsin** **Job Summary** Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy ... compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point...ABILITIES** : * 2 - 3 years customer service, provider service, or claims experience in a… more
- Mount Sinai Health System (New York, NY)
- …provides necessary follow-up. * Communicates and resolves reimbursement issues to coordinate payer/ provider relations between payers and MSHS. * Identifies and ... **Job Description** Provide analysis and demonstrate understanding of pharmacy revenue...optimize the payment cycle for retail and specialty pharmacy claims . Ensure maintenance and understanding of the overall workflow… more
- The County of Los Angeles (Los Angeles, CA)
- …permanent appointment to Community Health Worker. Essential Job Functions Facilitates relations between the agency and the community by communicating agency policies ... housing, medical, mental health, or substance use care. Serves as an advocate for client/patient access to departmental and community resources. Assists clients,… more
- UGI Corporation (Wilkes-Barre, PA)
- …facilitation of training programs and initiatives as required. + Labor Relations - Provide local labor contract clarification, interpretation, administration, ... friends, and families in providing best-in-class products and services! Job Summary: Provide Human Resources leadership and services in all major functional areas… more
- The Cigna Group (Bloomfield, CT)
- …to utilization management, case management, network, contracting, pharmacy, and service operations ( claims ). This is an entry to mid-level position for a physician ... Performs benefit-driven medical necessity reviews for coverage, case management, and claims resolution, using benefit plan information, applicable federal and state… more
- The Cigna Group (Bloomfield, CT)
- …utilization management, case management, network, contracting, pharmacy, and service operations ( claims ). Primarily regional with national level case work for Cigna ... Performs benefit-driven medical necessity reviews for coverage, case management, and claims resolution, using benefit plan information, applicable federal and state… more
- Ducommun (Coxsackie, NY)
- …all areas of HR including recruiting, benefits administration, employee relations , training, development, orientation, data administration and documentation, talent ... Ducommun Way methodology to achieve objectives. + Drive strong employee relations through frequent and clear communications, clarity of expectations, and promoting… more