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The Claims Team Lead assists the Claims Manager with managing the day to day operations of claims while assisting in the direct supervision of the Claims Examiners. Essential Functions The essential functions listed represent the major duties of this role, additional duties may be assigned. Identify and coordinate staff training as necessary utilizing established guidelines, policies and procedure
Posted 1 day ago
The Customer Service Representative is responsible for handling inbound customer calls from both providers and members. They are to ensure that the highest level of service is provided no matter what the question or concern. Essential Functions Answer questions from providers and members about benefits and eligibility. Escalate calls to the necessary department when appropriate. Make callbacks to
Posted 1 day ago
Advanced IT Developers are responsible for development, programming, coding of Information Technology solutions. Advanced IT Developers are responsible for documenting detailed system specifications, participation in unit testing and maintenance of planned and unplanned internally developed applications, evaluation, and performance testing of purchased products. Advanced IT Developers are responsi
Posted 1 day ago
Systems Administrators are accountable for ensuring a stable, integrated, operational technical environment for business use through the development of technical requirements based on customer needs, the technical configuration to ensure system optimization and connectivity and the ongoing operation of existing technology/applications. Using their knowledge of the technology infrastructure, they m
Posted 1 day ago
The Customer Service Representative is responsible for handling inbound customer calls from both providers and members. They are to ensure that the highest level of service is provided no matter what the question or concern. Essential Functions Answer questions from providers and members about benefits and eligibility. Escalate calls to the necessary department when appropriate. Make callbacks to
Posted 1 day ago
The Member Experience Specialist should engage with members to identify and uncover needs and provide solutions that will enhance their health and wellness through phone and digital communication. They should proactively identify potential issues ensuring the organization is consistently providing exceptional member service. This function is office based and resides within a customer focused "POD"
Posted 1 day ago
The Client Resolution Specialist maintains responsibilities similar to a Customer Service Representative and is responsible for handling inbound customer calls from both providers and members, but is more highly focused on resolving client related issues. Essential Functions The essential functions listed represent the major duties of this role, additional duties may be assigned. Work directly wit
Posted 1 day ago
IT Systems Analysts collect and analyze information to formulate the scope and objectives of technology solutions. Conducts feasibility studies to design possible technology solutions. Writes system and programming specifications so that when the system is implemented it will meet user needs. Provides input into cost estimations and project plans. Prepares and maintains technical documentation inc
Posted 1 day ago
The Customer Service Representative is responsible for handling inbound customer calls from both providers and members. They are to ensure that the highest level of service is provided no matter what the question or concern. Essential Functions Answer questions from providers and members about benefits and eligibility. Escalate calls to the necessary department when appropriate. Make callbacks to
Posted 1 day ago
This position is responsible for data entry of claim forms and mailroom support. Essential Functions The essential functions listed represent the major duties of this role, additional duties may be assigned. Enters data from medical and dental claim forms Enters data from precert and referral forms. Assists with review and repair of claims in designated queues. Meets or exceeds qualitative and qua
Posted 1 day ago
This job includes claim processing and adjudication; claims research where applicable. Must meet and/or exceed qualitative and quantitative production standards. Essential Functions Claims processing and adjudication; claims research where applicable. Meets and/or exceeds qualitative and quantitative production standards. Primary client contact for accounts; responsible for processing of claims (m
Posted 1 day ago
The Customer Service Representative is responsible for handling inbound customer calls from both providers and members. They are to ensure that the highest level of service is provided no matter what the question or concern. Essential Functions Answer questions from providers and members about benefits and eligibility. Escalate calls to the necessary department when appropriate. Make callbacks to
Posted 1 day ago
Essential Functions The essential functions listed represent the major duties of this role, additional duties may be assigned. Work with other developers to design, build, and implement technology solutions. Assist in gathering and translating business requirements. Provide support, guidance, and collaborating with application developers to implement database design and review developers work to e
Posted 1 day ago
This job includes claim processing and adjudication; claims research where applicable. Must meet and/or exceed qualitative and quantitative production standards. Essential Functions Claims processing and adjudication; claims research where applicable. Meets and/or exceeds qualitative and quantitative production standards. Primary client contact for accounts; responsible for processing of claims (m
Posted 1 day ago
The Member Experience Specialist should engage with members to identify and uncover needs and provide solutions that will enhance their health and wellness through phone and digital communication. They should proactively identify potential issues ensuring the organization is consistently providing exceptional member service. This function is office based and resides within a customer focused "POD"
Posted 1 day ago
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