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Are you an experienced Claims Customer Service Representative looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If…
Provide claims information through telephone inquiry from providers of service. Provide claim information through inquiries receive via facsimile from providers of service. Recognize potential problems and refers them…
Processing invoices Preparing adjustments Collecting payments due within the department's required time frame Effectively follows-up on accounts receivable. Maintains excel spreadsheets Adheres to the End of Month…
• CDI Registered Nurse will be working onsite at the Hospital. • Registered nurses will review our in-house Medicare cases. We will need them to identify the working DRG using the 3M encoder, write queries, do…
Are you an experienced Customer Service Representative looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you…
Are you an experienced RN Case Manager looking for a new opportunity with a prestigious healthcare company? Do you have Disease Management experience within a Healthcare setting? Do you want the chance to advance your…
Job Title: Quality Improvement Registered Nurse Are you an experienced RN with Quality Improvement experience looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your…
Purpose of the Position: • Perform duties to assist in activities related to the medical and psychosocial aspects of utilization and coordinated care Day to Day Duties: • This person works assisting the Case…
Consultant and strategic partner to Miami Cancer Institute (MCI) hiring leaders, develops creative sourcing plans difficult to fill positions, research, clinical, and other positions that support MCI. Proven ability to…
This position is responsible for generating and tracking both incoming and outgoing correspondence related to complaints from Providers within the company's network. This position will interact (VIA E-mail) with…
• Administers documentation and completion of Pre/Post Employment processes such as Work Eligibility- I-9, New Employee Screening, Background checks, Offer Letters, etc. Coordinates the new Associate onboarding…
• This person will be working directly with members to assess, plan, and coordinate care • They will have a caseload of about 75 members! • Perform care management duties to assess, plan and coordinate all aspects of…
Job Title: Utilization Review/Outpatient Care RN Are you an experienced Registered Nurse with Utilization Review experience looking for a new opportunity with a prestigious healthcare company? Do you want the chance to…
Position Purpose: Review provider requests through fax or telephone to ensure medical necessity for services requiring pre-authorization Utilize nationally recognized criteria to determine medical necessity of services…
Company Job Description/ Day to Day Duties: You provide a deliberate patient and family centered partnership with the healthcare team that facilitates a seamless patient experience between the Inpatient and Outpatient…
• Call Center setting • Making outbound calls to member • Responsible for 30-40 calls per day, don’t focus so much on amount, focus on quality (talk time Monday-Friday 8a-5p, Full time with medical benefits offered •…
Job Title: Field Registered Nurse Case Manager Employment: Long Term Contract Shift: 8:00-5:00 pm M-F Start Date: ASAP Location: Columbus, OH ABOUT THE POSITION: -Will be working with Medicare Members with complex…
This role will ensure that initial and concurrent reviews for all prospective and retrospective inpatient admissions are completed within specified timeframes using evidence based criteria for medical appropriateness…
Are you an experienced RN Telephonic Care Manager looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered…
• Will be making outbound calls to providers and updating internal software system, Portoco. • They were just provided all of their provider’s data and will be calling to make sure all information in the system is…
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