Job Category: Operations Job Description: Responsible for the adjudication of medical claims at all pend levels... resolution of pended claims in an accurate and timely manner according to departmental processes, procedures and guidelines...
Job Summary - Supervisor, Leave Administration Maintains accountability for the supervision of the Leave.... Establishes strong healthy partnerships with Human Resources, and other strategic partners. Essential Functions - Supervisor...
ABOUT US: Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing... to conduct surveillance and investigative activities to identify potential fraudulent insurance claims. This role involves...
ABOUT US: Ethos Risk Services is a leading insurance claims investigation and medical management company, specializing... to conduct surveillance and investigative activities to identify potential fraudulent insurance claims. This role involves...
communities we serve as requested by Store Manager, Healthcare Supervisor, or District Manager. Operations Counsels patients... with information technology. Finds opportunities to improve productivity Ensures insurance claims are processed accurately to prevent...
claims to resolve customer issues and prevent payment rejections. Follows-up with insurance companies as well as medical... development by monitoring one's own performance, solicits for constructive feedback, and leverages Healthcare Supervisor as mentor...
and presentations to clients. Mentorship Assist the Manger(s) and Supervisor(s) with individual and team growth and development... through collaboration with Manager(s) and Supervisor(s) in other office(s) Project future staffing needs and participate...
. Ensure committee, State and Federal decisions are properly implemented. Assist the Lead, Supervisor and/or Manager... documentation from enterprise-wide systems including: claims payments, billing and enrollment, care management, medical, pharmacy...
direction of medical coordinator and /or casework supervisor in accordance with applicable contractual, regulatory requirements... and document activity related to the child; report observations to social worker with case responsibility or to supervisor...
and /or casework supervisor in accordance with applicable contractual, regulatory requirements and accreditation standards Provide... child; report observations to social worker with case responsibility or to supervisor as needed Complete progress notes...
claims. · Write report with evidence for each unit and report findings. · Attend daily meeting to report findings MDI..., preventive maintenance. · Additional tasks as required by your supervisor or manager Key Qualifications High School...
of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with insurance companies as well... KPI's with Pharmacy Manager, Store Manager, and Healthcare Supervisor. Develops and maintains good relationships...
disputes, including denied claims, reassertions, repeat offenders, and Private Bank client customers. The Analyst actively..., and ensuring compliance with Uniform Commercial Code (UCC) and Regulation E and Regulation Z claims. The Analyst uses various bank...