Especialista de Manejo de Cuidado Regular Exempt GENERAL DESCRIPTION: Carries out nursing functions in performing care management process, organizational determinations, and transitional care, including, but not limited to, health a...
to Grievances, Dental Pre-Service, and Payment Appeals, filed by MCS Classicare or MCS Life policyholders, in compliance... (Upheld). For appeals, in the event a reconsideration or member request is denied and request second level appeal, for MCS...
Lider de Regulaciones en Farmacia Regular Exempt GENERAL DESCRIPTION: Responsible for the implementation, evaluation, analysis, and presentation of pharmacy regulatory programs derived from federal and state regulations, market and ...
Representante De Servicio I - CS Caguas Regular Non-Exempt GENERAL DESCRIPTION: The Customer Service Representative I – SC is responsible for assisting customers and prospects with information about the company's products and servic...
and verbal) English Intermediate (comprehensive, writing and verbal) "MCS Healthcare Holdings, LLC. (MCS) is an Equal Employment... Opportunity Employer and take Affirmative Action to recruit Protected Veterans and Individuals with Disabilities. MCS...
Analista Senior de Negocios Regular Exempt GENERAL DESCRIPTION Develops and produces high-complexity recurring reports by extracting and integrating data from multiple sources related to claims payments by business line. Identifies ...
per hour established by MCS (which may vary from time to time), maintaining financial accuracy and processing claims...
Lider de Grupo Regular Non-Exempt GENERAL DESCRIPTION: Supports daily unit operations by completing document intake, evaluation, classification, and distribution processes. Provides guidance to technicians, resolves escalated issues...
Representante de Servicio al Cliente - CR Regular Non-Exempt GENERAL DESCRIPTION: Responsible for resolving service cases received from various sources, including email, voicemail, fax, and internal referrals, that are processed acc...
, coordinates, and provides guidance to new and existing providers related to MCS products, billing, claims processing, complaints..., and ensures that communications that are sent by delegated entities that mention or impact MCS meet the same standards...