Responsibilities Review hospital claims and determine action needed to resolve pended claims Process and evaluate hospital claims manually or through claims work flow Validate information entered in hospital claims module (QNXT);deter...
Responsibilities Participate in the coordination and development of goals and outcomes using HEDIS specifications for Quality Improvement and Corrective Action Plans Review generic charts, and other population-based data or abstractions,...
Responsibilities Understand and interpret business requirements and develop solutions to fit those requirements in a project environment Design and develop new web-based user-facing applications and maintain existing applications using ....
Responsibilities Assist with scheduling and managing data entry for job seeker participation in career services programs. Track member engagement and ensure accurate documentation of career services activities. Provide general administr...
Responsibilities Supervise, mentor, and develop a team of data analysts, fostering growth, collaboration, and a culture of continuous learning. Assess training needs and provide ongoing skill-building opportunities for team members. All...
Responsibilities Responsible for the general ledgers of assigned Fund, this includes but is not limited to preparing daily, monthly & yearly transactions, journal entries and recording of adjustments Analyze general ledger accounts and i...
Responsibilities Maintain scheduled mopping, buffing, stripping and waxing of VCT floors as directed Change lights/bulbs on 2x2 and 2x4 fixtures as well as exit sign bulbs Clean and set up conference/break rooms, classrooms, break room...
Responsibilities · Manage the operations of the organization's Telephone Quality Monitoring program to ensure proper quality assurance policies and procedures are met · Oversee all quality assurance for the Member Services operations in...
Responsibilities: · Review suspense reason of medical claims and determine actions to be taken to handle edit · Verify information entered in medical claims system (QNXT) is correct, including patient’s name, provider tax identification...
Responsibilities Train new employees and retraining of current staff when required Review eligibility control report daily for discrepancies/inconsistencies and update of COBRA event status Research and update COBRA based on member por...