Overview: Responsible for being the first point of contact for patients, staff, and guests presenting at the clinic, and performing all the administrative tasks associated with patient check in. Responsibilities: DUTIES AND RESPONSIBIL...
Job Summary: The Stars Manager is responsible for leading the design, implementation, and continuous improvement of strategies to achieve and maintain superior CMS Star Ratings. This role serves as the key driver of cross-functional initi...
JOB SUMMARY: Responsible for overseeing the day-to-day execution, performance, and optimization of the risk adjustment program across vendor management, medical record retrieval, coding quality, analytics, reporting, and audit readiness. Th...
JOB SUMMARY: Perform quality review on claims, enrollment, and customer service personnel on select criteria determined by management. Audit personnel daily of randomly selected output and complete appropriate forms for manager/supervisor...
JOB SUMMARY: The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, ...
JOB SUMMARY: Responsible for working with members, providers, and other multidisciplinary team members to facilitate, collaborate and coordinate healthcare for members identified with complex healthcare needs. Work with members throughout...
JOB SUMMARY: Responsible for processing reports, reconciling transactions and updating the system. Create and maintain customer eligibility in the company database, generate customer correspondence for new packets, assemble and distribute...
JOB SUMMARY: The Data Engineer will be responsible for expanding, optimizing and monitoring our data and data pipeline architecture, as well as optimizing data flow and collection across organizational teams. The Data Engineer will suppor...
JOB SUMMARY: Support revenue cycle through accurate billing, payment processing, and customer account maintenance. Plans include Medicare, Marketplace, Group coverage and EAP. Collaborates closely with internal teams and external customer...
JOB SUMMARY: The Medical Review Examiner Nurse is responsible for auditing provider and facility claims. Identifying issues related to and/or participates in various projects aimed at identifying areas of non-compliance and/or potential f...