to providers' inquiries regarding contracting, claims, benefits and complex issues that include medical or payment policy questions... such as Claims Administration and Medical Management. Mentor and develop staff to successfully meet the objectives of their PMP...
Job Description: Monitor calls in queue and unresolved group or member enrollment, eligibility and billing issues and inquiries. Handle and resolve elevated irate/complaint calls. Direct and regulate the resolution of routine issues and ...
Job Description: Develop a plan and manage the "onboarding" and implementation of the system for designated customers, serving as a liaison with internal and external customers to move them onto an electronic platform. Work with large an...
reports, and procedure manuals. Knowledge/experience of medical insurance plans and rating methods. Proficient...
and interpret documents such as group agreements, financial reports and procedure manuals. Knowledge/experience of medical...
Job Description: Responsible for accurately calculating and analyzing rates for large employer groups using the historical utilization and demographics of the account. Extract and analyze historical data of the account to ensure accuracy...
Job Description: Administrative and Financial Administration Prepare and submit expense reports, for departmental staff Assist with the tracking of departmental budgets and expenditures Assist with purchase orders, invoices, check ...
with the state of Hawaii Department of Commerce and Consumer Affairs or pass all four sections of the state licensing... state of Hawaii is a condition of employment. Must have valid driver's license, access to an automobile with current...
Job Description: Coordinate and monitor activities with appropriate MP and operational departments to ensure that standards are being met timely and accurately;escalate issues as needed. Conduct analysis of ad hoc and questions, researc...
, membership enrollment, claims processing, financial statements, customer service, provider contracting, quality improvement...