Job Description: General Administrative Support Relieves the CEO/assigned Executive(s) of majority of administrative functions and tasks, ensuring the most effective/efficient use of the Executive's attention and focus. Drafts routine...
Job Description: Corporate Compliance Training Administration Manage the training database for employees and temporary workers/contractors with the assignment of administering onboarding and annual continuing education training;foll...
. Three years progressively responsible experience in work involving medical plan rating, accounting, statistics, or math...
Job Description: Utilize medical necessity criteria from established medical policies and clinical practice... guidelines to render precertification determinations as described in the Medical Management UM work plan. This detailed clinical...
Job Description: Monitor the performance and address issues with any business partners or vendors that supports the Members Servicing Department. Build relationships with both internal and external customers to include members and emplo...
Job Description: Sustains strong knowledge of encounter system processes within HMSA and external partners. Coordinates and reconciles data exchange with external entities, monitoring quality. Researches complex claim-member-provider s...
Job Description: Analyzes encounter system processes within HMSA and external partners. Coordinates and reconciles exchange of data with external entities. Researches various claim-member-provider scenarios to determine root cause of d...
Job Description: Sustains mastery of encounter system processes within HMSA and external partners, for multiple lines of business. Monitors trends in data exchange with external entities and recommends adjustments as needed. Researches...
Job Description: Responsible for managing all aspects of the planning, execution, controlling, and closure of projects/programs. Responsibilities include, but are not limited to, the following: Receives high-level business requirements a...
reports, and procedure manuals. Knowledge/experience of medical insurance plans and rating methods. Proficient...