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Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The Claims Review Representative 3 makes appropriate claim decision based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. The Claims Review Representative 3 performs advanced ..
Description The Care Management Support Assistant 3 contributes to administration of ... members. The Care Management Support Assistant 3 performs advanced administrative/operational/customer support duties that require independent ... Responsibilities The..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
... & Appeals Representative 3 (Fully Bilingual English/Spanish) San Juan, PR in ... Appeals Representative 3 performs advanced administrative/operational/customer support duties that require independent ... tactics and processes for completing..
Description Do you enjoy helping those in need? Do you love researching, analyzing medical documents to determine if something was missed? Have you ever considered yourself a detective for medical claims ..
Job Information Humana Market Leadership Advisor (Managed/Health Care Industry) San Juan, PR in San Juan Puerto Rico Description The Market Leadership Advisor manages the development, operations, and results of a health ..
... Outbound Contact Representative 3 (FULLY Bilingual English/Spanish) San Juan, Puerto Rico ... Contacts Representative 3 performs advanced administrative/operational/customer support duties that require independent ... tactics and processes for completing..
Description The Subrogation Representative 3 identifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health ..
Description The Outbound Contacts Representative 3 represents the company by making outbound contacts to members and/or providers regarding a variety of issues. The Outbound Contacts Representative 3 performs advanced administrative/operational/customer support ..
Job Information Humana Senior Business Support Professional (Fully Bilingual English/Spanish) San Juan, PR in San Juan Puerto Rico Description The Senior Business Support Professional follows established procedures and guidelines to provide ..
Description The Credentialing Assistant 3 obtains and reviews documentation ... a health plan. The Credentialing Assistant 3 performs advanced administrative/operational/customer support duties that require independent ... mathematical skills. Responsibilities The..
Description The Supervisor, Consumer Service Operations is responsible for the daily activities across multiple service functions area. The Supervisor, Consumer Service Operations works within thorough, prescribed guidelines and procedures; uses independent ..
