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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 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 ..
... business need including occasional weekends Bilingual in Spanish and English. Must ... interact with us at the time and location most convenient for ... the Federal Government. Humana Perks:..
Job Information Humana Call Quality Professional 1 (Bilingual English/Spanish) in San Juan Puerto Rico Description The Call Quality Professional 1 monitors and evaluates the quality of inbound and/or outbound customer service ..
Description The Quality Assurance Technician develops and implements programs to establish and maintain quality standards of existing products and services, as well as developing programs to focus employees on the quality ..
... Research & Resolution Representative 2 (Bilingual - English/Spanish) (Remote) in San ... Juan Puerto Rico Description The Bilingual Claims Research and Resolution Representative ... Competitive 401k match Generous Paid..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g. CPT) to patient records. The Medical Coding Auditor ..
Description The Project Manager 2 manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Project Manager 2 work assignments ..
Job Information Humana Grievances & Appeals Representative 3 (Bilingual English/Spanish) San Juan, PR in San Juan Puerto Rico Description The Grievances & Appeals Representative 3 manages client medical denials by conducting ..
... independent initiative and judgment. From time to time apply intermediate mathematical skills and ... STELLAR 401K MATCH - PAID TIME OFF What you need for ... attention to detail,..
... 2/TPA (Renewable Contract position with Full Benefits) Work at Home Puerto ... equipment capacity and limitations, operating time, and form of desired results. ... including Word, Excel and PowerPoint..
Job Information Humana Outbound Contact Representative 3 (FULLY Bilingual English/Spanish) San Juan, Puerto Rico in San Juan Puerto Rico Description The Outbound Contacts Representative 3 represents the company by making outbound ..
Job Information Humana Grievances & Appeals Representative 3 (Fully Bilingual English/Spanish) San Juan, PR in San Juan Puerto Rico Description The Grievances & Appeals Representative 3 manages client medical denials by ..
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 ..
Description The Product Manager 2 Conceives of, develops, delivers, and manages products for customer use. The Product Manager 2 work assignments are varied and frequently require interpretation and independent determination of ..
Description The Bilingual Claims Research and Resolution Representative ... Competitive 401k match Generous Paid Time Off accrual Tuition Reimbursement Parent ... Where you Come In The Bilingual Claims Research &..
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 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 Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description The Supervisor, Inbound Contacts represents the company by addressing incoming telephone, digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, prescribed guidelines and procedures; uses independent judgment requiring ..
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 ..
Description The Senior Internal Auditor develops, plans and executes internal audits to provide assurance for Puerto Rico's accounting records and the operational activities of Puerto Rico to ensure compliance with the ..
... Inbound Contacts Representative 2 (Fully Bilingual in English/Spanish) in San Juan ... illness and trauma at the time of their call. Required Qualifications ... ability to learn systems real..
