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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 Supervisor, Consumer Service Operations is responsible for the daily ... area. The Supervisor, Consumer Service Operations works within thorough, prescribed guidelines ... Responsibilities The Supervisor, Consumer Service Operations..
Description The Credentialing Assistant 3 obtains and reviews documentation to determine status in a health plan. The Credentialing Assistant 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. ..
Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..
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 ..
Job Information Humana Inbound Contacts Representative 2 (Fully Bilingual in English/Spanish) in San Juan Puerto Rico Description The Inbound Contacts Representative 2 represents the company by addressing incoming telephone, digital, or ..
Description The Supervisor, Grievances & Appeals manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Supervisor, Grievances & Appeals ..
Description The Subrogation Professional 2 iIdentifies, 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 Bilingual Claims Research and Resolution Representative 2 address customer needs which may include complex financial recovery questions, and resolving issues. Records details of inquiries, comments or complaints, transactions or ..
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 ..
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 ..
