Reporting to the VP Quality & Controls Assurance, the incumbent is responsible for independent quality reviews of medical claims, and evaluating Call Center activities for compliance with policies and Standard Operating Procedures (SOP). Additionally, this role will review issuance of ID Cards, and Welcome Kits for accuracy. This role will also conduct reviews to verify a

Performs patient service and administrative duties and office work. Coordinates diagnostic tests referrals and tracks appointments visits and authorization Verifies Insurance Prepares Billing Collects data and generates quality assurance reports May provides cross coverage to other practices and/or positions, as appropriate Provides basic information to patients Triages P

The Clinical Care Manager provides holistic medical care management services for members throughout the continuum of care by assessing the member clinically as well as member's readiness to make behavioral changes and actively participate in a care plan, establish goals and meet those goals. Well Sense Health Plan members may include those who have chronic conditions and

AHEAD builds platforms for digital business. By weaving together advances in cloud infrastructure, automation and analytics, and software delivery, we help enterprises deliver on the promise of digital transformation. At AHEAD, we prioritize creating a culture of belonging, where all perspectives and voices are represented, valued, respected, and heard. We create spaces t

Assistant Program Coordinator New Bedford, MA, USA Req #18310 Wednesday, April 10, 2024 Full Time Assistant Program Coordinator Opportunity Tu 2p 11p, W 2p 11p, Th 10a 7p, F 2p 9p, Sa 9a 3p = 40 Hrs Are you ready to make a difference in the lives of individuals with Autism and other developmental disabilities? Do you thrive in an environment where collaboration and inclus

Client Experience Manager Job Locations US CT Southington | US NY Latham | US NJ Plainsboro | US NH Nashua Requisition ID 2024 16758 Category Claims Workers Compensation Position Type Regular Full Time Overview The Client Experience Manager, reports to the Manager, Client Experience and is responsible for client support throughout the life of the policy. The Client Experi

Office Manager EPA (Temp Position) Job Ref 29248 Category Clerical & Administrative Support Location Emerson Hospital Groton Facility, 100 Boston Road, Groton, MA 01450 Department Emerson Health Primary Care Groton Schedule Temporary Position Shift Day shift Hours 8AM 5PM Job Summary Reporting to the Practice Manager and the Physician(s), the Office Manager performs a wid

include but are not limited to Proforma generation and edits, creating timecard summaries, updating matter and Timekeeper rates, and running client reports at the request of the partners and attorneys. Ensure timeliness, accuracy, and acceptance of invoices on a monthly basis. Follow up with Billing partners and others in order to resolve client billing issues and ensure i

Why This Role is Important to Us The Clinical Director, Hospital to Home, is responsible for leading CCA's engagement with acute care hospitals and developing strategies and partnerships to support CCA members through transitions across care settings. The position provides supervision and leadership to a team of facility based providers (medical and behavioral health) as

Maintains confidentiality of patient and proprietary information. Qualifications High School Diploma/GED or equivalent required; Associate's Degree or some college preferred Minimum two (2) years of experience collecting referral information in the healthcare market Experience working with all payer types, including Medicare, Medicaid and commercial insurance companies Kn

Company Description We help job seekers and career changers prepare for and advance in careers with a focus on sustainable, high growth, high demand industries. Our committed and well trained workforce professionals deliver comprehensive workforce solutions at integrated career centers, sector focused centers and community, and partner sites. Job Description Under supervis

Program Support Primary support to and work with the LISC facilitated Health Equity Zone for Pawtucket and Central Falls. The Health Equity Zone is a collaborative approach to advancing health through place based, resident lead, social determinate of health strategies. Specific responsibilities may include Facilitating meetings of the HEZ collaborative. Facilitating subco

Kyowa Kirin is a fast growing global specialty pharmaceutical company that applies state of the art biotechnologies to discover and deliver novel medicines in four disease areas bone and mineral; intractable hematologic; hematology oncology; and rare disease. A Japan based company, our goal is to make people smile by delivering breakthroughs where no adequate treatments c

Duties WHAT IS THE TAS TAXPAYER ADVOCATE SERVICE DIVISION? A description of the business units can be found at Vacancies will be filled in the following specialty areas Taxpayer Advocate Service (TAS) Deputy Executive Director Case Advocacy (DEDCA) The following are the duties of this position at the full working level. If this vacancy includes more than one grade and you

Are you ready to join a team committed to making a meaningful impact on cancer treatment through the discovery and development of precision medicines? At Kura Oncology, you have an opportunity to be a part of something bigger, with a lasting impact that you can be proud of. At Kura Oncology, we are working to change the paradigm and improve the science of cancer treatment