- Commonwealth Care Alliance (Boston, MA)
- …outcomes for CCA members. The Assessment nurse reports to the Regional RN Supervisor . **Supervision Exercised:** + No, this position does not have direct reports. ... or screeners as needed, including relevant behavioral health screeners (PHQ-9, EASI, Audit , DAST). + Uses clinical judgment to escalate members with urgent needs… more
- LA Care Health Plan (Los Angeles, CA)
- …staff on identified areas of improvement, such as Appeals and Grievance processes, Claims , etc. Through various delivery methods that meet business needs (web, LMS, ... department standards and will design and implement a scorecard audit procedure to assess the Customer Service performance of...findings of surveys and performance studies to the training Supervisor , to analyze and identify areas of training needs… more
- NJM Insurance (Trenton, NJ)
- …outstanding customer service was reaffirmed by the most recent JD Power Auto Insurance Claims Survey. Over the last five years, the Company has focused on a ... The Commercial Lines function encompasses Underwriting, Sales, Operations, Premium Audit , Product Management, Product Development, Loss Prevention and Business… more
- Genesis Healthcare (Camp Hill, PA)
- Overview POSITION SUMMARY: Under the direction of the RN Nursing Supervisor , Unit Manager, ADON or ADON - Unit, or Director of Nursing (Nurse Leader), the Registered ... within the Compliance and Ethics Program, Standard/Code of Conduct, Federal False Claims Act and HIPAA. 2. Participates in required orientation and training… more
- SSM Health (Fond Du Lac, WI)
- …in Charge (PIC) in the absence of the Pharmacy Supervisor /Manager. **Job Responsibilities and Requirements:** PRIMARY RESPONSIBILITIES + Verifies prescription ... day check out, with minimal shortage/overages. Ensures all insurance claims are processed according to policy and procedures. Confirms...days' supply, quantity, MME, source and DAW to avoid audit charge backs and ensure compliance with Fraud Waste… more
- Financial Partners Credit Union (Downey, CA)
- …Remit Payment lockbox and ensure accuracy of data. + Complete review of audit reports to ensure servicing accuracy. + Process Reconveyances, Consumer and Real Estate ... loan transfers to new accounts + Process GAP, Credit Life and Disability insurance claims + Assist staff in resolving difficult loan issues + Process forced placed… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- …Payable Specialist to join the Finance Team. Reporting to the Accounting Supervisor , the Accounts Payable Accountant will be responsible for accounts payable ... running of "pay when paid" model with the AR Supervisor to capture all current accounting data needed to...Subrogation Recoveries ensuring all recoveries received are processed by claims department and then appropriately accounted for and returned… more
- WestCare Foundation (Henderson, NV)
- …reports to the management team on a defined basis + Handle CARF Service Claims Audit reports quarterly including facility reports to Billing Supervisor . ... reporting features. + Attend staff meetings, training and in-service as assigned by supervisor and/or as required by the agency; + Develop concise and timely… more
- Walgreens (Janesville, WI)
- …to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... companies as well as medical providers and participates in 3rd party audit . + Follows-up with medical providers' offices to clarify prescribed medications, dosages,… more
- Walgreens (Quitman, TX)
- …Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... companies as well as medical providers and conducts or participates in 3rd party audit . + Assists and supports Store Manager and Pharmacy Manager in analyzing and… more