Job Description Job Summary: The Assurance Senior Manager is responsible for developing suggestions to improve client internal controls and accounting procedures as well as advising the client on various economic and regulatory risks in a specific
Essential Duties and Responsibilities: - Responsible for directing all quality operations including planning, implementation monitoring and reporting functions. - Develop and oversee an effective management system to continuously identify opportunities for improvement while maintaining adherence to contract
Essential Duties and Responsibilities: - Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters). - Calls are predominantly routine, but may require deviation
Essential Duties and Responsibilities: - Lead and execute sensitive, high-risk investigations (e.g., harassment, discrimination, retaliation, serious misconduct), including matters involving senior leaders and significant organizational risk; gather evidence, conduct interviews, assess credibility, and document findings. -
Essential Duties and Responsibilities: - Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments. - Provide written clinical rationales for CA Workers Compensation
Essential Duties and Responsibilities: - Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations. - Render medical necessity determinations for Medicare State East cases assigned. - Resolve all other technical issues within Medicare