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 from
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 from
Essential Duties and Responsibilities: - Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements. - Issue approvals, denials or recommendations based on contract requirements.
Essential Duties and Responsibilities: - Supervise team members and processes to sustain an effective reporting program that gathers, prepares, trends, and analyzes operational activity. - Coordinate and evaluate the work of Reporting Specialist(s). - Assist with
Essential Duties and Responsibilities: - Supervise the workforce management team and workflow to support management in all aspects of the workforce function within the project. - Create and maintain workforce monitoring schedules for team members to
Essential Duties and Responsibilities: - Facilitate the development of cross-line-of-business solutions by combining knowledge of business capabilities, value streams, and business processes. Consult with technical subject matter experts to develop technical solutions and advise on options,
Essential Duties and Responsibilities: - Provides advanced clinical inquiry responses (verbal and written) to health-related inquiries from consumers, educators or medical/health professionals. - Provides medical subject matter expertise. - Performs advanced database searches. - Composes documents,
Essential Duties and Responsibilities: - Works on assignments that are semi-routine in nature but recognizes the need for occasional deviation from accepted practice. - Follow procedures and directions to assess the quality of service provided through monitoring
Essential Duties and Responsibilities: - Supervise the work of call center staff to ensure adherence to quality standards, deadlines, and proper procedures, correcting errors or problems as needed - Interview and recommend hiring and promotion of
Essential Duties and Responsibilities: - Provide feedback regarding the design, development and distribution of training programs and materials as needed. - Conduct, plan, and coordinate training to a variety of audiences. - Coordinate logistics for instruction
Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organizations coding procedures and standards. - Accurately enter coded data in a system and validate data entered.
Essential Duties and Responsibilities: - Provides advanced clinical inquiry responses (verbal and written) to health-related inquiries from consumers, educators or medical/health professionals. - Provides medical subject matter expertise. - Performs advanced database searches. - Composes documents,
Essential Duties and Responsibilities: - Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data. - Enter coded data into a system
Essential Duties and Responsibilities: - Facilitate the development of cross-line-of-business solutions by combining knowledge of business capabilities, value streams, and business processes. Consult with technical subject matter experts to develop technical solutions and advise on options,