Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries. Description Ensures effective customer relations by responding accurately, timely and courteously to telephone, written, web, or walk in inquiries. Accurately documents inquiries. Initiates or processes adjustments or performs other rese

Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries. Description 65% Ensures effective customer relations by responding accurately, timely and courteously to telephone, written, web, or walk in inquiries. Accurately documents inquiries. 15% Initiates or processes adjustments or performs ot

Coordinates the quality control program for the medical review area. Researches the Center for Medicare and Medicaid services (CMS) changes. Trains new staff and provides continuing education to clinical staff. Description Reviews medical review decisions for accuracy and to ensure CMS instructions have been applied correctly. Develops/implements the quality control progr

Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Inquiries may be non routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Description This position is on site in Columbia, SC. Ensures effective customer relations by responding accurately, timely, and courteous

Ensures claims can be processed timely to meet departmental goals by reviewing claims for proper information. Returns claims or requests missing information. Description Investigate claims in order to provide information that is missing or cannot be determined by processors. Contacts providers and members to obtain information necessary to process claims. Screens, codes,

Under general supervision, performs a variety of routine to complex clerical/accounting functions such as inventory balancing, reconciliations, generating refund request letters, processing disbursements and deposits, keying journal entries and logging items in accordance with standard procedures in one or more of the following areas; general accounting, accounts payable,

Responsible for managing contract staff and administration of all contracts to ensure that contractual obligations are met and compliance is maintained with mandatory governmental regulations, applicable laws and corporate policies and procedures. Ensures effective relationships between the company and the customer contracting officers on all contractual matters in order

Provides prompt, accurate, thorough and courteous responses to all complex customer inquiries. Inquiries are typically non routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates complex or specialty claims and/or non medical appeals. Determines whether to return, deny or pay c

Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Performs research as needed to resolve inquiries. Description Ensures effective customer relations by responding accurately, timely and courteously to telephone, written, web, or walk in inquiries. Accurately documents inquiries. Initiates or processes adjustments or performs other rese

Position will support current and future telehealth product solutions. Conducts market, product, and competitor research to be used in the development of new telehealth and other ancillary products. Collects and analyzes market data. Uses internal data sources to show engagement, usage, cost savings or avoidance and revenue. Implements products through the full product li

Responsible for responding to customer inquiries. Inquiries may be non routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. Description Requi

Responsible for providing administrative and project support to executive staff. Gathers and analyzes data for report preparation. Exercises diplomacy and maintains confidentiality. Description Provide administrative support for executive staff including but not limited to drafting reports and presentations. Communicating with various staff and vendors including schedulin

Creates and analyzes reports to support operations. Ensures correctness of analysis, and reports findings in a concise manner to senior management. Directly responsible for accuracy of data as financial and operational decisions are made based on the data provided. Description Generates internal and external reports to support management in determining productivity and ef

Manages claims and customer service areas. Description Manages staff responsible for providing excellent customer service and timely and accurate processing of claims or appeals. Ensures department standards for production, timeliness, and quality are met. Prepares and reviews management reports. Monitors monthly reports to ensure department standards for production, time

Performs varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information, and distributing mail. Applies knowledge of department policies and procedures, and utilizes a general understanding of other departments' functions to resolve most issues. Maintains records