MagnaCare Jobs in United States

Key Responsibilities · Apply medical policy, contractual provisions, and operational procedures to ensure accurate Medical claims. · Resolve claim holds, review history records, and determine benefit eligibility for services rendered. · Research and document all pertinent infor ...

Magnacare · Director, Enrollment–Eligibility & Contribution Accounting · Department: Enrollment-Eligibility Contribution Accounting · Location: Las Vegas, NV – On-site (daily presence required) · Reports To: Vice President, Enrollment & Eligibility Operations · FLSA Status: Exemp ...

About The Role · The Customer Service Representative assists members, physicians, hospitals, revenue agencies and other healthcare providers with member benefits, eligibility, claims inquiry, claim reconsiderations and appeals. The Customer Service Representatives must be able to ...

The research assistant will handle mail and packages, manage outgoing mail, log incoming checks, oversee check printing and distribution processes, · Receive, sort and distribute incoming mail and packages. · Manage outgoing mail. · ...

Eligibility Enrollment Specialist I at Magnacare · Primary Responsibilities: · Verify new member or group data and update the enrollment database. · Respond to eligibility questions and verify status. · Key Job Functions: · <ol style= ...

About the Claims Manager Role · Leads strategic oversight of claims function, focusing on team performance and process optimization. · Key Responsibilities: · Manage remote and office-based teams to promote strong leadership and employee engagement. · Foster a collaborative work ...

Brighton Health Plan Solutions is seeking an experienced Account Executive with deep expertise in commercial, self-insured employer benefit plans, PPO network strategies, and Third-Party Administration (TPA) organizations. · ...

Claims Manager · The Claims Manager leads the strategic oversight of the claims function, focusing on team performance, process optimization and quality outcomes. · Fosters a culture of continuous improvement through high-level coaching, mentoring and training to drive performanc ...

The Eligibility Enrollment Specialist I is responsible for verifying new member or group data into the enrollment database and updating it with changes. They also respond to member eligibility questions and verify enrollment status. · ...

Key Responsibilities · Apply medical policy, contractual provisions, and operational procedures to ensure accurate Medical claims. · Resolve claim holds, review history records, and determine benefit eligibility for services rendered. · Research and document all pertinent informa ...

About The Role · The Director of Enrollment–Eligibility & Contribution Accounting is a senior operational leader responsible for hands-on, day-to-day oversight of eligibility and employer contribution operations within a complex Taft-Hartley environment. This role requires a stro ...

About The Role · The Claims Manager leads the strategic oversight of the claims function, focusing on team performance, process optimization, and quality outcomes. This role provides high-level coaching, mentoring, and training to team members to drive continuous improvement. The ...

About The Role  · The Director of Enrollment–Eligibility & Contribution Accounting is a senior operational leader responsible for hands-on, day-to-day oversight of eligibility and employer contribution operations within a complex Taft-Hartley environment. This role requires a str ...

Job summary · About The Role BHPS provides Utilization Review services to its clients. The UM Denials Coordinator supports the Utilization Management function by reviewing denied and partially denied authorizations and preparing denial correspondence within the Utilization Manage ...

About The Role · MagnaCare is seeking a hands-on, Las Vegas-based On-Site Customer Service Supervisor to manage the day-to-day operations of our high-volume call center serving members and providers. The Supervisor is responsible for directly overseeing call center representative ...

Director, Customer Service · Magnacare is seeking an Onsite Director of Customer Service in Las Vegas to lead the strategic direction and day-to-day management of a multi-channel customer service organization. · Plan and oversee contact center operations, establish policies and p ...

· Primary ResponsibilitiesVerify the loading new member or group data into the enrollment database & update the database with changes · Responding to member eligibility or group questions & verify enrollment status · Reconciling eligibility discrepancies, analyzing transactional ...

Job Title · Primary Responsibilities: · Verify the loading new member or group data into the enrollment database & update the database with changes · Responding to member eligibility or group questions & verify enrollment status · Reconciling eligibility discrepancies, analyzing ...

Claims Examiner · Key Responsibilities: · Apply medical policy, contractual provisions, and operational procedures to ensure accurate Medical claims. · The ideal candidate will have a strong understanding of medical terminology, CPT/HCPCS and ICD coding, and benefits administrati ...

Customer Service Supervisor Role · MagnaCare is seeking a hands-on, Las Vegas-based On-Site Customer Service Supervisor to manage the day-to-day operations of our high-volume call center serving members and providers. The key responsibilities include overseeing call center repres ...