UST HealthProof Jobs in United States

We are searching for a highly motivated Appeals and Grievances Operations Expert to join our team. As an Appeals and Grievances Operations Expert, you will serve as a subject matter expert on the Medicare Advantage appeals/grievance process. · Bachelor's degree in healthcare admi ...

We are looking for Claims Examiner II to report to the Claims Team Leader. The successful candidate will be responsible for adjudicating healthcare claims using specific policies and procedures. · ...

The Benefits Administrator is responsible for the day-to-day administration and coordination of employee benefit programs, · including health, dental, vision, life insurance, retirement plans, · wellness initiatives, · and other ancillary benefits.Administer group benefit program ...

We envision a bold future for American healthcare.UST HealthProof is searching for a Healthcare Utilization Management Intake Analyst who will support coordination of medical services including utilization management intake, requesting medical records, and provider requests to pr ...

Administrative Coordinator Role · This Administrative Coordinator will provide support to assigned department(s), including preparing materials and conferring with stakeholders. · The successful candidate will also perform general administrative duties such as ordering supplies a ...

Customer Service Representative · We are seeking outgoing and energetic individuals to work in our fast-paced call center environment. · Conduct research to determine data needed to handle inquiries regarding membership. · Analyze and service various product lines. · Follow depar ...

+ Configuration Analyst · Job Description: · We have a strong global presence and a dedicated workforce of over 4000 people spread across the world. · + We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively. · Assist in configuri ...

We are searching for a highly motivated Utilization Review RN to join our team. As a Utilization Review RN, you will perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity. · ...

We are searching for a Healthcare Utilization Management Intake Analyst who will support coordination of medical services including utilization management intake, requesting medical records, and provider requests to promote effective utilization of healthcare services. · The Oppo ...

We have a strong global presence and a dedicated workforce of over 4000 people spread across the world. · UST HealthProof is looking for a Manager I, Claim Operations to develop and maintain metrics/reports/tools to support various claim initiatives and personnel. · ...

Job Description · As a Customer Service Representative at Blue Cross Blue Shield of Michigan, you will be responsible for analyzing and resolving low complexity level membership issues under various product lines. You will conduct internal and external research to determine and r ...

The Supervisor, Utilization Management is responsible for management and oversight of staff who provide operational support and medical review on behalf of Medicare Advantage clients. This position ensures that all decisions made are accurate and complete and is responsible for d ...

The Director of EPMO provides strategic leadership for the organization's portfolio of initiatives, · ensuring programs and projects align with business objectives and deliver measurable value. · Full-time, regular employees accrue up to 16 days of paid vacation per year, · recei ...

+UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members' well-being. · +Collect, analyze, and interpret operational data to id ...

Medical Management Program Specialist · Provide thorough analysis and investigation of authorization requests for specialized medical/surgical/outpatient procedures in an expeditious and accurate manner ensuring provider, hospital/facility, Primary Care Group (PCG), and member qu ...

Administrative Supervisor · Ensuring efficient area management aligns with departmental and corporate standards. · Supervise staff activities for prompt, courteous customer responses. · Prioritize work assignments and address problems through scheduling adjustments. · Selecting a ...

We envision a bold future for American healthcare. Our values are the bedrock beliefs our organization holds dear.Simplicity underlines everything we do—this approach is what makes us unique. · We believe in being open and honest. · Care management intake · , provider requests to ...

UST HealthProof is searching for a highly skilled and experienced Director of Vendor Coding to join our growing team. · ...

We are looking for a strategic and customer-focused Manager to join our team.Full-time employees receive 16 days of paid vacation per year. · They also receive 6 days of paid sick leave each year. · The company offers medical, dental, and vision insurance to full-time employees. ...

The QA Analyst is responsible for assisting and in organizing and facilitating strategic program creation, providing in-depth analysis on current processes and implementation. · This role assists in researching and compiling appropriate and relevant data and feedback for risk act ...