Account Representative, Medicare - Arizona

Become a part of our caring community and help us put health first · The Medicare Inbound Contact Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries. · This is a high-volume call center setting, which can be stressful at times. ...

Leads and supervises a team of pharmacy call center representatives and operations staff responsible to ensure that members have access to medically necessary prescription drugs. · ...

We are looking for a Manager to oversee end-to-end claims services for provider segments. · Streamline shared processing to reduce management by exception · Set operational processes to align with market trends and customer demand · Manage accounting and financial reporting funct ...

++Provides support for claims activities including reviewing and resolving member and provider complaints. · Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members--> · Researches claims appeals and grievances usi ...

Provides lead level support for claims activities including reviewing and resolving member and provider complaints, · and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare an ...

We are currently looking for a Manager to oversee end-to-end claims services for provider segments in the Medicare environment. · Streamline shared processing to reduce management by exception. · Set operational processes to align with market trends and customer demand. · ...

We are seeking a motivated and experienced leader to drive sales performance and growth in Medicare Supplement, Dental, Life, and Specified Disease products. · ...

This position performs the department's credentialing work as outlined in the policies and procedures. Obtains all primary source information necessary for all organizational facilities and entities. · The incumbent maintains records and the integrity of highly confidential infor ...

You could be the one who changes everything for our 28 million members. · ...

The Regional VP, Network Performance manages the development, operations, · and results of a health plan. The Regional VP requires an in-depth understanding · of how organization capabilities interrelate across segments and the enterprise.Bachelor's Degree · Extensive leadership ...

The RN Clinical Appeals Nurse provides support for internal appeals clinical processes ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements Molina policies and procedures and medically appropriate clinical guideline ...

Leads and supervises team responsible for enterprise network management and operations activities including network development, network adequacy, and provider training and education. Serves as primary point of contact between the business and contracted providers within the Moli ...

Provides lead level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection projects ...

Become a part of our caring community and help us put health first. The Market CMO serves as a healthcare professional and capable of handling a variety of health-related problems. · ...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. · ...

The Consumer Engagement Representative oversees the enrollment, education, engagement and activation duties for client groups regardless of segment. · Perform basic administrative/clerical/operational/customer support/computational tasks. · ...

This Medical Billing Representative will provide revenue cycle process including charge capture, claim submission, payment posting, claim follow up and appeals to ensure efficient timely and accurate payment of accounts for Physical Therapy Practices. · ...

The Care Transformation Program Manager will support network performance by organizing structuring and analyzing performance data to identify operational opportunities trending data and developing reports that will be used in a variety of meetings. · Must possess a strong knowled ...

>Become a part of our caring community and help us put health first · The Senior Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performan ...

HonorHealth is seeking a Care Coordinator to collaborate with primary physicians and other healthcare team members in developing patient-centered goals and actions. · ...