Coverage Determination Specialist - San Juan, PR

Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning… Providing high quality services to client and beneficiaries is at the core of what we do every day. ...

We are a busy plastic surgery practice seeking an experienced Medical Biller & Claims Specialist with a strong focus on out-of-network insurance billing. · This role manages high-volume surgical claims and plays a critical role in revenue cycle performance. · ...

+Audits to assess the adequacy of the Corporation's Fraud Prevention & BSA/AML and Sanctions compliance programs. · +Audits department activities for compliance with management's plans and policies. · Identifies business processes and controls to evaluate risks. · ...

The Clinical Investigation Analyst CIC will investigate Optum Waste and Error stopped claims by gathering information, researching state and federal guidelines, and following internal procedure to determine the viability of the claim for further review in a production environment ...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. · The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to fee ...

Responsible for collecting evaluating and maintaining crucial data for the daily company Census Accountable for analysis ensuring data quality collaborating with hospitals and supporting user testing processes for implementing new technologies to enhance efficiency in the unit an ...

The Associate Rx Customer Service Specialist serves at the front line of all incoming and outgoing communication (calls, emails, and faxes) with pharmacies, beneficiaries, and prescribers. · ...

As the Associate Rx Customer Service Specialist, you will serve at the front line of all incoming and outgoing communication (calls, emails, and faxes) with pharmacies, beneficiaries, · and prescribers. · Manage all incoming calls,email,faxes,and web-generated requests from pharm ...

Performs general diagnostic ultrasound exams and related data for subsequent evaluation and treatment by the attending physician. · Performs all cardiac ultrasound (echocardiograms); Produces images of the heart to show hemodynamics and function. · Performs all routine vascular e ...

We are seeking a Unit Manager to oversee the Commercial Loans and Deposits Services activities. The successful candidate will provide commercial customers with credit services and deposit services to support their respective businesses. · ...

+Serves as an Aviation Safety Analyst in the Flight Standards Service Flight Technologies & Procedures Division. · ...

We seek experienced professionals with the drive and vision to make a lasting impact on the island. · This role requires a hybrid schedule and will be based in our Santurce office (Monday through Thursday) and work fully remotely on Fridays each week. ...

· This role requires a hybrid schedule and will be based in our Santurce office (Monday through Thursday) and work fully remotely on Fridays each week. · About Red Ventures Puerto Rico:  Five years ago, a group of determined young professionals ignited a movement to rebuild Puer ...

The IT Service Desk Analyst II serves as the primary technical contact within their specialized field and provides expert-level support to students faculty and administrative staff. · This role requires advanced knowledge and the ability to make independent decisions in support o ...

+ Create, update and maintain spatial data using ArcGIS Pro and ArcGIS Online. · + Manage geodatabases for various projects within ICF organization. · + Design maps for both hardcopy use and website display. · + Employ remote sensing data to enhance maps and assign surface type c ...

This position involves creating maintaining and updating spatial data using ArcGIS software performing aerial photography interpretation extracting data from various sources designing maps developing geodatabases managing metadata working independently communicating technical bus ...

This position is located in Puerto Rico and requires the ability to travel around the island to meet with clients and stakeholders. · Perform data capture updates analysis within ArcGIS Pro and ArcGIS Online. · Manage document geodatabases keep metadata updated. · ...

This position is a Junior GIS Specialist for ICF's GIS operations in Puerto Rico, leveraging Geographic Information Systems (GIS) software and spatial analysis to create, update, and maintain spatial and design data. · ...

DMI Medical is the preferred supplier in the Caribbean by maintaining a high degree of expertise and excellent customer service in diagnostics, microscopy and pathology fields. · We are looking for a high initiative Sales Specialist with a minimum of 2 years sales experience to j ...

+ Become an integral part of a dynamic team at one of the world's top tax firms. · Work with KPMG's extensive network of specialists & enjoy access to our Ignition Centers, where deep industry knowledge merges with cutting-edge technologies to create innovative tax solutions. ...