Care Review Processor I (56811)
Los Angeles, CA
Data Entry (Intake) enters information in system from fax system verifies eligibility, coverage, request for missing information, redirecting to in network facilities, assist in phone qu...

Care Review Clinician II (56652)
Los Angeles, CA
All UM standard Inpatient, Outpatient and Custodial Care processes and workflows for any requests, verbal notifications for denials/partial denials to both member and provider, participa...

Medical Referral Specialist
Indianapolis, IN
Remote Position 12 month contract with possibility of extension The Direct Specialist is responsible for ensuring that all new hire contractors and subcontractor personnel meet the requi...

RN Care Manager (119447)
Indianapolis, IN
Seeking an RN Care Manager with experience working with high risk OB members to perform care management duties to assess, plan and coordinate all aspects of medical and supporting servic...

Member Risk Adjustment Coordinator I (119687)
Indianapolis, IN
Schedule appointments, gather medical histories and updated member and provider information in support of member outreach and claims reimbursement. Essentials Understanding of basic medi...

Program Coordinator I
Indianapolis, IN
Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. Initiate authorization requests for output or input services in keeping with the...

Maintenance Assistant I (33040455)
Columbia, SC
Performs routine facility maintenance tasks to ensure company employees have a safe and properly conditioned work environment. Assemble, relocate, and repair free standing or modular off...

Care Manager V (56732)
Syracuse, NY
UAS Certified RN licensed in the state of NY. Conduct face to face assessments of members' functional status, medical, behavioral, psychosocial and community resource needs. Provides the...

Customer Service Advocate I
Indianapolis, IN
Job Title Customer Service Advocate I Location Remote (Indiana) Hours 11am 8pm Monday Friday (Eastern Standard Time Zone) Job Description Serves as the first line advocate that focuses on...

QA Analyst
Indianapolis, IN
The Quality Assurance Analyst works closely with higher level staff and/or management to outline general objectives and boundaries that this individual will follow to meet the requiremen...

Clinical Appeals Nurse
Dayton, OH
The Clinical Appeals Nurse is responsible for the completion of clinical appeals and state hearings from all states. Essential Functions Responsible for the completion of clinical appeals...

Clinical Administrative Coordinator (CAC)
Indianapolis, IN
Manage administrative intake of members Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers Process incoming and...

Customer Care Rep (Outbound)
Indianapolis, IN
A customer service representative, or CSR, will act as a liaison, provide services information, and resolve any emerging problems that our customer accounts might face with accuracy and...

Customer Care Representative
Indianapolis, IN
Responds to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. Analyzes problems and provides informati...

Data Capture Operator
Marion, IN
Data Capture Specialist is responsible for the accurate capture of the alphabetic, numeric, or symbolic data from electronic images and/or source documents according to the custom develo...