Responsibilities. Job Summary. The Coding Auditor is responsible for the overread of documentation and coding of medical records at various partnered medical practices. Will ensure accurate reporting of diagnoses and service codes to support optimal performance in risk adjustment and quality measurement. Performs an overread on all coding projects to ensure a 95% and above accuracy requirement is maintained. Serves as a guide, educator and traine...
Responsibilities. Job Summary. Workforce managers is responsible to oversee inbound and outbound call center efficiency by assessing, analyzing, and reporting employee productivity at the individual and departmental levels. Will manage ongoing laborer time using daily, weekly, and monthly measurements and use workforce optimization software to improve efficiency and forecast staffing needs taking contact volume and headcount requirements into acc...
Responsibilities. Job Summary. Works directly with patients over the phone and interacts with clinical staff. Responsible to schedule, reschedule, cancel, and remind patients on upcoming appointments. Maintains good working relationship within the network of doctors and performs other related duties as assigned. Qualifications. Qualifications and Requirements. High school diploma required. Two years’ experience performing clerical and data entry ...
Responsibilities. Job Summary. Primary Role is to be responsible for the implementation of marketing plans and creation of materials for Medicare Advantage and commercial product lines in collaboration with other members of the marketing team and outside vendors. Must be able to manage multiple projects across many different media under very tight deadlines. Must be proactive with strong organizational skills. Familiarity with all phases of desig...
Responsibilities. Job Summary. Reporting to the Vice President of Information Technology, the Director Information Services is responsible for planning, organizing and directing the functions of the information services department and the operations system support team of the Prominence Health Plan (PHP) companies. Works closely with corporate IS staff to ensure successful implementations and maintenance of existing systems. Ensures the proper co...
Responsibilities. Job Summary. The Member Outreach Representative serves as a call agent reaching out to members to promote quality and wellness programs. The primary function of the outreach agent will be contacting Prominence Health Plan members by phone to inform and educate them on the health insurance offerings, products or services, as well as respond to inquiries and assist with quality improvement and member health assessments. The Member...
Responsibilities. Job Summary. Prominence Health seeks a motivated and patient case-focused Pharmacy Technician to join our Member Outreach Pharmacy Team. The Member Outreach Pharmacy Representative is the liaison between Prominence Health Plan, its members, and contracted providers. The main focus of this position is contacting Prominence Health Plan members by phone to inform and educate them on the health insurance offerings, products, or serv...
