The Managed Care and Program Compliance Coordinator resolves managed care operational issues such as authorization for services, billing, and claims payment. Ensures all clinical operations comply with Medicaid guidelines and other managed care policies. Maintains managed care contracts and educational information databases. .
Large managed care company is looking for a Pharmacist to work with other pharmacists helping with aspects of workflow such as Data Entry Verification and Customer Service. This is a short-term position.WORK LOCATION: N171 W21840 Caymus Ct, Jackson, WI 53037PAY: $65.00CONTRACT DATES: ASAP - 3/13/26HOURS: M-F, 9:30am to 6pmRESPONSIBILITIESProduct VerificationOut of Stock NotificationsReturn to StocksQUALIFICATIONSBachelor's DegreePharmacists Licen...
Large managed care company is looking for a Pharmacist to work with other pharmacists helping with aspects of workflow such as Data Entry Verification and Customer Service. This is a short-term position.WORK LOCATION: N171 W21840 Caymus Ct, Jackson, WI 53037PAY: $65.00CONTRACT DATES: ASAP - 3/13/26HOURS: M-F, 9:30am to 6pmRESPONSIBILITIESProduct VerificationOut of Stock NotificationsReturn to StocksQUALIFICATIONSBachelor's DegreePharmacists Licen...
WHO WE ARE. AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation. . Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you. Are you looking to work for an organization that encourages growth and success from each and every one of its employees. . If so, AIDS Healthcare Foundation is the place for you. . Founded in 1987, AIDS Healthcare Foundation is the ...
The Managed Care and Program Compliance Coordinator resolves managed care operational issues such as authorization for services, billing, and claims payment. Ensures all clinical operations comply with Medicaid guidelines and other managed care policies. Maintains managed care contracts and educational information databases. .
It's more than a career, it's a calling. MO-REMOTE Worker Type: Regular Job Summary: Coordinates provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Attends in-services provided by various health plans. Travels to off-site locations as necessary. Gathers necessary clinical information and processes referrals, pre-certification, pre-determi...
General Description Of Responsibilities. The Adult Case Manager (ACM) provides services that focus on the specific needs of adults with behavioral health diagnoses and decreased ability to function independently in their homes and in the community. The ACM is responsible for developing the client-centered individual service plan to ensure that the services are approved through the Administrative Service Organization (ASO) Managed Care System. The...
Broward Specialtity Surgical Center is seeking a motivated Payment Poster, Full time. Welcome to Broward Speciality Surgical Center at Hollywood, FL. Broward Speciallity Surgical Center is a multi-specialty surgery center committed to producing the highest quality work and experience for patients and their families. Job Summary. Responsible for posting insurance and patient payments in PAS, adjusting account write offs as necessary per the explan...
Key Responsibilities. Implement initial credentialing and re-credentialing functions for employed and contracted practitioners. This would include obtaining Medicare, Medicaid and NPI provider numbers utilizing the PECOS, Medicaid, Availity and NPPES websites. Prepare Credentialing files for FOI Credentialing Committee. This would include completing all required primary source verifications. Maintain timely and accurate practitioner insurance pla...
Key Responsibilities. Implement initial credentialing and re-credentialing functions for employed and contracted practitioners. This would include obtaining Medicare, Medicaid and NPI provider numbers utilizing the PECOS, Medicaid, Availity and NPPES websites. Prepare Credentialing files for FOI Credentialing Committee. This would include completing all required primary source verifications. Maintain timely and accurate practitioner insurance pla...
Key Responsibilities. Implement initial credentialing and re-credentialing functions for employed and contracted practitioners. This would include obtaining Medicare, Medicaid and NPI provider numbers utilizing the PECOS, Medicaid, Availity and NPPES websites. Prepare Credentialing files for FOI Credentialing Committee. This would include completing all required primary source verifications. Maintain timely and accurate practitioner insurance pla...
APR Consulting, Inc. has been engaged to identify a. Referral Coordinator II. . Location. Oklahoma City, OK 73118. Position: Referral Coordinator II. Pay Rate. $21.30/hr. Duration. 13 weeks. Expected Shift. 40 hrs/week. on-site. 7a-4:30p Monday through Friday. Fridays rotate every other week as 8a-1p or 8a-4p. . JOB SUMMARY. Coordinates provider referrals, pre-certifications, and pre-authorizations for managed care insurance plans. . PRIMARY RESP...
