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Results based on filters ( 8 jobs found )

Research Analyst

Keystone First
Located in Ohio
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Your career starts now. We are looking for the next generation of health ...
Details
Summary
About the job:
care leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Claims Examiner

Keystone First
Located in Ohio
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Description: The Claims Examiner reports to the Supervisor of Claims. The ...
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Summary
About the job:
Claims Examiner is responsible for reviewing and adjudicating claims based on provider and health plan contractual agreements and claims processing guidelines. Responsibilities: Complies with all internal processes and procedures to ensure activities are handled in accordance with departmental and company policies and procedures. Review, research, analyze, and process complex healthcare claims by navigating multiple computer systems and platforms and accurately capturing the data/information for processing (e.g. verify...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Claims Adjusters, Examiners, and Investigators
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Customer Service Representative

Keystone First
Philadelphia, PA
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MUST LIVE IN OR NEAR PHILADELPHIA, PENNSYLVANIA, TO QUALIFY FOR ...
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Summary
About the job:
CONSIDERATION Responsibilities: Under the direct supervision of the operations supervisor, the customer service representative is responsible for responding to a diverse membership and their providers, as well as other customers, in a timely, professional, and courteous manner. This includes inbound and outbound member and/or provider phone calls or correspondence regarding benefits, eligibility, or customer issues. Makes outreach welcome calls to new members and conducts Health Risk Assessment Surveys as needed. Provides member...
Location:
Philadelphia, PA
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Provider Claims Service Representative

Keystone First
Philadelphia, PA
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Responsibilities: Under the general direction of the Operations Call Center ...
Details
Summary
About the job:
Supervisor, responsible for responding in a timely, professional and courteous manner to all customer needs. This includes provider phone calls or correspondence regarding benefit, eligibility, and other provider issues. Reviews and adjudicates claims based on provider and healthplan contractual agreements and claims processing guidelines. Serves as a Subject Matter Expert. Conducts cross training to staff as required. Demonstrates solid knowledge of Provider Service/Claim systems, functions and team process....
Location:
Philadelphia, PA
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
Keystone First
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Specialty Pharmacy Technician

Keystone First
Orlando, FL
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PerformSpecialty is a full-service specialty pharmacy. Our goal is to ...
Details
Summary
About the job:
provide personalized patient care and better access to achieve healthier outcomes. Each patient works with a Patient Care Coordinator who, along with the prescriber, creates a program to treat each condition individually and works to involve the patient in his or her own health. We know that successful treatment requires payers, patients, and pharmacies to work together. That’s why we provide patients and payers with access to the most up-to-date information, 365 days a year. From our team of clinicians working around the...
Location:
Orlando, FL
Job Type:
Full-Time
Permanent
Occupation:
Pharmacy Technicians
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
Keystone First
Certifications / Licenses:
Certified Pharmacy Technician
National Healthcareer Association
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Supervisor Service Coordinator

Keystone First
Philadelphia, PA
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Your career starts now. We are looking for the next generation of healthcare ...
Details
Summary
About the job:
leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. We want to connect with you if you're going to...
Location:
Philadelphia, PA
Job Type:
Full-Time
Permanent
Occupation:
Healthcare Social Workers
Career Level / Education:
Master's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
Licensed Social Worker
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Network Contractor Provider Network Management - Exchange product

Keystone First
Baton Rouge, LA
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Job Summary The primary responsibility of the Network Contractor is ...
Details
Summary
About the job:
contracting providers, the contracting and re-contracting of providers in an established market. Work Arrangement: Field based within Louisiana. May live anywhere within the state of Louisiana. Some travel required throughout the state visiting providers. Essential Functions - Supports network development strategy. - Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication. - Responsible for negotiating contracts to execute on network strategy and ensure...
Location:
Baton Rouge, LA
Job Type:
Full-Time
Permanent
Occupation:
Business Operations Specialists, All Other
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Keystone First
Certifications / Licenses:
National Committee for Quality Assurance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Manager Provider Network Management

Keystone First
Washington, DC
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Responsibilities: Responsible for managing the day-to-day activities of the ...
Details
Summary
About the job:
DC Medicaid Plan Network Management department and staff. Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication. This position is also responsible for all provider network recruiting and contracting management activities as it relates to the DC Medicaid Plan. Ensures that the department and staff remain current in all aspects of Federal and State rules, regulations, policies and procedures and creates or modifies departmental policies to...
Location:
Washington, DC
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Keystone First
Certifications / Licenses:
National Committee for Quality Assurance
Advanced Certification Administrator
Driver's License
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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