Grievance/Appeals Rep I

Position Title:Customer Care Rep I (PHL)Shift:Job Description:Responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery. Primary duties may include, but are not limited to: Responds to...

Position Title:Customer Care Rep I (Q4)- ManilaShift:Job Description:Responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues.Must pass the appropriate pre-employment test battery.  Primary duties may include, but are not limited...

Position Title:Customer Care Rep II - ManilaShift:Job Description:Responsible for responding to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. Proficient in all basic customer service areas performs some but not all types of moderately complex function. Must be able to...

Position Title:Nurse Medical Mgmt I (PHL)Shift:Job Description:Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient...

Position Title:Nurse Medical Mgmt IShift:Job Description:Responsible for collaborating with healthcare providers and or members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources for more complex medical issues. Ensures medically appropriate, high quality, cost effective care through assessing the...

Role Description UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members’ well‑being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve...

Overview RELX Telesales Rep I role located in Quezon City, National Capital Region, Philippines. Responsibilities Initiate outbound sales contact directly to prospective or assigned call lists to schedule qualified demonstrations, meetings, build pipeline, and produce real business opportunities and convert sales in accordance with approved sales management...

Position Title:Customer Care Rep I - IloiloShift:Job Description:Responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery.  Primary duties may include, but are not limited to:Responds...

Acting in a quality assurance capacity, Appeals and Grievances Analysts are responsible for processing appeals and grievances by evaluating the organization's initial decisions against CMS guidelines and enrollee benefits, by preparing a detailed summary statement of the appeal or grievance case, including research to substantiate the appeal or grievance,...

Job DescriptionThe Patient Service Center Representative I is responsible for creating a positive patient experience by accurately and efficiently handling the day-to-day operations relating to a patient's anticipated appointment. The PSC REP I may be assigned to either the financial clearance function or the scheduling function and is expected to maintain...