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- ...Technician - ASP is a professional in charge of receiving and processing medical prescriptions. They will attend to the patient with the... ...system to obtain patient and medication information to process claims to medical plans in a timely and efficient manner. Assist new...Claims
Alivia Health
Puerto Rico24 days ago - ...authorization requests, drug use review, among others, to ensure that claims are correctly and timely adjudicated. Essential Functions:... ...system overrides (e.g., prior authorization) on the PBM claims processing system to ensure that claims are correctly adjudicated. 5....Claims
APS Health Care PR
Puerto Rico25 days ago - ...admission, completion of patient demographic sheets, preparation of claim forms, keeping record of patient appointments and visits,... ...clinic daily utilization. 8. Collaborates with the EMR audit process. 9. Complies with all guidelines established by the Centers for...Claims
APS Health Care PR
Puerto Rico6 days ago - ...DUR research; # Award and review prescription drug insurance claims that will be delivered to patients and providers; Other duties... ...personal attention, and an efficient, transparent and simple process from end to end. The CM must tend to the Patient’s needs,...Suggested
Alivia Health
Puerto Rico24 days ago - ...change agent. Working directly with various business areas—such as accounting, underwriting, claims, sales, and operations—this specialist identifies manual or repetitive processes and helps users redesign them using AI tools. This is not a lab-based role but a field-...ClaimsInternshipFlexible hours
Optima Seguros
Puerto Rico5 days ago - ...support critical operations—ranging from business and back-office processes to interactions with customers, brokers, and partners. We are... ...Engage with internal platform users—teams across underwriting, claims, customer service, finance, and operations—to understand...ClaimsFlexible hours
Optima Seguros
Puerto Rico5 days ago - ...maturity, efficiency, and scalability by establishing risk-based processes, standards, methodologies, and technology-enabled solutions... ...responsible for verifying the credentials of any third party claiming to represent the company. Any reliance on fraudulent communication...ClaimsFull timeWork at officeLocal areaImmediate start2 days per week
- ...partner sites and product lines, identifying design, materials, and process opportunities to reduce total product costs and improve... ...are responsible for verifying the credentials of any third party claiming to represent the company. Any reliance on fraudulent communication...ClaimsFull timeContract workWork at officeLocal areaImmediate start2 days per week
- ...evaluating customer Change Request Items (CRIs) within planning processes. Ensure preconditions for End of Lease transition are... ...information flows and complete documentation. Ensure warranty claims, invoice clarifications, and disputes between LTPR and the customer...ClaimsContract workFlexible hoursShift work
Lufthansa Technik
Puerto Rico5 days ago - ...designs support efficient assembly, pack-out, storage, and shipping processes.Review and respond to packaging-related production issues from... ...responsible for verifying the credentials of any third party claiming to represent the company. Any reliance on fraudulent...ClaimsFull timeContract workWork at officeLocal areaImmediate startWorldwide2 days per week
- ...oriented Python and Perl, Linux environments, and manufacturing test processes.In this role, you will develop scalable and reliable test... ...responsible for verifying the credentials of any third party claiming to represent the company. Any reliance on fraudulent...ClaimsFull timeWork at officeLocal areaImmediate start2 days per week
- ...of cost, direction and people management. Provides guidance on process improvements and recommends changes in alignment with business... ...are responsible for verifying the credentials of any third party claiming to represent the company. Any reliance on fraudulent...ClaimsFull timeWork experience placementWork at officeLocal areaImmediate start2 days per week
$21 per hour
...This role investigates Health Insurance Waste and Error stopped claims by gathering information, researching state and federal... ...operations and procedures to ensure data integrity, data security and process optimization Investigate, recover, and resolve all types of...ClaimsHourly payFull timeContract workTemporary workRemote workMonday to Friday- ...manage the overall implementation, execution, and completion of the process while ensuring consistency with company strategy, commitments,... ...approach. Participate in E2E testing to ensure that claims processing requirements documented in the requirements gathering...ClaimsLocal areaVisa sponsorshipWork visaFlexible hoursAfternoon shift
Abarca Health LLC
Puerto Rico6 days ago - ...needed. Help with backroom duties, i.e., auto-load, returns, stock, etc., as needed. Assist with customer labor claims, making sure they are processed quickly and efficiently. All other duties as assigned. Skills/Education/Knowledge/Experience/Abilities...ClaimsLocal areaFlexible hours
$100k - $120k
...required to review project documentation, insurance policy details, claims settlements and other related documents that may be related to... ...or religious purposes in connection with the application process should contact ****@*****.*** for assistance.Working...Full timeContract workWork experience placementLive inWork at officeLocal areaRemote workWork from homeHome officeFlexible hoursAfternoon shift- ...management and be a key asset in operational efficiency increases and process improvements through data analysis and reporting.... ...contracts and reimbursement paid in the principal payors of PBM claims and inform respective department heads for correction as needed...Claims
- ...all back up. If payment center, make sure all is submitted as process in place. Revise BOL’s once the cargo is delivered or picked... ...short or damages cargo upon arrival. Notify cargo damage to claims department with corresponding backup. Responsible to manage...ClaimsImmediate start
$60k - $80k
...insurance companies, and guiding clients through the pre-litigation process with professionalism and empathy. This position is ideal for... ...Key Responsibilities: Manage a caseload of personal injury claims from intake through settlement. Evaluate cases for liability...ClaimsWork at office- ...health plan environments , with a solid understanding of pharmacy claims, eligibility, benefits, accumulators, and the systems and data... ...-gathering sessions, stakeholder interviews, workshops, and process reviews. Document business requirements, functional requirements...ClaimsContract workRemote work
- ...# Answer incoming pharmacy calls regarding issues related to a claim transaction, reimbursement, payment, and other required information... ...# Guide pharmacies, providers and beneficiaries regarding the process of claim transmission, reimbursement and payment. # Constantly...Claims
- ...deep expertise in Provider Data Management, Provider Operations, Claims, Credentialing, Contracting, and Healthcare Payer Operations,... ...provider credentialing, provider contracting, and provider onboarding processes. Partner with business leaders, Plan Presidents,...ClaimsFull timeContract workRemote work
- .../operations using radio communications • Organize ticket and cash reports • Handle delayed or missing baggage and process claims • Assure compliance with FAA and airport security procedures • Meet and marshal aircraft • Fueling Cape Air aircraft...ClaimsWork experience placementRemote workNight shiftWeekend work
- ...database. Obtain additional information from other investigative agencies and databases. Receive, suspense petitions, claims, and process requests. Reconcile inconsistencies. Gather information and organize investigative packages. Verify case files and case...ClaimsLocal area
- ...cancellation, disenrollment, service issues, missing ID card, benefits orientations, and claims, among others). Perform excellent orientation to assist members on the change of coverage process. Identify member grievances and appeals and resolve them in accordance to CMS...ClaimsFull timeImmediate start
$70 - $80 per hour
...us or for us as part of an application, interview, or selection process. Provide sensitive financial information such as credit card... ...If you receive a suspicious message, email, or phone call claiming to be from OpenKyber do not respond or click on any links. Instead...ClaimsFull timeContract work- ...including insurance eligibility verification, prior authorization processes, and Patient Assistance Program (PAP) activities. This role... ...exceptional service. • Support team operations by assisting with claim reversals, list movements, void processes, workflow...ClaimsWork at office
$13 per hour
...support to providers through live chat, to give updates on their members eligibility status or claims status and validates state specific requirements for claims and benefits processing. Focus on resolving issues on the first call, navigating through complex computer...ClaimsHourly payTemporary workWork at officeLocal areaShift work- ...PharmPix clients. The Benefit Configuration Specialist I will test claims and perform quality assurance reviews to ensure desired results... ...and take corrective action. #Research and respond to claims processing and system configuration inquiries from internal departments...ClaimsWork experience placementWork at officeImmediate startWeekend workAfternoon shift
- ...communicate findings to the Supervisor to identify and implement process improvements. \n Anticipate future needs based on consumption,... ...related to inventory discrepancies. \n Support return, claims, or merchandise disposal processes in accordance with company policies...ClaimsImmediate startRelocationWeekend work
