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A&G Case Specialist
Eingestellt von Synectics
Gesuchte Skills: Cms
Projektbeschreibung
- The A&G specialist will receive, investigate and resolve member and provider complaints and appeals exercising strong independent judgment.
- The position will provide resolution of complaints in compliance with CMS, DMHC, MBMIB and NCQA regulatory requirements.
- The A benefit coverage appeals and reconsideration, complex provider claims and disputes.
- Responsible for maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting noncompliance, adhering to company policy and procedures, including accreditation requirements, applicable federal state and local laws and regulations.
SKILLS:
QUALIFICATIONS
- Pharmacy technician specialist
- Requires strong knowledge of regulatory standards and claims processing; strong analytical, oral, written and presentation skills, able to monitor and be compliant with strict regulatory deadlines.
Projektdetails
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Einsatzort:
Los Angeles (Downtown), Vereinigte Staaten
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Projektbeginn:
asap
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Projektdauer:
Keine Angabe
- Vertragsart:
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Berufserfahrung:
Keine Angabe
Geforderte Qualifikationen
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Kategorie:
Webentwicklung