Viewing 1 - 10 of 12 jobs
States. St. Lukes offers a full range of healthcare services and programs, with a strong emphasis on surgical services, including cardiovascular, neurological, orthopedic, and bariatric procedures. The hospital utilizes some of the most...
local Hospital Staff and the Regional Project Managers for IASIS facilities in their assigned region. This position ... States. St. Lukes offers a full range of healthcare services and programs, with a strong emphasis on surgical...
This position is responsible for reporting and analysis of medical claims, PCP profiles, enrollment, and Hedis data using Excel, Access and SQL. The incumbent must be comfortable with large amounts of data and the use of extensive excel...
Research and resolve outstanding claim payment/denial issues, status provider claims, handle member claim issues, oversee the correction of claims adjudicated in error and resolve and correct claim encounter errors. Qualifications High...
Adjudicate and determine payment of claims to meet time frames determined by Health Choice Arizona, contractual agreements and AHCCCS. Prescreen all claims types for appropriate coding and documentation. Apply policies and procedures to...
Make outbound retention calls to primarily Medicare members, to avoid churn, and increase membership retention rates. Provide customer service for members by completing all necessary paperwork, taking a fair share of calls, answering...
The Community Outreach Liaison conducts outreach to both current and potential members, participates in outreach events, assists the Outreach Supervisor in planning outreach activities, supports member retention programs, establishes and...
Ensure the quality and efficiency of processing membership Transaction in collaboration with the Member Services Management team by assisting in all aspects of the enrollment/disenrollment process by following reporting requirement and...
Performs routine cleaning of patient rooms, nursing units, offices, clinical areas, waiting areas, lobbies, lounges, rest rooms, corridors, elevators and stairways in a clean, neat and sanitary manner. Qualifications High School...
This role is responsible for securing data integrity and includes the following duties: auditing claims for accuracy; auditing provider demographics information; performing weekly random quality audits of UB04s, dental and HCFA 1500s...