The Utilization Management Assistant answers first-level calls to evaluate certification requests and triage them for nursing review. They are responsible for reviewing medical records and coordinating with healthcare providers to ensure patients receive appropriate, cost-effective care.
The Utilization Management Assistant evaluates certification requests by reviewing group requirements and triaging calls to determine if a nurse is needed. They are responsible for reviewing medical records, coordinating with healthcare providers, and ensuring patients receive appropriate, cost-effective care.
The Utilization Management Assistant handles initial calls for health participants and evaluates certification requests against group requirements. They are responsible for reviewing medical records, coordinating with healthcare providers, and ensuring patients receive appropriate, cost-effective care.
The adjuster will investigate, evaluate, negotiate, and settle workers compensation claims on behalf of clients. They are responsible for managing the full lifecycle of claims, including taking statements, paying lost wage benefits, and handling litigation.
The Salesforce Administrator will serve as the primary owner of the platform, managing system configuration, automation, and data integrity. They will partner with business stakeholders to translate needs into scalable solutions and drive user adoption through training and documentation.
The adjuster will manage commercial auto liability bodily injury claims in a fast-paced environment. They are responsible for investigating and resolving claims while maintaining compliance with relevant laws and regulations.
Manage a caseload of general liability claims, specifically focusing on construction defect exposures. Investigate, evaluate, negotiate, and resolve claims while collaborating with various stakeholders to ensure fair and timely outcomes.
Handle inbound and outbound telephonic calls to participants enrolled in the Condition Management Program. Assist participants via email and online messaging while accurately documenting all communications.
Handle inbound and outbound telephonic communications with participants enrolled in the Condition Management Program. Assist participants via email and online messaging while accurately documenting all communications.
The RN Case Manager provides telephonic case management and utilization review to ensure quality and cost-effective outcomes for consumers. They develop individualized care plans and collaborate with healthcare providers and payors to coordinate care.
The RN Case Manager provides comprehensive case management and utilization review to ensure quality and cost-effective outcomes for consumers. This includes developing individualized care plans and collaborating with healthcare providers and payors.
The Account Manager serves as the primary contact for brokers and clients, ensuring inquiries are handled promptly and accurately. They coordinate with internal departments to manage renewals, mid-year changes, and Open Enrollment support.
The role involves providing expert advice and guidance to clients in navigating employee benefits insurance and programs. The individual will evaluate complex insurance plans and identify cost-saving opportunities.
The primary responsibilities include leveraging and expanding the network with channel partners and developing effective employee benefit solutions. The role also involves meeting and exceeding sales and retention targets.
The Sales Executive will be responsible for writing more business by leveraging access to markets, tools, and expertise. They will also work with a service team to ensure client retention.
The Licensed Service Representative will answer customer inquiries regarding benefits plans and process medical and dental claims. They must also navigate multiple record-keeping systems and retain large amounts of technical information.
The Account Executive will act as the primary point of contact for clients, managing their accounts and addressing coverage gaps. They will also lead risk analysis and present strategies to ensure client satisfaction.
