Execute and manage a set list of rotating task assignments centered on monitoring incoming and outgoing files, and data syncing across systems.
Understand and facilitate account structure updates for eligibility and accumulator requirements. Validate system configurations for accuracy by monitoring inbound files from external partners.
Monitor ongoing operations and provide troubleshooting support for our claims adjudication processes including eligibility, accumulators, reporting, and syncing of systems with data.
SmithRx is a rapidly growing Health-Tech company aiming to disrupt the Pharmacy Benefit Management (PBM) sector. With hundreds of thousands of members onboarded since 2016, they have a mission-driven and collaborative culture.
Review, analyze, and reconcile pharmacy claims and payments data.
Configure vendors for payment processing in our financial system.
Ensure accurate and timely processing of pharmacy, member, and provider payments and remittances.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They have full-service health benefit management solutions and consolidate all claim administration-related workflows in one scalable, secure platform.
Support the Regional Sales team with back-office administration and agent interactions.
Assist with sales pipeline updates and maintain sales scorecards.
Manage and resolve day-to-day operational queries from both Sales and Agents.
Western Union is a global financial services company that provides money transfer and payment services. They have over 8,000 employees serving 200 countries and territories, with a focus on diversity and inclusion.
Conduct research and provide problem-solving support to the Customer Service Department, Brokers and Sales.
Provide efficient, courteous, professional quality service to Groups, Plan personnel and Brokers/Sales in a timely manner.
Ensure compliance with organizational and regulatory requirements.
They promise to go the extra mile for their team and community. Capital Blue Cross values your professional and personal growth by investing heavily in training and continuing education.
Support stakeholders with the quoting and contracting process for direct and partner agreements offline or Salesforce CPQ, as appropriate.
Assist the Sales teams with deal crafting, strategies, and best practices to drive growth, deal velocity, and revenue.
Identify opportunities for process automation and optimization, with a focus on scalability and driving significant growth.
Amwell is transforming healthcare for all through technology and innovation. They are dedicated to providing convenient, affordable, and effective care, and they are passionate about making healthcare more equitable and accessible.
Conduct high-volume outbound and inbound calls with patients, providers, and pharmacies.
Collaborate with patients to identify and remove barriers to medication adherence.
Accurately document all interactions, outcomes, and identified barriers in appropriate systems.
Aledade empowers independent primary care practices. They were founded in 2014 and have become the largest network of independent primary care in the country, with a collaborative, inclusive, and remote-first culture.
Provide subject matter expertise support on Judi’s function and reporting capabilities related to prior authorization
Take accountability for accurate translation of reporting requirements for Capital Rx’s customers
Support analytics and reporting needs for the prior authorization team and related groups
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They have full-service health benefit management solutions to employers, TPAs, and health plans, with the industry’s leading proprietary Enterprise Health Platform.
Manage Five9 user profiles, skills, campaigns, and IVR scripts.
Utilize SQL to query, manage, and audit contact center data.
Resolve platform issues, connectivity problems, and integration errors.
I am sorry, but I am unable to find enough information about the company from this job description to fulfill this request. I need more context to provide an accurate company description.
Own and maintain sales reporting, dashboards, and operational playbooks.
Drive process optimization and enablement initiatives, including onboarding, training materials, and SOPs.
Partner with Sales leadership and collaborate cross-functionally to align systems, processes, and reporting across the sales lifecycle.
Clover Health is reinventing health insurance by combining the power of data with human empathy to keep members healthier. They have custom software and analytics to empower clinical staff, putting members first, with passionate and mission-driven individuals.
Troubleshoot and resolve issues related to customer transactions.
Manage transaction statements to perform reconciliations of company assets.
Develop, maintain, and improve operational policies, processes, and procedures to enhance efficiency.
Xapo Bank aims for economic freedom and wealth protection for all, regardless of location. They are a fully distributed team of over 130 employees, working remotely from 30+ countries, fostering a culture of hard work, global thinking, and mutual inspiration.
Answer inbound calls and return voicemails from members, delivering exemplary customer service and support.
Troubleshoot and resolve prescription-related issues for members whose plans utilize CVS or Carelon as the PBM.
Coordinate with providers’ offices and retail/mail-order pharmacies as needed to resolve claims processing, prior authorization, and medication access issues.
Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. They focus on cost containment strategies and driving down the cost of plans with innovative solutions. Point C provides equal opportunity in all employment practices.
Lead and supervise a team of external Customer Experience Agents across email, chat, and phone channels.
Set clear performance expectations, KPIs, and quality standards; conduct regular coaching and feedback sessions to support team development.
Serve as the initiation escalation point for high-impact customer issues, directly responding to customer inquiries in a timely and professional manner.
NBCUniversal is one of the world's leading media and entertainment companies. We create world-class content, which we distribute across our portfolio of film, television, and streaming, and bring to life through our global theme park destinations, consumer products, and experiences.
You'll be a foundational part of our Client Support team, ensuring our software runs smoothly from the moment a new client is onboarded throughout their journey with us.
Use your technical skills to directly impact the online reputation and profitability of medical practices across the country.
Energized by solving technical puzzles and thrive on being the go-to expert, looking to grow into being a leader of the team and who makes clients successful.
Rater8, the healthcare industry’s leader in reputation management, helps medical practices establish pervasive online visibility. Based in the United States, rater8 is a rapidly growing healthtech innovator, serving over 25,000 providers at practices and hospitals of all sizes and specialties, and providing unlimited career growth and pay opportunities for its employees.
Manage the migration of data from existing systems into the platform.
Collaborate across teams and facilitate consultations with customers.
Clean, format, and manipulate data to ensure accuracy and consistency.
Houzz is the leading platform for home remodeling and design, providing an all-in-one software solution for industry professionals and tools for homeowners to update their homes from start to finish. Houzz is a community-centric, innovative tech company that continues to disrupt the home renovation and design industry.
Responsible for being the main point of contact for TPA (an external client) for new group implementations.
Ensure all requirements are documented in the standard project templates and tools.
Manage day to day coordination and task managements for a pod of Implementation Managers and/or Implementation Specialists to maintain workplace productivity.
SmithRx is a rapidly growing, venture-backed Health-Tech company aiming to disrupt the Pharmacy Benefit Management (PBM) sector. They accomplish this through technology and customer service, with a mission-driven and collaborative culture that inspires employees.
Be accountable for Partner satisfaction and relationship
Build trusting relationships with Partners’ operational leadership
Maintain a comprehensive understanding of business and technical challenges faced by customers
SmithRx is a rapidly growing, venture-backed Health-Tech company. Their mission is to disrupt the expensive and inefficient Pharmacy Benefit Management (PBM) sector. They pride themselves for their mission-driven and collaborative culture that inspires their employees to do their best work.
Establish and monitor performance metrics to measure the reliability and latency of payer data feeds.
Serve as the primary point of escalation for high-priority payer data issues, coordinating with various teams.
Oversee the documentation and submission processes for clinical data extracts to ensure audit readiness.
Aledade empowers independent primary care practices to deliver better patient care and thrive in value-based care. As the largest network of independent primary care in the country, they focus on creating value-based contracts, strengthening care continuity, and aligning incentives to ensure physicians are paid for keeping patients healthy.
Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations and enhanced service delivery. Based in Alexandria, Virginia, they support more than a dozen agencies including Veterans Affairs, Transportation, Defense, Homeland Security and the National Science Foundation and have 300+ employees.
Enters data into scheduling and billing software for all incoming surgical cases received from facilities and surgeon office staff via email, fax, or phone calls.
Identifies and resolves any discrepancies, conflicts, or missing information through communication with facilities and surgeon office staff.
Posts cases according to division specific requirements to include general patient demographics, procedure, diagnosis, location, time of case, and estimated time required for completion.
US Anesthesia Partners, Inc. provides anesthesia related services. They are committed to equal employment opportunities and value diversity.
Respond to client inquiries and provide timely updates on prescription status
Monitor prescription workflows and proactively flag delays or discrepancies
Assist with reshipments and coordinate issue resolution with internal teams
Precision Medicine is revolutionizing healthcare by providing accessible, personalized, and efficient healthcare solutions. They value diverse perspectives and foster an environment where employees can thrive, innovate, and make a meaningful impact on patients’ lives.