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Medical Claims Examiner Jobs in San Juan, Puerto Rico

Currently, there are no Medical Claims Examiner jobs available in San Juan, Puerto Rico which match this search. You may wish to explore similar job titles on the Healthcare jobs in Puerto Rico page or view related jobs below.
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Casualty Claims Adjuster Job Posting Number: 15122 Company: Crawford Location: Rio Piedras, Company: Crawford Location: Rio Piedras, Based in Atlanta, Ga., Crawford & Company (www.crawfordandcompany.com) is one of the world's largest independent provider of claims management solutions to the risk management and insurance industry as well as self-insured entities, with an expansive global netw...
Based in Atlanta, Ga., Crawford & Company (www.crawfordandcompany.com) is one of the world's largest independent provider of claims management solutions to the risk management and insurance industry as well as self-insured entities, with an expansive global network serving clients in more than 70 countries. Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V ...
POSITION DESCRIPTION The Utilization Data Analyst is responsible for the design, development and analysis of complex reports, queries and data extracts from multiple data sources and assist the organization to better understand Medicaid contract deliverables, provider and managed care trends including but not limited to population health, quality of care, utilization and access to healthcare. Th...
Puerto Rico Medical Director Requisition ID 161546 Business Overview Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities ...
Role: Puerto Rico Medical Director Assignment: Senior Products Location: San Juan PR Humana’s dream is to help our members and our own associates achieve lifelong well-being. Use your clinical experience to work with patients and providers in a nontraditional environment where your knowledge will make a difference. Our associates know their work is vitally important; we strive to ensure we prov...
The Bankruptcy Junior Associateis in charge of validating personal information, customer’s accounts in the Bankruptcy Court (PACER), filing Proof of Claims, calculating sufficiency of Chapter 13 plans, answering disputes and solving account doubts for the Call Center and to customers along with their supervisor. Duties & Responsibilities · Receive Bk notifications (from SHAW or BANKO) and evalua...
JOIN OUR TEAM! A leading financial institution setting the pace through its commitment to corporate values and a superior client satisfaction, seeks a qualified candidate to join its BANCO POPULAR team of successful professionals in Puerto Rico for the following position: Service Representative Fraud Risk Control Retail Banking Group General Description: It is responsible for detection of po...
Requisition ID 694812BR Job Title Merchandise Claims & Control Associate Business Stores - Kmart Hourly Job Function Asset Protection/Loss Prevention Employment Category Regular, Full-time Sears Req Type Hourly Job Description Jobs in this category are responsible for accumulating and processing items that are returned by customers and those authorized for return to vendors for credit. In ad...
Full Time Technician Staffing Positions Integrated Service Solutions, Inc., located in Pennsylvania, USA is recruiting for two (2) technicians: a Metrology Technician and a Process Mechanic. Currently both positions are located in Pennsylvania. Initial interviews held via Skype or Facetime or Phone METROLOGY (Calibration Technician) Job Summary: We are recruiting for an experienced Calibrat...
CARING ONE LLC Telehealth RN Job Description Caring One is a leading provider of healthcare information services for hospitals, MCOs, TPAs, and other healthcare provides, enabling them to manage cases, supervise treatment plans, obtain patient information, and improve patient outcomes. Our mission is to help healthcare organizations accomplish their patient and client service objectives through ...
CARING ONE LLC Utilization Review Nurse Caring One is a leading provider of healthcare information services for hospitals, MCOs, TPAs, and other healthcare provides, enabling them to manage cases, supervise treatment plans, obtain patient information, and improve patient outcomes. Our mission is to help healthcare organizations accomplish their patient and client service objectives through globa...
Job Summary: Responsible for improving, enhancing, and maintaining efficiency, system availability controls, and manufacturing processes in control to maintain performance levels of each process. Actively support operational excellence practices and continuous improvement processes to ensure compliance with the regulations of the quality systems. Knowledge/Skills/Abilities: · Work on such issue...
Job title Department Location Sales Professional Sales San Juan, Bayamón, Ponce, Caguas and Cayey Position Summary: Develop sales strategies by identifying customer needs and identifies business opportunities, marketing products in and out of the dealers. Overcome customer objections and effectively resolve customer concerns. Benefits: Hourly Salary Commission and Bonus Plan Car Allowan...
Job Title: Business Intelligence Developer Location: San Juan, PR. Description: The incumbent will be responsible for developing & implementing the sales & marketing strategies focusing but not limited for Qlikview in a business-to-business environment. Perform detailed analysis of source systems & source system data & model that data in QlikView. Design, develop, & test QlikView scripts to imp...
As the only global provider of commercial solutions, Quintiles understands what it takes to deliver nationally and internationally. Our teams help biopharma get their medicines to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product's value to payers, physicians and patients. A significant part of our business is acting as th...
A Leading Manufacturer in the East Coast of PR is looking for a candidate to perform as Supplier Quality Engineer under a long term contract. SQE is responsible for the maintenance and continuous improvement of the supplier management program within Quality System. The scope of the position encompasses, but is not limited to supplier assessment and establishment of effective process controls to i...
Wanted: Enthusiastic doers and thinkers Aflac Insurance Sales Agent While a career in sales may not be for everyone, those who have been successful say it's been one of the most rewarding ventures of their lives. So what do these people have in common? They're problem solvers. They share the desire to help people. And they have a good work ethic. As an independent consultant backed by Aflac, you...
SUPERVISORY MECHANICAL ENGINEER San Juan, PR Duties: Duty Location: VA Caribbean Healthcare System  San Juan, PR Responsible for the management of the maintenance and repair of buildings, grounds and utility systems, building service equipment, personal property, air conditioning, refrigeration and ventilation systems, boiler plant and steam distribution systems, laundry plant systems, all pi...
Shift: 8am-5pm M-F and possibly Saturdays (Until inventory is under control). 3 month minimum assignment; extension of assignment a possibility depending on results/work load). There is a chance to be converted to FTE depending on business needs Duties: They will be working side by side with A&G Clinical nurses completing cases that were denied in the Pre-Authorization process and appealed by mem...
Program Specialist San Juan, PR Duties: The Program Specialist is primarily responsible for the coordination, management and review of the VA Community Care, Non VA Care/Choice/Choice First/Providers Agreement processes; which include verifying appropriateness of Non VA Care/Choice/Choice First/Providers Agreement consults, review of unauthorized claims, assists Non VA Care/Choice/Choice First/...