Empleos de documentation en San Juan

Regular Non-Exempt **GENERAL DESCRIPTION:** Responsible for receiving, registering, and forwarding requests for organizational determination and/or any associated clinical documentation or documentation for the clinical management of the insured. Works with the authorizations of services already predetermined through the automatic process using...

Regular Exempt **GENERAL DESCRIPTION:** Analyzes, investigates, supports, and answers Grievances, Dental Pre-Service, and Payment Appeals filed by members, insureds, Providers, and/or Non-Part Providers within the time stipulated contractually for both Lines of Business (LOB)and following the terms stated in the contracts established and the...

**About the Role** Our client is seeking a **Legal HR Generalist** to join the Human Resources team. This opportunity is ideal for a professional who is currently pursuing a Juris Doctor (JD) and has an interest in developing a career at the intersection of Human Resources, employment law, and employee relations. The selected candidate will work closely...

Regular Exempt **GENERAL DESCRIPTION:** Provides education to internal and external clients on operational topics that promote efficiency in the process executed by our providers and business partners, such as the Risk Adjustment payment model “CMS-HCC”, ensuring best practices in coding standards and clinical documentation within the medical...

Regular Non-Exempt **GENERAL DESCRIPTION:** The Beneficiary Value Program Efficiency Clerk is responsible for the accurate classification, registration, and monitoring of operational items related to Te Paga within designated electronic portals. The Clerk ensures items are properly categorized, validated, documented, and escalated when issues...

Regular Exempt **GENERAL DESCRIPTION:** Responsible for the ongoing monitoring of all elements of the Special Needs Plan Care Coordination (SNP-CC) as needed to comply with regulatory requirements and quality indicators. Evaluates care coordination frameworks, identifies risks and improvement opportunities, supports audit readiness, and works...

We are seeking an organized, proactive, and detail-oriented Executive Assistant to provide high-level support to senior management. The selected candidate will be responsible for managing schedules, coordinating meetings, handling communications, and assisting with the preparation of documents and presentations, ensuring effective follow-up on executive...

**GOVERNANCE, RISK & COMPLIANCE (GRC) ANALYST** **CORPORATE IT SECURITY** **FIRSTBANK PR** **Our Company** At **FirstBank PR** , we strive to be trusted advisors to our clients, and our employees are the ones that ensure we deliver on our promise of excellence in personalized customer service. Our more than 3,100 employees in Puerto Rico, the Virgin...

Regular Non-Exempt **GENERAL DESCRIPTION:** Supports daily unit operations by completing document intake, evaluation, classification, and distribution processes. Provides guidance to technicians, resolves escalated issues, and acts as a liaison between internal and external teams to ensure efficient workflow and service delivery. Monitors...

Regular Non-Exempt **GENERAL DESCRIPTION:** Responsible for receiving, registering, and forwarding applications received within the unit to certify the chronic conditions of beneficiaries for a chronic product. Responsible for the confirmation of chronic conditions for the C-SNP plan members. Enters data from health status and risk factor...

Regular Exempt **GENERAL DESCRIPTION:** The Beneficiary Value Program Efficiency Manager leads the strategic planning, customer management, “Te Paga” initiatives, and investment efforts aligned with the company’s corporate strategy. Ensures seamless integration of technical and operational requirements to support internal and external...

Regular Non-Exempt **GENERAL DESCRIPTION:** The Customer Service Representative I – CC is responsible for providing excellent service when answering requests from policyholders, members, and providers through phone calls received. Solves situations or service needs, channeling them through the established operational processes and service...

Regular Non-Exempt **GENERAL DESCRIPTION:** Calls medical offices to request, receive by fax, and register documents contained in the medical records of Classicare policyholders, as required and according to the different initiatives worked on in the unit. Refers documents received by the medical offices to the Risk Assessment unit, to complete...

Regular Exempt **GENERAL DESCRIPTION:** Responsible for seeking out new prospects to present the company's products and ensuring appropriate follow-up until the sales cycle is completed, to meet the company's established goals. Research and stay updated on new trends within the industry and commercial sales processes. **ESSENTIAL...

Temporary - AEP Non-Exempt **GENERAL DESCRIPTION:** The Customer Service Representative I – SC is responsible for assisting customers and prospects with information about the company's products and services. They address and clarify any questions from beneficiaries who have concerns. Resolves service needs by following established...

At Fluor, we are proud to design and build projects and careers. We are committed to fostering a welcoming and collaborative work environment that encourages big-picture thinking, brings out the best in our employees, and helps us develop innovative solutions that contribute to building a better world together. If this sounds like a culture you would like to...

PACIV, a global leader in industrial automation solutions servicing the Life Sciences sector, is seeking a **IT / CSV Specialist** to provide technical support for laboratory applications, systems, infrastructure, and validation activities within a pharmaceutical manufacturing environment. **Position Responsibilities / Essential Functions:** - Provide IT...

**Our Company** At FirstBank PR, we strive to be a trusted advisor to our clients and our employees are the ones that ensure we deliver on our promise of excellence in personalized customer service. Our more than 3,100 employees in Puerto Rico, the Virgin Islands and Florida share a passion for excellent customer service. We are proud of our team because...

The Junior Automation Business Architect supports the design, development, implementation, and optimization of automation solutions that enhance operational efficiency and business processes across the organization. Working closely with the Operational Design & Automation Manager, this role contributes to the analysis of business requirements, process...

**Role Description** The SAP Implementation Specialist is a contract, on-site role based in San Juan. This role is responsible for planning, configuring, and implementing SAP modules, with a focus on aligning system functionality to client business processes and operational requirements. Daily tasks include analyzing current workflows, gathering...