Empleos de e-file en San Juan

Buscamos un recurso para un cliente importante en tecnologia en PR, para ser parte de su equipo de Data Management, el recurso seria contratado por 12 meses con posibilidad de renovacion al vencimiento.  Debe ser responsable, organizad@ y con conocimientos técnicos, que pueda ayudar al equipo a revisar solicitudes, resolver problemas, documentar el...

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 Non-Exempt **GENERAL DESCRIPTION:** Receive the Grievances, Pre-Service Appeals, Post-Service Appeals, Payment Disputes, Payment Appeals, and Administrative Organizational Determinations (AOD) filed by Providers and members, as applicable. Responsible for filling and assigning cases to the Specialists in accordance with established time...

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 Non-Exempt **GENERAL DESCRIPTION:** Responsible for the monitoring and implementation of regulatory processes such as Explanation of Benefits (EOB), Maximum Out of Pocket (MOOP), and Financial Information Report (FIR) transactions. Monitor monthly invoices, validate, and create Likely to Benefit (LTB) letters for the Medicare Prescription...

Regular Exempt **GENERAL DESCRIPTION:** Carries out nursing functions in performing care management process, organizational determinations, and transitional care, including, but not limited to, health assessments, biopsychosocial needs assessment, and barriers for policyholders with medical conditions to develop a comprehensive and customized...

Regular Exempt **GENERAL DESCRIPTION:** Represents the company in official service negotiations with assigned group. Attend, channel, and solve the different situations from customers, underwriters, and producers as required. Responsible for coordinating and negotiating with the underwriting department the renewal proposal of groups assigned to...

**Job Summary** **JOB DESCRIPTION** The Grant Manager will be responsible for providing support and technical advice to the State and its subrecipients in support of their recovery initiatives to include all facets of launch, implementation, and close out of Disaster Recovery programs, projects, and activities. This position supports clients with procurement...

The Assistant Attorney Manager is responsible for supervising, leading, and mentoring a team of 8–10 attorneys, while also maintaining direct involvement in certain, select cases. To be successful in this role, the Assistant Attorney Manager reviews cases and provides guidance to their attorneys across all phases of case and docket management, and meets...

The Condado Collection is a collection of hospitality properties in Puerto Rico ranging from classic and modern luxury full-service hotels, to fine dining and entertainment. La Concha Resort is a modern luxury resort in Condado, Puerto Rico with history dating back to 1958. Epitomizing the fun “Latino Chic” lifestyle, offering stylish...

Leads testing and commissioning strategy for LUMA’s large-scale, flagship PAC and IEC-61850 special projects, coordinating engineering, field, and vendor teams across a multi-year project pipeline to ensure safe, compliant, and schedule-driven energization outcomes. Responsibilities: Oversees the planning, execution, and validation of...

Requires the ability to learn and follow policies, procedures and standards of their area, department and other departments related. Performs planning efforts within the department, either for operational situations daily or on assigned projects. This role involves executing tasks related to inventory, maintenance and repair, communication and...

The Advisor, Information Technology (Applications & Database Administrator) is responsible to build, implement, operate, and support application and database environments. Oversee and tune system performance, establish user and database access controls, prevent, monitor, and address security events and lead other IT resources with respect to...

GENOS LLC is seeking a Bioinformatics Research Assistant for a 6-month co-op with a stipend of $14k to support the execution of computational projects in genomics, molecular modeling, and translational studies. This role is ideal for a technically capable and intellectually curious individual looking to apply their bioinformatics skills into commercial...