general

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...

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...

**Description & Requirements** Smurfit Westrock (NYSE:SW) is the go-to leader and partner of choice in sustainable packaging. We are dedicated to creating efficient and scalable paper and packaging solutions to help solve complex packaging challenges. Guided by our values of safety, loyalty, integrity and respect, we are committed to delivering meaningful...

**FUNCION GENERAL** Su función principal consiste en identificar y captar nuevas oportunidades de clientes. Esto implica realizar visitas comerciales, presentar servicios de mantenimiento, asesorar a los clientes sobre las mejores soluciones para sus necesidades, etc. Además, debe estar al tanto de las tendencias del mercado y la competencia, lo que le...

Regular Exempt **GENERAL DESCRIPTION:** The Coding & Payment Rule Specialist is responsible for identifying coding guidelines established by the American Medical Association's (AMA) standard classification systems (ICD-10, CPT, HCPCS) and payment rules established by the Centers for Medicare & Medicaid Services (CMS) for the proper and timely...

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 operational...

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 operational...

Regular Non-Exempt **GENERAL DESCRIPTION:** Analyzes, processes, and adjudicates all types of complex claims submitted in Centers for Medicare and Medicaid Services Form 1500 (CMS‑1500) and Uniform Billing Form 04 (UB‑04) formats, applying the highest level of analytical judgment to determine appropriate payment or denial. This includes the...

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...

Temporary - AEP Non-Exempt **GENERAL DESCRIPTION:** Manages the orientation, presentation, and medical plan sales process, complying with established policies and procedures in conjunction with the laws and regulations applicable to the industry. Receives calls from prospective clients, identifying their eligibility, and fosters interest to guide...

**Claims Adjuster | Puerto Rico** **PRIMARY PURPOSE** To handle losses and claims for property and casualty insurers. **ESSENTIAL FUNCTIONS AND RESPONSIBILITIES** - Examines insurance policies and other records to determine insurance coverage. - Interviews, telephones, and/or corresponds with claimants and witnesses regarding claims. - Consults police...

We are seeking an Operational Accounting Associate to join our Finance Operations team in San Juan, Puerto Rico. In this role, you will play a critical part in maintaining the accuracy, integrity, and efficiency of our accounting processes. From supporting Accounts Payable, General Ledger activities, reconciliations, and month-end close, to contributing to...

Regular Exempt **GENERAL DESCRIPTION:** Manages and ensures the effective execution of the Care Management Program work plan for the Company's lines of business. Ensures that the appropriate resources are in place to ensure compliance with the appropriate care management of the participating members of the program(s). Participates in designing,...

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...

QUALITY CONSULTING GROUP, a leader in the pharmaceutical, biotech, medical devices, and manufacturing industry, is looking for a talented, highly motivated and enthusiastic to join our team. In this role, you’ll work with a highly enthusiastic team, contributing in a world-class manufacturing industry in Puerto Rico & USA. Responsibilities: - **Performs...

QUALITY CONSULTING GROUP, a leader in the pharmaceutical, biotech, medical devices, and manufacturing industry, is looking for a talented, highly motivated and enthusiastic to join our team. In this role, you’ll work with a highly enthusiastic team, contributing in a world-class manufacturing industry in Puerto Rico & USA. Responsibilities: - **Performs...

## What you’ll do: **DESCRIPCIÓN GENERAL DEL PUESTO** Preparar y documentar embarques de productos, terminados dirigidos a nuestros almacenes o directo a los clientes **COMPETENCIAS DEL PUESTO** 1.    Entrar información de embarques a los diferentes sistemas (AS400, VISTA, UPS, Federal Express, License Plate & AES Aereo). 2.    Empacar,...

Regular Non-Exempt **GENERAL DESCRIPTION:** Responsible for providing frontline support within the Human Resources Services function by responding to employee inquiries and processing routine HR transactions throughout the employee lifecycle. Ensures transactions are completed accurately, timely, and in compliance with established policies,...

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...

Descripcion En Mapfre, cuidamos lo que te importa y nos aseguramos de que tu crecimiento y bienestar estén siempre presentes. Ofrecemos un ambiente abierto, colaborativo y diseñado para potenciar el aprendizaje continuo. Actualmente buscamos a un(a) **Corporate Governance & Legal Operations Attorney** para unirse a nuestro equipo en Hato Rey y...