Clinical Support Specialist

About the Role:As a Clinical Reviewer at Optum, you will play a critical role in ensuring the accuracy and integrity of medical claims. Your expertise in clinical review will help identify potential issues and ensure that claims are processed correctly.Your Responsibilities:Clinical Case Reviews: You will be responsible for reviewing medical claims to...

Adecco Puerto Rico seeks a skilled Banking Support Specialist to join our team. As a key member, you will play a vital role in maintaining the high standards of our clients by ensuring accurate and efficient transaction processing. Your expertise will directly impact client satisfaction and trust.Key qualifications include:Bachelor's degree completed or...

About the RoleThis role is an exciting opportunity to join our customer service team as a Healthcare Support Specialist. As a member of our team, you will be responsible for providing phone support to address the needs of our members or providers.You will actively listen to thoroughly understand the type of assistance required and ask appropriate questions...

Javier E Bidot & Associates is a dynamic organization that requires a skilled Administrative Support Specialist to join our team.The ideal candidate will have a strong background in administration and possess excellent organizational skills. Responsibilities will include:Assisting in the preparation of reports and presentations;Coordinating meetings and...

As an Administrative Support Specialist at Pss Pathfinders, Inc., you will be responsible for providing exceptional support to our dynamic team.The ideal candidate will have a strong background in office systems and excellent customer service skills.We are looking for a highly organized and proactive individual who can thrive in a fast-paced environment and...

Job DescriptionYou will provide phone support to address the needs of members or providers, while actively listening to thoroughly understand the type of assistance required.You will ask appropriate questions to determine the suitable procedures to resolve customer issues and/or questions, document all interactions in computer systems, research complex...

Job DescriptionProvide Live Person Chat support to Healthcare Professionals (HCP's) and assist with checking status on Credentialing, Contracting, and Products/Contract load status, EFT Issues.Provider Education on various topics, including but not limited to, initial credentialing, re-credentialing, contract, demographic, market closed, provider portal,...

Key ResponsibilitiesReceives and Responds to Escalated Pharmacy Inquiries: Respond to escalated pharmacy inquiries from various communication venues, including phone queue, portal, claim queue, department email box, or fax.Coordinates and Assists Initial Screening of MAP Enrollment Requests: Assist in the initial screening of MAP enrollment requests via all...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

Summary: Performs clinical, analytical, and technical tasks to support the development, implementation, and ongoing monitoring of the local Quality & Compliance programs and activities for the Clinics Operations. Works collaboratively with operational leadership, to ensure measurable improvement in clinical outcomes, operational excellence, and customer...

Optum is a global organization committed to delivering care and support to individuals worldwide. As a Medical Assistance Program Specialist, you will play a critical role in ensuring the successful implementation and execution of all pharmacy programs and processes.Your primary responsibility will be to determine eligibility for the Medical Assistance...

Job Position: Inventory Specialist Location: San Juan (On Site) About DCMC Partners DCMC Partners, a Great Place to Work Certified company, specializes in disaster recovery, hazard mitigation, and crisis management with over 30 years of expertise.We support clients in preparing for, mitigating, responding to, and recovering from crises effectively.Job...

Join us at Smartlogix as a Business Intelligence Specialist and play a pivotal role in shaping our business strategy through data-driven insights. Your primary responsibility will be to develop and apply data analysis and visualization techniques to inform business decisions.Key ResponsibilitiesCollect and analyze large datasets from various sources.Create...

Sobre NosotrosMAROXA es una empresa comprometida con ofrecer servicios de alta calidad a nuestros clientes. Buscamos a alguien que compartan nuestros valores y estén dispuestos a trabajar en un ambiente colaborativo.Desarrollo ProfesionalOfrecemos oportunidades de crecimiento y desarrollo para los candidatos que se unen a nuestra empresa. Estamos...

Caribbean Sign Supplies is seeking a skilled ERP Software Specialist to join our team. This individual will be responsible for managing our ODOO ERP database system, ensuring optimal performance, and adapting the software to our specific needs.The ideal candidate should have advanced knowledge in development and technical support, particularly in the Odoo...

Req ID:308079NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.We are currently seeking a PeopleSoft Functional Specialist to join our team in San Juan, Puerto Rico (US-PR), United States (US).Overview of...

At Popular, we are dedicated to delivering exceptional financial solutions and services to our communities in Puerto Rico, the United States, and the Virgin Islands. As employees, we strive to make our customers' dreams come true by offering personalized financial solutions at every stage of their life. Our extensive experience demonstrates the resilience...

About the Role:The Community Engagement Liaison will serve as a key representative between clients and local communities where generation sites are located.This individual will travel to project sites to facilitate open communication, build relationships, and engage with community members to support project staffing, address concerns, and ensure a positive...

Job TypeFull TimeGeneral DescriptionProvide technical support on Cyber and Information Security Incident Response in the banking industry with knowledge and understanding of best practices in security risk framework, business strategy, regulatory and federal compliance requirements. Support risk and security assessments of network configurations, log...

About Pearl: Pearl connects top talent from around the world with US and EU-based startups that care about finding sharp and hungry talent that they can grow with long-term.We provide candidates who pass our vetting process with exclusive upskilling opportunities that enable them to get promoted faster in their new roles.We only work with employers who are...