Duties: Responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to ...
Department 10247259 Ambulance Services-Midlands Share your talent with us! Our vision is simple: to transform healthcare...Inspire health. Serve with compassion. Be the difference. Job Summary The Manager Prisma Health Ambulance Services...
that retains top talent Collaborate with Sales Directors and Solution Architects to propose and sell Professional Services to new... – and . TITLE: Vice President, Professional Services WHAT YOU’LL DO: The Vice President, Professional Services, is a key leader...
: Recruitment: We match talent with open jobs. Contract staffing: We place technical and exempt professionals in temporary...Director, Global Manufacturing Full-Time Columbia, SC Meet your Talent Advise Dan Witters A leading global Tier...
Senior Developer Job Summary: Talent Software Services is in search of a Senior Developer for a contract position... AWS cloud services Ensure alignment with: Architectural standards Business goals Collaborate with: Cloud...
Sr. Analyst, System Testing II Job Summary: Talent Software Services is in search of a Sr. Analyst, System Testing... testing Track and report quality assurance metrics Provide testing services for multiple clients, including onsite support...
. Take appropriate actions to protect state data, systems, and technology services. REQUIRED SKILLS (Ranked by Importance) 5...
asset assigned to an end-user is properly documented in the designated IT Services asset Management system in accordance...
, coordinate, monitor, and evaluate medical necessity, options, and services required to support members in managing their health... for appropriate services within benefit and medical necessity guidelines. Participate in data collection/input into the system...
, monitor, and evaluate medical necessity, options, and services required to support members in managing their health, chronic... plans in cooperation with members, monitoring services, and implementing plans to include member goals. Perform medical...
frameworks CI/CD integration: Jenkins GitHub AWS CodePipeline AWS services (hands-on): EC2, IAM, S3, RDS/Aurora... support GitHub Actions and version control workflows Additional AWS services: DynamoDB SNS, SQS Step Functions...
, Aurora, VPC, Lambda, CloudWatch, CloudTrail, API Gateway, DynamoDB Azure: Azure Functions, App Services, Cosmos DB... or Azure Functions Define and manage cloud infrastructure using Terraform (IaC) Integrate cloud services such as API Gateway...
to claims processing, onboarding new plans for services and managed care work....
, and HIPAA compliance. Coordinate HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department...
and/or care plan compliance, options, and services required to support members. Perform medical or behavioral review.../authorization processes, ensuring coverage for appropriate services within benefit and medical necessity guidelines. Assess service...
services for security compliance. Documentation & Reporting Use Microsoft Office, System Center Service Manager, Archer...
Daily Duties & Responsibilities Design and implement secure hybrid and multi-cloud network architectures across AWS and Azure. Architect VPC/VNet segmentation, routing, and connectivity, including hub-and-spoke and transit VPC/VNet mode...
Duties: Responsible for overall coordination, status reporting, and stability of project-oriented work efforts. Responsible for multiple work efforts of any size, from minimum complexity system/customer impacts to greater complexity syste...
Duties: Responsible for daily workflow activities to include the following membership/enrollment activities: processing of applications for new enrollments, terminations/cancellations, changes, renewals, and database updates. •50% Receive...
Education Requirements (One of the following) Bachelor's degree in Computer Science, Information Technology, or related field OR 4 years of relevant job-related work experience OR Associate's degree in CS/IT (or related field) plus 2 yea...