Job in USA, JOBS USA, United States Jobs 2021, Job Vacancy in USA


Health Insurance

Job Location: Collabera Austin, TX Contractor (United States)

Industry: Health Care

Job Title: Health Insurance

Duration: 5+ months with (extension and permanent placement depending on attendance and performance)

Work Hours: (hours of Operation M-F 7am- 7pm CST)

Location:  Remote Anywhere in US [remote during COVID-19]

Skills:

  • Experience in, or understanding of, healthcare and/or insurance industry
  • Call/contact center experience
  • Working knowledge of the health insurance industry
  • Strong telephone verbal and listening skills
  • Ability to work in a fast paced environment
  • Dedication and commitment to exceptional customer service when selling and servicing our customers
  • Capable of working and communicating with many people possessing diverse personalities
  • Excellent verbal and written communication skills, including oral presentation
  • Strong organizational skills with an attention to detail
  • Working knowledge of MS Word & Excel
  • Understanding of the various insurance policies
  • Able to work independently and in a team setting

=====================================================================

Health Insurance Verification Representative

Location: Medix Orange, California, United States

At Medix, we are dedicated to creating opportunities for talent through our Healthcare, Scientific and Information Technology divisions. Our dedicated recruiters offer a personalized service to make sure we truly understand your employment needs. We are currently seeking a (omitted but job title with relevant experience).

Partner with Medix, and you will experience the multiple benefits our company has to offer. We will hold a personal consultation with you to understand your skills and aspirations! Our placement services provide flexibility to accommodate your schedule and needs, offering contract, contract-to-hire and direct hire positions.


Health Insurance Verification Representative – Prior Authorization – Administrative Clerical – Healthcare


Job Responsibilities

As an Insurance Verification Representative, you will be responsible for obtaining required documentation in compliance with governmental and commercial payer requirements in order to ensure the reimbursement of services provided to patients. You will review requests from doctors and pharmacists to determine whether prior authorization of medication coverage can be given; this will be accomplished by screening and reviewing requests based on benefit plan design, client specifics, and clinical criteria.

Other responsibilities of the Prior Authorization role include:

  • Verifying insurance benefits for commercial and governmental payers
  • Obtaining insurance authorizations in a timely manner for equipment/services provided
  • Handling inbound telephone and written inquiries from pharmacists and doctors
  • Screening and reviewing requests based on benefit plan design, client specifics, and clinical criteria
  • Providing information to clients, participants, pharmacists, and doctors regarding participants pharmacy benefits and drug coverage
  • Providing accurate procedures for medication exceptions
  • Facilitating resolution of drug coverage issues and proactively resolving issues
  • Maintaining accurate and complete documentation of all inquiries for continuous improvement

 


Health Insurance Verification Representative – Prior Authorization – Administrative Clerical – Healthcare


RequirementsAs an Insurance Verification Representative, you must be able to work independently, prioritize tasks, and stay organized in a high volume, inbound call center setting. You must have excellent communication and organizational skills with the ability to multitask and collaborate in a team-oriented environment.

Other requirements of the Prior Authorization role include:

  • High school diploma or equivalent certification
  • Previous administrative clerical or related experience
  • Previous Prior Authorization Representative experience, a plus
  • Knowledge of medical terminology
  • Computer skills and experience with Microsoft Office Applications

 


Health Insurance Verification Representative – Prior Authorization – Administrative Clerical – Healthcare


Benefits

In order to be eligible for health benefits, you must be employed for 30 days and must average 30 hours per week for four consecutive weeks.

As a contract employee with Medix, you can choose to enroll in our Benefits Program during your eligibility period and enjoy:

  • 401(k) Retirement Plan
  • Medical, dental and vision plan with American Worker
  • Prescription Programs
  • Term Life Insurance Plan

 


Health Insurance Verification Representative – Prior Authorization – Administrative Clerical – Healthcare


Medix – Positively Impacting Lives

Featured on such prestigious lists as Inc. Magazine’s “Inc. 5000” list of the nation’s fastest growing private companies, as well as Inavero’s “Best of Staffing” Client list.

“The Medix team’s support and encouragement provided me with the confidence I required while pursuing a position in which I continue to excel and grow, both professionally and personally.” -Sam, Medix Talent.

====================================================================

Manager, Health Insurance

Location: Public School Teachers’ Pension & Retirement Fund of Chicago Chicago, IL, United States

General Description:

Under the direct supervision of the Chief Benefits Officer, the Manager, Health Insurance oversees all functional areas related to health insurance. The Manager, Health Insurance leads the department in providing oversight of program administration and contracts.

Job Requirements:

Primary Responsibilities

  • Develop, manage, and administer the retiree health insurance benefits program for the Fund.
  • Lead the Health Insurance team in all aspects of supervising, evaluating, and managing their workload and activities.
  • Implement strategic initiatives including revisions and improvements to program administration, allowing for program enhancements and improved efficiency.
  • Provide support to the Chief Benefits Officer by performing program research, conducting data analysis, and reporting to the Board of Trustees.
  • Collaborate with the Health Insurance Consultant to conduct the annual program review and plan renewal process.
  • Oversee and direct the annual open enrollment process in collaboration with stakeholders, external vendors, and cross functional teams.
  • Direct the development, editing, approval, and distribution of health insurance related communications.
  • Provide health insurance plan recommendations, allowing for a strategic direction on future offerings that remains competitive and cost effective.
  • Address various health insurance and Medicare topics through presentations to audiences throughout the system.

Position Qualifications

  • Strong interpersonal and vendor management skills.
  • Ability to concentrate on details, apply sound logic and judgment, and prioritize tasks.
  • Excellent verbal and communication skills.
  • Ability to manage, oversee, and evaluate employees.
  • Strong leadership skills with ability to strategize, plan, and collaborate with employees and management.

Education and Experience

  • Bachelor’s degree required with emphasis in Business, Human Resources, Finance, or Actuarial Science.
  • Minimum 10 years experience with proficient knowledge of health insurance and health insurance carriers.
  • CEBS designation preferred.
  • High level of proficiency in Microsoft Word, Excel, and PowerPoint.

Physical Requirements

  • While performing the duties of this job, the employee will likely sit for long periods of time, with some standing and repetitive physical activity.
  • The employee may occasionally lift and/or move up to 10 pounds.

Environment

  • This job operates in a professional office environment. This role routinely uses standard office equipment (i.e., computers, phones, and photocopiers).

Disclaimers

  • This job description reflects management’s assignment of essential functions; nothing in this document restricts management’s rights to assign or reassign duties and responsibilities to this job at any time.
  • It is understood that a full-time exempt employee will generally work a minimum of 35 hours per week; however, in the scope of an exempt employee’s normal job, work outside the usual schedule is often required. This might include evening meetings, weekends, limited travel, or work hours well beyond 35 in a given week.

General Description:

Under the direct supervision of the Chief Benefits Officer, the Manager, Health Insurance oversees all functional areas related to health insurance. The Manager, Health Insurance leads the department in providing oversight of program administration and contracts.

Job Requirements:

Primary Responsibilities

  • Develop, manage, and administer the retiree health insurance benefits program for the Fund.
  • Lead the Health Insurance team in all aspects of supervising, evaluating, and managing their workload and activities.
  • Implement strategic initiatives including revisions and improvements to program administration, allowing for program enhancements and improved efficiency.
  • Provide support to the Chief Benefits Officer by performing program research, conducting data analysis, and reporting to the Board of Trustees.
  • Collaborate with the Health Insurance Consultant to conduct the annual program review and plan renewal process.
  • Oversee and direct the annual open enrollment process in collaboration with stakeholders, external vendors, and cross functional teams.
  • Direct the development, editing, approval, and distribution of health insurance related communications.
  • Provide health insurance plan recommendations, allowing for a strategic direction on future offerings that remains competitive and cost effective.
  • Address various health insurance and Medicare topics through presentations to audiences throughout the system.

Position Qualifications

  • Strong interpersonal and vendor management skills.
  • Ability to concentrate on details, apply sound logic and judgment, and prioritize tasks.
  • Excellent verbal and communication skills.
  • Ability to manage, oversee, and evaluate employees.
  • Strong leadership skills with ability to strategize, plan, and collaborate with employees and management.

Education and Experience

  • Bachelor’s degree required with emphasis in Business, Human Resources, Finance, or Actuarial Science.
  • Minimum 10 years experience with proficient knowledge of health insurance and health insurance carriers.
  • CEBS designation preferred.
  • High level of proficiency in Microsoft Word, Excel, and PowerPoint.

Physical Requirements

  • While performing the duties of this job, the employee will likely sit for long periods of time, with some standing and repetitive physical activity.
  • The employee may occasionally lift and/or move up to 10 pounds.

Environment

  • This job operates in a professional office environment. This role routinely uses standard office equipment (i.e., computers, phones, and photocopiers).

Disclaimers

  • This job description reflects management’s assignment of essential functions; nothing in this document restricts management’s rights to assign or reassign duties and responsibilities to this job at any time.
  • It is understood that a full-time exempt employee will generally work a minimum of 35 hours per week; however, in the scope of an exempt employee’s normal job, work outside the usual schedule is often required. This might include evening meetings, weekends, limited travel, or work hours well beyond 35 in a given week.