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15 Jobs
Manager of BH Medical Claims
MetroPlus Health PlanRussell, IA
Job Description: Job Description About NYC Health Hospitals MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
Claims Call Center Representative
MetroPlus Health PlanRussell, IA
About NYC Health Hospitals MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
jobsearcher.com/articlesClaims Analyst Certificate
If they have all of their information lined up and they are certified with Tricare, the PCA will pay out the claim
We promise to know you and help youJob Description:The Revenue Cycle Senior is part of a team that participates in various Healthcare Revenue Cycle projects.
MetroPlus Health Plan: Contracting Administrator
Metroplus Health PlanRussell, IA
Work on special projects as needed, and assist in all areas of the Provider Contracting DepartmentIdentify network need, recruit, and contract providers/facilities to meet and maintain regulatory network complianceMinimum QualificationsBachelor’s Degree, preferably in Health Care Administration, Business Administration or other related area of study.
Manager of BH Claims And Compliance
Metroplus Health PlanRussell, IA
Position Overview Under the general direction of the Claims Director/Deputy Director, the Manager of BH ClaimsandCompliance's task is to ensure consistent oversight of Behavioral Health Claims and Medical Claims.
Contracting Administrator
MetroPlus Health PlanRussell, IA
Work with Claims, Provider Maintenance, and participating providers to correct claims processing issues. Work with providers to resolve contract related issues, and coordinate resolutions with other internal departments, including Claims, Credentialing, Provider Maintenance, Network Relations, and others.
Senior Claims Call Center Representative
Metroplus Health Plan IncRussell, IA
Provides assistance, guidance, and on-the-job training to the claims call center representatives. Position Overview MetroPlus Health Plan is looking for an experienced problem solver to join the claims Call Center Team as a Senior Call Center Representative.
jobsearcher.com/blog
10 Reasons HR is Important to an Organization

"Nothing we do is more important than hiring and developing people."

Claims Quality Manager
MetroPlus Health PlanRussell, IA
The Claims Quality Manager is a liaison between claims operations, configuration, utilization management, and product. Ensure compliance with regulatory related to claims processing including accuracy, timeliness, interest payments, and other claims processing statistics.
MetroPlus Health Plan: Senior Director of Claims
MetroPlus Health PlanRussell, IA
Oversee and provide direction with the Director of ClaimsManage the relationship with the TPA/BPO for claims processing. Oversite of claims process of delegated vendors including but not limited to the TPA, dental vendor, vision vendor and other vendors for which claims is outsourced.
Director of Casualty Claims
MetroPlus Health PlanRussell, IA
Position Overview Under the general direction of the Claims Director/Senior Director, the Behavioral Health Medical Claims Manager's task is to ensure consistent oversight of Behavioral Health Claims and Medical Claims.
Manager of BH Medical Claims & Compliance
MetroPlus Health PlanRussell, IA
Position Overview Under the general direction of the Claims Director/Deputy Director, Manager of BH Claims and Compliance's task is to ensure consistent oversight of Behavioral Health Claims and Medical Claims.
jobsearcher.com/blog
7 Importances of Organizational Culture and How to Build It

The world of work has drastically changed in the past few years. Where a good salary and a nice office might have been enough to attract talent in the past, employees today expect flexibility, growth opportunities, and a healthy work environment. In fact, 77% of applicants say they’d consider a company’s culture before applying for a job. 

MetroPlus Health Plan: Senior Director of Claims - Enhanced Salary
MetroPlus Health PlanRussell, IA
Direct and oversee all Claims Department functions including front end processing, adjustments, specialpricing, recoupments, claims complaints, claims correspondence, benefit configuration, audit and testing.
MetroPlus Health Plan: Manager of Bh Medical Claims
MetroPlus Health PlanRussell, IA
Expected to be the subject matter expert on Behavioral Health and Medical claims processing rules and guidelines. Bachelor’s degree requiredExperience working in a managed care organization, medical /behavioral claims processing, and knowledge of regulatory requirements affecting medical/behavioral claim outcomes.
Behavioral Health Claims Service Representative
Metroplus Health PlanRussell, IA
The incumbent works closely with Provider Relations, Medical Management, Member Services and the Claims Processing unit. Work with the management team to stay updated on claims processing criteria, regulatory updates, new benefits and/or products and be informed of any changes in company policies.
MetroPlus Health Plan: Manager of Bh Medical Claims & Compliance
MetroPlus Health PlanRussell, IA
Industry knowledge: Understands behavioral health/medical claims processing guidelines, and have knowledge of local, state, and federal health care regulations. Manage claims operational reports for visibility into vendor performance trends.
jobsearcher.com/blog
Collaborative Recruiting: The Key to a Better Talent Acquisition Strategy

Talent acquisition is a multi-stage process where candidates undergo various application steps before getting hired. The unfortunate reality is that it is a labor-intense system, with the hiring manager and recruiter often handling all of the work on their own. Ask any one of them, and you will hear about the overabundance of applications and the demanding task of filtering through them to find the best candidates. The quality of talent suffers under the weight of all that work on one person's hands. It's not easy, but as many companies are starting to realize, there is a better way. The future of talent acquisition lies in collaborative recruiting!

Benefits Configuration Analyst
MetroPlus Health PlanRussell, IA
Position Overview This Configuration Analyst will be responsible for constructing the Claims Processing Systems to process new enrollments. ope of Ro Job Description Configure MHP's core systems to meet regulatory requirements and business needs.

claims claims processing regulatory jobs Company: metroplus health plan in Russell, IA

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