PepsiCo Beverages North America
Remote (Austin, TX)
$19.35 per hour CLICK HERE to view our Warehouse Person (Loader) Realistic Job Preview Video
This labor-intensive position is responsible for hand building pallets of product for bulk, and route trucks. Each type of loading requires strict attention to order accuracy with respect to loading outgoing trucks and unloading incoming trucks. Works from Electronic order system or order sheets to build loads using a forklift and/or electronic pallet jack. Position is responsible for accuracy in loading and complying with shipper/receiver documentation. Follows warehouse instructions in building loads (). Employees must maintain a clean and safe work environment. Position may be required to work across a wide variety of weather conditions and hours, shift duration depends on work load and may vary daily.
Transport truck loading involves moving full pallets of products from the warehouse onto a trailer and removing any returned pallets/plastic flats. Responsible for unloading raw...
Sep 16, 2021
$19.35 per hour CLICK HERE to view our Warehouse Person (Loader) Realistic Job Preview Video
This labor-intensive position is responsible for hand building pallets of product for bulk, and route trucks. Each type of loading requires strict attention to order accuracy with respect to loading outgoing trucks and unloading incoming trucks. Works from Electronic order system or order sheets to build loads using a forklift and/or electronic pallet jack. Position is responsible for accuracy in loading and complying with shipper/receiver documentation. Follows warehouse instructions in building loads (). Employees must maintain a clean and safe work environment. Position may be required to work across a wide variety of weather conditions and hours, shift duration depends on work load and may vary daily.
Transport truck loading involves moving full pallets of products from the warehouse onto a trailer and removing any returned pallets/plastic flats. Responsible for unloading raw...
One team. Global challenges. Infinite opportunities. At Viasat, we're on a mission to deliver connections with the capacity to change the world. For more than 35 years, Viasat has helped shape how consumers, businesses, governments and militaries around the globe communicate. We're looking for people who think big, act fearlessly, and create an inclusive environment that drives positive impact to join our team.Job ResponsibilitiesThe Global Infrastructure IT Team at Viasat provides a highly available, scalable, and secure platform that powers our commercial and government products and services. This platform spans public cloud and on-premises infrastructure and involves a fair amount of open source and commercial off the shelf software. As a member of the Global Infrastructure Applications team, you will be working with product teams supporting a wide variety of platforms and technologies including cloud services, identity and access management, CICD pipelines, Collaboration...
Sep 15, 2021
One team. Global challenges. Infinite opportunities. At Viasat, we're on a mission to deliver connections with the capacity to change the world. For more than 35 years, Viasat has helped shape how consumers, businesses, governments and militaries around the globe communicate. We're looking for people who think big, act fearlessly, and create an inclusive environment that drives positive impact to join our team.Job ResponsibilitiesThe Global Infrastructure IT Team at Viasat provides a highly available, scalable, and secure platform that powers our commercial and government products and services. This platform spans public cloud and on-premises infrastructure and involves a fair amount of open source and commercial off the shelf software. As a member of the Global Infrastructure Applications team, you will be working with product teams supporting a wide variety of platforms and technologies including cloud services, identity and access management, CICD pipelines, Collaboration...
Position Purpose: Utilize multiple systems to investigate escalated inquiries on Members and follow the member experience from beginning to resolution Manage resolution of activities in CRM, including HICS from CMS according to defined turnaround times Collaborate with internal teams and external partners to resolve complaints and document issue and resolution in CRM Conduct member outreach based on a variety of trends such as frequent caller data and out of network claim denials Ensure compliance with State and Federal laws, following State and Federal guidelines as well as the procedures for the plans and the Corporation Recommend workflows and policy as a result of Member feedback and escalation data analysis Work cross functionally with internal departments regarding client needs and requests, work procedures, gaps in policy, and other elements of supporting assigned clients and conduct member, provider and health plan telephonic education as needed Document...
Sep 15, 2021
Position Purpose: Utilize multiple systems to investigate escalated inquiries on Members and follow the member experience from beginning to resolution Manage resolution of activities in CRM, including HICS from CMS according to defined turnaround times Collaborate with internal teams and external partners to resolve complaints and document issue and resolution in CRM Conduct member outreach based on a variety of trends such as frequent caller data and out of network claim denials Ensure compliance with State and Federal laws, following State and Federal guidelines as well as the procedures for the plans and the Corporation Recommend workflows and policy as a result of Member feedback and escalation data analysis Work cross functionally with internal departments regarding client needs and requests, work procedures, gaps in policy, and other elements of supporting assigned clients and conduct member, provider and health plan telephonic education as needed Document...
Position Purpose: Provide legal advice and services including advising management concerning state and federal legislation, regulations and other requirements applicable to Centene business activities and initiatives. Responsibilities • Serve as a lead resource to Centene departments and entities for research and interpretation of specific healthcare policies and regulations • Provide legal advice to Centene entities to define and develop solutions to regulatory requirements that impact various product lines and programs • Review regulations, RFPs and other documents affecting such activities, and identify and appropriately respond to regulatory risks or opportunities • Support Government Relations and Compliance departments by assessing and translating complex legislation, rules and regulations into understandable information and facilitating analysis of compliance and implementation implications • Review, draft and negotiate contracts, policies and procedures and related...
Sep 15, 2021
Position Purpose: Provide legal advice and services including advising management concerning state and federal legislation, regulations and other requirements applicable to Centene business activities and initiatives. Responsibilities • Serve as a lead resource to Centene departments and entities for research and interpretation of specific healthcare policies and regulations • Provide legal advice to Centene entities to define and develop solutions to regulatory requirements that impact various product lines and programs • Review regulations, RFPs and other documents affecting such activities, and identify and appropriately respond to regulatory risks or opportunities • Support Government Relations and Compliance departments by assessing and translating complex legislation, rules and regulations into understandable information and facilitating analysis of compliance and implementation implications • Review, draft and negotiate contracts, policies and procedures and related...
About CSL With operations in 35+ nations and ~27,000 employees worldwide, CSL is driven to develop and deliver a broad range of lifesaving therapies to treat disorders such as hemophilia and primary immune deficiencies, and vaccines to prevent influenza. Our therapies are also used in cardiac surgery, organ transplantation and burn treatment. CSL is the parent company of CSL Behring and Seqirus. CSL Behring is a global leader in the protein biotherapeutics industry, focused on bringing to market biotherapies used to treat serious and often rare conditions. CSL Behring operates CSL Plasma, one of the world's largest collectors of human plasma, which is used to create CSL's therapies. Seqirus is one of the largest influenza vaccine companies in the world and is a transcontinental partner in pandemic preparedness and a major contributor to the prevention and control of influenza globally. We invite you to take a look at the many career possibilities available around the globe and...
Sep 14, 2021
Full Time
About CSL With operations in 35+ nations and ~27,000 employees worldwide, CSL is driven to develop and deliver a broad range of lifesaving therapies to treat disorders such as hemophilia and primary immune deficiencies, and vaccines to prevent influenza. Our therapies are also used in cardiac surgery, organ transplantation and burn treatment. CSL is the parent company of CSL Behring and Seqirus. CSL Behring is a global leader in the protein biotherapeutics industry, focused on bringing to market biotherapies used to treat serious and often rare conditions. CSL Behring operates CSL Plasma, one of the world's largest collectors of human plasma, which is used to create CSL's therapies. Seqirus is one of the largest influenza vaccine companies in the world and is a transcontinental partner in pandemic preparedness and a major contributor to the prevention and control of influenza globally. We invite you to take a look at the many career possibilities available around the globe and...
About CSL With operations in 35+ nations and ~27,000 employees worldwide, CSL is driven to develop and deliver a broad range of lifesaving therapies to treat disorders such as hemophilia and primary immune deficiencies, and vaccines to prevent influenza. Our therapies are also used in cardiac surgery, organ transplantation and burn treatment. CSL is the parent company of CSL Behring and Seqirus. CSL Behring is a global leader in the protein biotherapeutics industry, focused on bringing to market biotherapies used to treat serious and often rare conditions. CSL Behring operates CSL Plasma, one of the world's largest collectors of human plasma, which is used to create CSL's therapies. Seqirus is one of the largest influenza vaccine companies in the world and is a transcontinental partner in pandemic preparedness and a major contributor to the prevention and control of influenza globally. We invite you to take a look at the many career possibilities available around the globe and...
Sep 14, 2021
Full Time
About CSL With operations in 35+ nations and ~27,000 employees worldwide, CSL is driven to develop and deliver a broad range of lifesaving therapies to treat disorders such as hemophilia and primary immune deficiencies, and vaccines to prevent influenza. Our therapies are also used in cardiac surgery, organ transplantation and burn treatment. CSL is the parent company of CSL Behring and Seqirus. CSL Behring is a global leader in the protein biotherapeutics industry, focused on bringing to market biotherapies used to treat serious and often rare conditions. CSL Behring operates CSL Plasma, one of the world's largest collectors of human plasma, which is used to create CSL's therapies. Seqirus is one of the largest influenza vaccine companies in the world and is a transcontinental partner in pandemic preparedness and a major contributor to the prevention and control of influenza globally. We invite you to take a look at the many career possibilities available around the globe and...
Retail MerchandiserYou will be servicing various Hallmark departments within stores; you will not be working in a Hallmark store. The Retail Merchandiser is a part-time position that performs service work in the Hallmark department in various retail stores such as grocery stores, drug stores, department stores and mass retailers. These positions do not service Hallmark Card Shops. To view the Retail Merchandiser Career Profile video: Click Here This is your opportunity to represent the world's best-known greeting card brand and develop retailer relationships in your community. Hallmark provides paid training, paid travel time and mileage reimbursement between stores and access to a variety of corporate discounts. There are three major components of this PART-TIME position:Day to Day Service:Product merchandising: You will handle all aspects of product merchandising within your assigned stores. You will use a Hallmark-issued, hand-held mobile device to replenish, straighten and track...
Sep 14, 2021
Retail MerchandiserYou will be servicing various Hallmark departments within stores; you will not be working in a Hallmark store. The Retail Merchandiser is a part-time position that performs service work in the Hallmark department in various retail stores such as grocery stores, drug stores, department stores and mass retailers. These positions do not service Hallmark Card Shops. To view the Retail Merchandiser Career Profile video: Click Here This is your opportunity to represent the world's best-known greeting card brand and develop retailer relationships in your community. Hallmark provides paid training, paid travel time and mileage reimbursement between stores and access to a variety of corporate discounts. There are three major components of this PART-TIME position:Day to Day Service:Product merchandising: You will handle all aspects of product merchandising within your assigned stores. You will use a Hallmark-issued, hand-held mobile device to replenish, straighten and track...
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Provide patient and provider education Facilitate member access to community based services Monitor referrals made to community based organizations, medical care and other services to support the...
Sep 14, 2021
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients Provide patient and provider education Facilitate member access to community based services Monitor referrals made to community based organizations, medical care and other services to support the...
Position Purpose: Identify, analyze, and resolve provider claims and encounter submission issues. Act as a liaison between the plan, claims, providers and various departments to effectively resolve claims and encounters issues. Research and resolve complex provider claims inquiries and pending or denied encounters Track trends in claims processing and encounter submission issues, assist in identifying and quantifying solutions, make recommendations, and assist with implementations Research and resolve systemic issues that may impact state compliance Identify providers experiencing a large number of claims issues or with the potential to develop claims issues and proactively work to eliminate barriers for accurate and timely claims processing Establish and monitor prioritization process to reduce backlog of encounters projects Assist with reviews and initiate discussion with providers as needed on encounter scrubs and pends Lead claim projects, pricing issues and...
Sep 14, 2021
Position Purpose: Identify, analyze, and resolve provider claims and encounter submission issues. Act as a liaison between the plan, claims, providers and various departments to effectively resolve claims and encounters issues. Research and resolve complex provider claims inquiries and pending or denied encounters Track trends in claims processing and encounter submission issues, assist in identifying and quantifying solutions, make recommendations, and assist with implementations Research and resolve systemic issues that may impact state compliance Identify providers experiencing a large number of claims issues or with the potential to develop claims issues and proactively work to eliminate barriers for accurate and timely claims processing Establish and monitor prioritization process to reduce backlog of encounters projects Assist with reviews and initiate discussion with providers as needed on encounter scrubs and pends Lead claim projects, pricing issues and...
Position Purpose: Oversee the Audit Management team of the Compliance Department. Manage external regulatory audits - work with department managers and Compliance leads to manage and respond to external audits. Conduct internal reviews and work with Internal Audit to ensure compliance. Write corrective action plans and work with contract and department managers to ensure timely completion and compliance with local, state and regulatory requirements. Investigate instances of suspected noncompliance within the health plan and report to appropriate management and regulatory entities. Assist management with enforcement and discipline in appropriate instances of non compliance. Regularly inform health plan's senior leadership of the status of and activities pertaining to compliance. Education/Experience: Bachelor's degree in related field or equivalent experience. 5+ years of compliance program management and contract experience with State Medicaid programs...
Sep 14, 2021
Position Purpose: Oversee the Audit Management team of the Compliance Department. Manage external regulatory audits - work with department managers and Compliance leads to manage and respond to external audits. Conduct internal reviews and work with Internal Audit to ensure compliance. Write corrective action plans and work with contract and department managers to ensure timely completion and compliance with local, state and regulatory requirements. Investigate instances of suspected noncompliance within the health plan and report to appropriate management and regulatory entities. Assist management with enforcement and discipline in appropriate instances of non compliance. Regularly inform health plan's senior leadership of the status of and activities pertaining to compliance. Education/Experience: Bachelor's degree in related field or equivalent experience. 5+ years of compliance program management and contract experience with State Medicaid programs...
Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. Provide advanced analytical support for business operations in all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management. Develop reports and deliverables for management Model data using MS Excel, Access, SQL, and/or other data ware house analytical tools Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis. Assist with training and mentoring other Data Analysts. Education/Experience: Bachelor's degree in related field or equivalent experience....
Sep 14, 2021
Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. Provide advanced analytical support for business operations in all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management. Develop reports and deliverables for management Model data using MS Excel, Access, SQL, and/or other data ware house analytical tools Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis. Assist with training and mentoring other Data Analysts. Education/Experience: Bachelor's degree in related field or equivalent experience....
Position Purpose: Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings, provide and/or review intakes and initial evaluations, brief focused treatment interventions, monitor quality of care, collect and analyze utilization and cost of care data, assist with discharge planning, arrange transportation; provide member assistance and participate in special utilization projects. Authorize, direct and monitor care for mental health and substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care. Ensure compliance with all performance measures in regards to appeals, denials, higher level of care admission certification and concurrent review timeliness, Outpatient Treatment Report review timeliness, readmissions, and others as indicated. Interact with physicians and social workers for...
Sep 14, 2021
Position Purpose: Perform duties to authorize and review utilization of mental health and substance abuse services provided in inpatient, outpatient and intermediate care settings, provide and/or review intakes and initial evaluations, brief focused treatment interventions, monitor quality of care, collect and analyze utilization and cost of care data, assist with discharge planning, arrange transportation; provide member assistance and participate in special utilization projects. Authorize, direct and monitor care for mental health and substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care. Ensure compliance with all performance measures in regards to appeals, denials, higher level of care admission certification and concurrent review timeliness, Outpatient Treatment Report review timeliness, readmissions, and others as indicated. Interact with physicians and social workers for...
Position Purpose: Maintain enrollment and membership records within core internal systems related to qualifications for coverage under contracts or agreements and resolve related issues. Perform audits and analyses on completed member data load processes and monitor eligibility loads, data updates and all internal/external requests Work with internal and external stakeholders to communicate and resolve membership data issues Provide timely, efficient support for the eligibility load process and coordinate with corporate IS department to resolve issues that arise during the process Review, investigate and resolve inquiries regarding loaded membership Handle and resolve complex member data issues, such as loading errors, limited reconciliations and direct entry of data into core systems Generate adhoc reports on membership across multiple lines of business using Business Objects, Access, and other reporting tools Education/Experience: High school diploma or equivalent. 3+ years...
Sep 14, 2021
Position Purpose: Maintain enrollment and membership records within core internal systems related to qualifications for coverage under contracts or agreements and resolve related issues. Perform audits and analyses on completed member data load processes and monitor eligibility loads, data updates and all internal/external requests Work with internal and external stakeholders to communicate and resolve membership data issues Provide timely, efficient support for the eligibility load process and coordinate with corporate IS department to resolve issues that arise during the process Review, investigate and resolve inquiries regarding loaded membership Handle and resolve complex member data issues, such as loading errors, limited reconciliations and direct entry of data into core systems Generate adhoc reports on membership across multiple lines of business using Business Objects, Access, and other reporting tools Education/Experience: High school diploma or equivalent. 3+ years...
Position Purpose: Act as an advocate for the Member and a liaison between the Health Plan and Provider(s) to ensure availability and access to care. Establish a community presence, promote Member education, identify and resolve any systemic barriers that limit Members access to appropriate care. Receive and respond to Member complaints and formal grievances and identify potential access barriers and resolve as indicated in the grievance procedure. Investigate and resolve access and cultural sensitivity issues identified by Member Services staff, State staff, providers, advocacy organizations and recipients. Participate in local community organizations to acquire knowledge and insight regarding the special health care needs of Members and update and revise educational materials as appropriate. Serve as primary contact for Member advocacy groups, human services agencies and the State entities. Maintain confidentiality per HIPAA guidelines. Education/Experience: High school...
Sep 14, 2021
Position Purpose: Act as an advocate for the Member and a liaison between the Health Plan and Provider(s) to ensure availability and access to care. Establish a community presence, promote Member education, identify and resolve any systemic barriers that limit Members access to appropriate care. Receive and respond to Member complaints and formal grievances and identify potential access barriers and resolve as indicated in the grievance procedure. Investigate and resolve access and cultural sensitivity issues identified by Member Services staff, State staff, providers, advocacy organizations and recipients. Participate in local community organizations to acquire knowledge and insight regarding the special health care needs of Members and update and revise educational materials as appropriate. Serve as primary contact for Member advocacy groups, human services agencies and the State entities. Maintain confidentiality per HIPAA guidelines. Education/Experience: High school...
Centene is transforming technology and creating a digital evolution that will empower us to better serve our over 25 million members. Our scope covers all forms of healthcare, including Medicaid, Medicare, Marketplace, Commercial, and even specialty coverage. As a Paralegal, your talents and skills will be challenged, recognized and rewarded. We are a pay-for-performance environment that promotes employees based on talent and contribution. In this Paralegal role, you will: Provide paralegal services to the organization, including file control, preparing various legal filings or applications, drafting documents and conducting research. Provide factual information to various departments in response to requests on products, contracts or processes Prepare and file regulatory filings with various state departments of insurance. Assist with preparing documentation and filing applicable contracts, statements, and any needed amendments Prepare and distribute minutes for...
Sep 14, 2021
Centene is transforming technology and creating a digital evolution that will empower us to better serve our over 25 million members. Our scope covers all forms of healthcare, including Medicaid, Medicare, Marketplace, Commercial, and even specialty coverage. As a Paralegal, your talents and skills will be challenged, recognized and rewarded. We are a pay-for-performance environment that promotes employees based on talent and contribution. In this Paralegal role, you will: Provide paralegal services to the organization, including file control, preparing various legal filings or applications, drafting documents and conducting research. Provide factual information to various departments in response to requests on products, contracts or processes Prepare and file regulatory filings with various state departments of insurance. Assist with preparing documentation and filing applicable contracts, statements, and any needed amendments Prepare and distribute minutes for...
Position Purpose: Oversee the day-to-day quality review function, ensuring accurate and timely review of department processes to ensure compliance with applicable state, federal and accrediting body requirements. Provide supervision for appeals and grievance, quality of care/service; provider redeterminations and other applicable department activities including policies, procedures, workflows, letters, and reports. Communicate and reinforce standards for the quality team Prepare any applicable department state, federal, or accrediting body reports and submit timely. Prepare other quality review reports on departmental findings, identifying individual and organizational trends Identify and analyze team performance trends, address barriers, and recommend process improvements. Ensure non-clinical and clinical audits are conducted according to established tools and standards Provide recommendations for development, or revision of policies, procedures, work flows, documents or other...
Sep 14, 2021
Position Purpose: Oversee the day-to-day quality review function, ensuring accurate and timely review of department processes to ensure compliance with applicable state, federal and accrediting body requirements. Provide supervision for appeals and grievance, quality of care/service; provider redeterminations and other applicable department activities including policies, procedures, workflows, letters, and reports. Communicate and reinforce standards for the quality team Prepare any applicable department state, federal, or accrediting body reports and submit timely. Prepare other quality review reports on departmental findings, identifying individual and organizational trends Identify and analyze team performance trends, address barriers, and recommend process improvements. Ensure non-clinical and clinical audits are conducted according to established tools and standards Provide recommendations for development, or revision of policies, procedures, work flows, documents or other...
Position Purpose: Develop, recommend and implement interventions at the practice and membership level to improve clinical quality and operational efficiency. Collaborate with practices to facilitate redesign efforts, support care teams, introduce population health management and support achievement towards improved financial, process and clinical outcomes. Serve as a liaison to practices to provide on-site and remote assistance and facilitation to the clinicians, care teams and their associated practices to drive improvement in clinical quality and operational efficiency. Develop and execute set of intervention work plans to drive practice improve quality measures and transformation. Develop and implement workflow design and redesign, including electronic health record (EHR) optimization, clinical documentation, billing practices, assessments, financial analyses, and financial performance improvement and reporting. Develop and implement changes to root causes of financial and...
Sep 14, 2021
Position Purpose: Develop, recommend and implement interventions at the practice and membership level to improve clinical quality and operational efficiency. Collaborate with practices to facilitate redesign efforts, support care teams, introduce population health management and support achievement towards improved financial, process and clinical outcomes. Serve as a liaison to practices to provide on-site and remote assistance and facilitation to the clinicians, care teams and their associated practices to drive improvement in clinical quality and operational efficiency. Develop and execute set of intervention work plans to drive practice improve quality measures and transformation. Develop and implement workflow design and redesign, including electronic health record (EHR) optimization, clinical documentation, billing practices, assessments, financial analyses, and financial performance improvement and reporting. Develop and implement changes to root causes of financial and...
Position Purpose: Generate and process denial letters and Notice of Action (NOA) for pre-services, leveling of care and denied medical services. Process intake for appeal requests including: member, provider and interdepartmental correspondences inquiries and escalations Conduct audits and ensure auditing tools are current Maintain the denial and/or appeals logs and assessments in accordance with associated guidelines Responsible for the Medical Management denial & appeal process including letter printing, tracking and disposition of letters within contractual guidelines to ensure compliance Serve as the department liaison for all denial and/or appeals issues Train team on denial and/or appeals work processes Prepare monthly, quarterly, and annual reports for denials and/or appeals Assist management with creating work flows and implementing new processes Education/Experience: High school diploma or equivalent. Associate's degree preferred. 3+ years of related...
Sep 14, 2021
Position Purpose: Generate and process denial letters and Notice of Action (NOA) for pre-services, leveling of care and denied medical services. Process intake for appeal requests including: member, provider and interdepartmental correspondences inquiries and escalations Conduct audits and ensure auditing tools are current Maintain the denial and/or appeals logs and assessments in accordance with associated guidelines Responsible for the Medical Management denial & appeal process including letter printing, tracking and disposition of letters within contractual guidelines to ensure compliance Serve as the department liaison for all denial and/or appeals issues Train team on denial and/or appeals work processes Prepare monthly, quarterly, and annual reports for denials and/or appeals Assist management with creating work flows and implementing new processes Education/Experience: High school diploma or equivalent. Associate's degree preferred. 3+ years of related...
About CSL With operations in 35+ nations and ~27,000 employees worldwide, CSL is driven to develop and deliver a broad range of lifesaving therapies to treat disorders such as hemophilia and primary immune deficiencies, and vaccines to prevent influenza. Our therapies are also used in cardiac surgery, organ transplantation and burn treatment. CSL is the parent company of CSL Behring and Seqirus. CSL Behring is a global leader in the protein biotherapeutics industry, focused on bringing to market biotherapies used to treat serious and often rare conditions. CSL Behring operates CSL Plasma, one of the world's largest collectors of human plasma, which is used to create CSL's therapies. Seqirus is one of the largest influenza vaccine companies in the world and is a transcontinental partner in pandemic preparedness and a major contributor to the prevention and control of influenza globally. We invite you to take a look at the many career possibilities available around the globe and...
Sep 13, 2021
Full Time
About CSL With operations in 35+ nations and ~27,000 employees worldwide, CSL is driven to develop and deliver a broad range of lifesaving therapies to treat disorders such as hemophilia and primary immune deficiencies, and vaccines to prevent influenza. Our therapies are also used in cardiac surgery, organ transplantation and burn treatment. CSL is the parent company of CSL Behring and Seqirus. CSL Behring is a global leader in the protein biotherapeutics industry, focused on bringing to market biotherapies used to treat serious and often rare conditions. CSL Behring operates CSL Plasma, one of the world's largest collectors of human plasma, which is used to create CSL's therapies. Seqirus is one of the largest influenza vaccine companies in the world and is a transcontinental partner in pandemic preparedness and a major contributor to the prevention and control of influenza globally. We invite you to take a look at the many career possibilities available around the globe and...
Position Purpose: Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility. Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census. Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member's attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs. Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the...
Sep 12, 2021
Position Purpose: Assist in activities related to the medical and psychosocial aspects of utilization and coordinated care. Initiate authorization requests for output or input services in keeping with the prior authorization list. Research claims inquiry specific to the department and responsibility. Perform tasks necessary to promote member compliance such as verifying appointments, obtaining lab results. Assess and monitor inpatient census. Screen for eligibility and benefits. Identify members without a PCP and refer to Member Services. Screen members by priority for case management (CM) assessment. Perform transition of care duties to include but not limited to, contact the member's attending physician, member or medical power of attorney, other medical providers (home health agencies, equipment vendors) for information pertaining to special needs. Coordinate services with community based organizations. Attend marketing and outreach meetings as directed to represent the...
