- Humana (San Juan, PR)
- …a part of our caring community and help us put health first** The Pharmacy Claims Representative assists local pharmacies with claims adjudication to support ... maintaining hospice/facility/pharmacy relationships under the direction of the Pharmacy Claims Team Leaders & the Pharmacy Claims ...Pharmacy Claims Team Leaders & the Pharmacy Claims (Support Services) Manager * Assist pharmacies with … more
- Sedgwick (San Juan, PR)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Liability Claims Representative | Remote Are you looking for an opportunity to ... Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. +...OF THE ROLE:** To analyze mid-level Commercial General Liability claims on behalf of our valued clients to determine… more
- Sedgwick (San Juan, PR)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Representative - Auto **PRIMARY PURPOSE** : To analyze and process ... low to mid-level auto and transportation claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Processes auto property...+ Processes auto property damage and lower level injury claims ; assesses damage, makes payments, and ensures claim files… more
- Humana (San Juan, PR)
- …a part of our caring community and help us put health first** The Claims Review Representative 3 makes appropriate claim decisions based on strong knowledge ... claims procedures, contract provisions, and state and federal legislation. The Claims Review Representative 3 performs advanced administrative / operational /… more
- Ryder System (San Juan, PR)
- …small to medium 3rd party property damage and cargo claims under Ryder's self-insured, self-administered liability program. **ESSENTIAL FUNCTIONS** Investigates, ... to medium exposure 3rd party property damage and cargo claims pursued against Ryder Ensures the most appropriate and...to verify the legitimacy of an interview or Ryder representative , please contact Ryder at ###@ryder.com or ###. **Current… more
- FirstBank PR (San Juan, PR)
- Business Support Representative Our Company At FirstBank PR, we strive to be a trusted advisor to our clients and our employees are the ones that ensure we deliver ... Center. . Provides a variety of services to customers, such as: payment claims , debit claims , late charges claims , delivery of payment coupons, and claims… more
- Conduent (Guaynabo, PR)
- …a culture where individuality is noticed and valued every day. **Customer Service Representative II** **100% - Onsite Guaynabo, PR** $12.10 HR Opportunity to earn an ... month. **Great Benefits and Paid Training!** **Summary:** As a **Customer Service Representative II,** you will be responsible for the resolution of multi-product… more
- FirstBank PR (San Juan, PR)
- CUSTOMER SERVICE & SALES REPRESENTATIVE FIRSTLINE CALL CENTER FIRSTBANK PR Our Company At FirstBank PR, we strive to be a trusted advisor to our clients and our ... one place for you. A Brief Overview The Customer Service & Sales Representative answers telephone calls to respond to customer inquiries or perform sales activities.… more
- Evolent (San Juan, PR)
- …+ Answer and manage inbound inquiries regarding health plan benefits and claims , eligibility, medical and other healthcare procedures, billing and payments and other ... related topics from customers in a prompt, courteous manner. Conduct out-bound and/or return calls to customers as necessary. + Ask appropriate questions and listen actively to identify specific questions or issues to provide appropriate response and type of… more
- Oriental Bank (San Juan, PR)
- …to the appropriate sales team member. + Receives, records, and channels claims , and inquiries from customers or potential customers and provides applicable guidance. ... + Documents calls and service inquiries in existing bank systems and applications. + Escalates and refers customer matters to next-level management or appropriate operational areas. + Consistently provides the customer with a high level of quality service. +… more
- HealthEdge Software Inc (San Juan, PR)
- …implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior ... level role in analyzing claims data, as well as translating contract terms, policies,...permanent **Work Environment:** The physical demands described here are representative of those that must be met by an… more
- Elevance Health (San Juan, PR)
- **Position Title:** Customer Care Representative I (Hybrid) **Location: Hybrid (Candidates must live within commutable distance of the San Juan, PR Pulse Point: 654 ... and business operations services for health plans. The Customer Care Representative is responsible for successfully completing the required basic training. Able… more
- HealthEdge Software Inc (San Juan, PR)
- …and QE. We have divided our product teams into Value Streams (ie, Claims , Billing & Financials, Enrollment, BlueCard, Integration, and Platform). Each Value Stream ... integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a… more
- HealthEdge Software Inc (San Juan, PR)
- …issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite ... of provider rate and/or claim editing provisions in a claims adjudication system and/or third-party vendor application. + Working...None **Work Environment:** The physical demands described here are representative of those that must be met by an… more
- Banco Popular Puerto Rico (Guaynabo, PR)
- …based on analysis of prospect circumstances. + Provides support to the claims department. + Other duties may be assigned. Education Bachelor's Degree Experience ... + Certified Insurance Counselor (CIC) or Certified Insurance Service Representative (CISR) designation Other Qualifications: + Strong communication, analytical,… more
- Ford Motor Company (San Juan, PR)
- …and state arbitrations. **What you'll do ** + Act as Ford's corporate representative in consumer "lemon law" litigation in California + Be knowledgeable regarding ... vehicle buyback requests + Provide training and direction to a team of Consumer Claims Analysts located in California + Ensure that all training guides / educational… more
- Humana (San Juan, PR)
- …investigation experience in managed care or CMS. + Prior health insurance claims experience + Demonstrated formal or informal people management + Excellent PC ... of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and… more
- HealthEdge Software Inc (San Juan, PR)
- …root-cause issues areidentifiedand addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete ... (USA Only):** Exempt **Work Environment:** The physical demands described here are representative of those that must be met by an employee to successfully… more
- HealthEdge Software Inc (San Juan, PR)
- …solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration capabilities, a ... Employment:** Full-time, permanent **Work Environment:** The physical demands described here are representative of those that must be met by an employee to… more