Responsible for daily processing of dental claims and encounters within plan timelines; job function may differ depending on the specific area of assignment (e.g. claims, referrals, pre-estimates).
This position is location in our Tampa Office and does not offer relocation expenses.
Member Services Representatives (MSRs) are expected to provide excellent customer service to all incoming callers and will answer inquiries related to; dental benefits, eligibility, provider information, claims, grievance and appeals, fulfillment requests and other miscellaneous inquiries. MSRs must observe all local, state and federal guidelines and regulations.
**This is a Union position in Irvine, CA**
The Audit/Compliance Coordinator will be responsible for carrying out duties related to the ongoing administration of various Quality Management (QM)-related initiatives, programs, meetings and activities while coordinating various ongoing compliance activities as needed.
The purpose of a business analyst is to act as the interception point between the business and technical team. As such, you will be responsible for understanding business processes and translating these into a set of requirements as well as working with the development team on functional designs for the solution.
As a business analyst with a passion for technologies, you will be a key part of the LIBERTY team, working closely alongside our team and developers to enable us to deliver services, critical to the success of a growing organization. You will need to understand the strengths and benefits of the Microsoft platform.
To be successful in the role, you'll need to understand how collaborative technologies can benefit business users, simplifying processes to achieve goals. You'll also be expected to be able educate business users.
Involved throughout the project lifecycle, a Business Analyst works with our team to understand as-is and to-be business process flows and requirements, as well as how information flows and changes through the business. The Business Analyst uses this information to assist in the design of the optimal IT solution and works closely with development and business users through implementation.
The Grievance Analyst I will be responsible for intake of all member, provider and Health Plan Partner grievances and appeals. In addition, the Grievance Analyst I will investigate and resolve certain member, provider and Health Plan Partner grievances and appeals.