Location: Rico, CO
Company: Elevance Health
than 118 million people. MMM Holdings, LLC es una compañía que provee cubiertas de Medicare Advantage y Medicaid en Puerto Rico. Actualmente, MMM Holdings, LLC opera en Puerto Rico bajo Elevance Health, Inc. una compañía líder en servicios de salud dedicada a mejorar la calidad de vida de las comunidades en los Estados Unidos.
Por medio, de sus empresas afiliadas. Claims Representative II (Health & Dental) Location: Puerto Rico The Claims Representative II (Health & Dental) is responsible for keying, processing health claims in accordance with claims policies and procedures. Works without significant guidance w/ basic understanding of multiple products (HMO, PPO, COB, etc. ). How you
will make an impact Primary duties may include, but are not limited to: Able to handle more complex claim with a good understanding of the application of benefit contracts, pricing, processing, policies, procedures, government regs, coordination of benefits, healthcare terminology and/or adjust claims.
Good working knowledge of claims and products, including the grievance and/or re-consideration process. Excellent knowledge of the various operations of the organization, products, and services. Reviews, analyzes and processes claims/policies related to events to determine extent of company's liability and entitlement. Researches and analyzes claims issues. Responds to inquiries, may
involve customer/client contact. Minimum Requirements: Requires a HS diploma or equivalent and a minimum of 1 year of claims processing experience; previous experience using PC, database system, and related software (word processing, spreadsheets, etc.
); or any combination of education and experience which would provide an equivalent background. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler.
We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week.
Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation.
Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, interaction, interactionual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@for assistance.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, interaction, interactionual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.
Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@for assistance.
Nevada, New Mexico, Tennessee, Texas, and Utah. You’ll be a perfect fit for our team if you are a caring and compassionate individual, someone who takes a patient-first approach, and values collaborative, mission-driven work. If that sounds like you, apply now and become part of our team at Giving Home!
We are looking for a compassionate and skilled Registered Nurse (RN) in Arvada, CO to administer patient home health care in accordance with a physician established care plan. This role is a part time, 1099 contract opportunity, with the current need being 8 hours per week - 2 visits of 4 hours each week. Care is provided at the patient’s residence which is located between Indiana and
86th parkway. Offers are contingent upon passing a background check. Responsibilities Execute physician prescribed plans of care. Complete compliant documentation of the care provided in the system of record.
Manage and administer prescribed medication, treatment, and therapies. Conduct patient backssments in coordination of care plan. Perform various activities associated with daily living. Monitor for changes in the patient’s condition such as weight loss/gain, self-care abilities, and indicators of disease progression. Communicate with family members, physicians, case managers, and other prescribed individuals regarding the health of the patients. Minimum Qualifications Current State
or Compact License as a Registered Nurse or Licensed Practical Nurse.
Current CPR certification Maintain required insurance. Good interpersonal skills Hand-eye coordination and manual dexterity Must have dependable transportation and be willing to commute to the patient’s home. Ability to provide basic medical management up to medically fragile end of life care. Preferred Qualifications 1+ years of experience as an RN/LPN in a clinical or home health setting. In order to ensure the life-changing care our patients require, we know that we must have a team of exceptionally caring and passionate individuals who are committed to advocating for and empowering those in need.
To develop an exceptional team, we are dedicated to ensuring we provide each team member with a collaborative company culture, competitive benefits and compensation, and growth opportunities to develop their skills and advance their career. If you are ready to embark on a rewarding journey and be part of an organization that makes an impact on patients’ lives, we encourage you to apply for a position at Giving Home today! Giving Home Health Care is an equal-opportunity employer and welcomes candidates of all backgrounds to apply. Pando Logic. Keywords: Registered Nurse (RN), Location: ARVADA, CO - 80004For more details: jobs-search.
org/insurance_arvada-c426824/arvada-co-home-health-registered-nurse-rn-arvada_i1973465701
a trailblazing spirit, and a celebrated history, we? re making new strides every day. We? ve been Magnet-designated four times by the American Nurses Credentialing Center and are consistently recognized among the nation? s top 10 pediatric hospitals by U.
S. News & World Report. As a national leader in pediatric care, we serve children and families from all over the nation. Our System of Care includes four pediatric hospitals, 11 specialty care centers, 1,300+ outreach clinics and more than 10,000 healthcare professionals representing the full spectrum of pediatric care specialties. Here, we know it takes all of us, every role, to deliver the best possible care to each child and family
we treat. That? s why we build our teams toward a foundation of equity in access, advancement, and opportunity. We know teams of individuals with different identities and backgrounds can nurture creativity and innovation.
We know we can see, treat, and heal children better when our team reflects the diversity of our patient population. We strive to attract and retain diverse talent because we know a truly inclusive and equitable workforce will help us one day realize our most basic calling: to heal every child who comes through our doors. A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child. Here, it? s different.
Additional Information Department: Insurance Verification Hours per week: 40, eligible for benefits Shift: Monday - Friday 08:30 - 1700 Job Overview The Insurance Verification Representative Senior handles high risk insurance accounts in Finance and serves as a lead, coordinator or mentor.
Verifies insurance policy benefit information and obtains authorization and precertification, prior to the patient's visit or non-scheduled admission. Responsibilities POPULATION SPECIFIC CARE No direct patient care. ESSENTIAL FUNCTIONS An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all of the functions which the employee may be expected to perform.
Performs lead duties within the unit as well as focuses on insurance accounts identified as high risk by the department. Provides insurance verification training and support to the unit. Mentors and coaches co-workers; collaborates with management in order to reach goals and business outcomes. Notifies insurance company of services being rendered and obtains authorization if applicable; ensures notification, authorization and verification is completed for each account. Completes and obtains insurance information and referrals; verifies policy information and obtains detailed benefit information; codes work list according to departmental guidelines.
Updates and edits coverage information on non-scheduled or pre-admitted patients; coordinates reporting activities Identifies problems and assures insurance information and appropriate referrals have been completely and accurately obtained. Serves as a subject matter expert for co-workers and staff. Provides customer service in person by phone or email; assists customers, patients, families, providers, and staff with complex or escalated insurance questions. Works in conjunction with hospital departments to solve intradepartmental issues.
Assists on special projects as assigned by the Supervisor. Other Information COMPETENCIES DIVERSITY & INCLUSIVITY? Is sensitive to cultural diversity, race, gender, and other individual differences in the workforce; recognizes the value of diverse perspectives and experiences and fosters a work environment reflective of the community at large. BUILDING CUSTOMER LOYALTY - Meeting and exceeding internal or external customer expectations while cultivating relationships that secure commitment and trust. BUILDING PARTNERSHIPS - Developing and leveraging relationships within and across work groups to achieve results.
COMMUNICATION - Conveying information and ideas clearly and concisely to individuals or groups in an engaging manner that helps them understand and retain the message; listening actively to others. CONTINUOUS LEARNING - Actively identifying new areas for learning; regularly creating and taking advantage of learning opportunities; using newly gained knowledge and skill on the job and learning through their application. DECISION MAKING - Identifying and understanding problems and opportunities by gathering, analyzing, and interpreting quantitative and qualitative information; choosing the best course of action by establishing clear decision criteria, generating and evaluating alternatives, and making timely decisions; taking action that is consistent with available facts and constraints and optimizes probable consequences.
EMOTIONAL INTELLIGENCE - Establishing and sustaining trusting relationships by accurately perceiving and interpreting own and others? emotions and behavior; leveraging insights to effectively manage own responses so that one? s behavior matches one? s values and delivers intended results.
MANAGING RELATIONSHIPS - Meeting the personal needs of individuals to build trust, encourage two-way communication, and strengthen relationships PLANNING AND ORGANIZATION - Establishing an action plan for self and others to complete work efficiently and on time by setting priorities, establishing timelines, and leveraging resources. QUALITY ORIENTATION - Accomplishing tasks by considering all areas involved, no matter how detailed; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time. RESOLVING CONFLICT - Helping others deal effectively with an antagonistic situation to minimize damage to the relationships and promote shared goals; using appropriate interpersonal methods to reduce tension or conflict between two or more people and facilitate agreement.
STRESS TOLERANCE - Maintaining stable performance under pressure or opposition (e. g. experiencing time pressure, conflict, or job ambiguity); handling stress in a manner that is acceptable to others and to the organization. SCOPE AND LEVEL Guidelines: Guidelines are generally numerous, well established, and directly applicable to the work assignment. Work assignment and desired results are explained by general oral or written instructions.
Complexity: Duties assigned are generally repetitive and restricted in scope but may be of substantial intricacy. Employee primarily applies standardized practices. Decision Making: Decisions or recommendations on non-standardized situations are limited to relating organizational policies to specific cases. Brings non routine issues to supervisor. Problems that are not covered by guidelines or are without precedent are taken up with the supervisor. Communications: Contacts with the public or employees where explanatory or interpretive information is exchanged, gathered, or presented and some degree of discretion and judgment are required within the parameters of the job function.
Supervision Received: Under normal supervision, within a standardized work situation, the employee performs duties common to the line of work without close supervision or detailed instruction. Work product is subject to continual review. Qualifications EDUCATION? High School Diploma or Equivalent EXPERIENCE? Three years of customer service required, including two years in a medical office setting. Physical Requirements Ability to Perform Essential Functions of the Job Audio-Visual: Hearing: Good Audio-Visual: Near Vision: Good General Activity: Sit: 2-4 hrs.
per day Motion: Bend: Up to 1/3 of time Use of Hands/Feet: Precise Motor Function Weight Lifted/Force Exerted: Up to 30 pounds Work Environment Mental and Emotional Requirements: Independent discretion/decision making. Mental and Emotional Requirements: Makes decisions under pressure. Mental and Emotional Requirements: Manages stress appropriately. Mental and Emotional Requirements: Works with others effectively. Equal Employment Opportunity It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.
We do not discriminate on the basis of race, color, religion, national origin, interaction, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. Salary Information Annual Salary Range (Based on 40 hours worked per week): $42,065.38 to $63,098.07 Hourly Salary Range: $20.22 to $30.34 Benefits Information As a Children? s Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, 403b employer match (retirement savings), and a robust wellness program.
about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role.
The typical candidate is hired below midpoint of the range. FT - Night, Ortho Spine RN Do you have a passion for healthcare and helping others? Do you enjoy working in a fast-paced, patient-centered environment? Jump-start your career as a Registered Nurse (RN) at The Medical Center of Aurora. Submit your application today! We offer you a generous benefits package including: Medical, Dental,
Disability and Life Insurance Flexible Spending Accounts Paid Time Off Employee Discount Program Employee Stock Purchase Program Tuition Reimbursement Student Loan Repayment When you work as an RN on our Ortho/Neuro unit, you are joining a team of nursing and healthcare professionals that are working together to care for our patients like family.
If you want to work with a team that will help you take your career to the next level, this is the nursing position for you. Join our Ortho/Neuro family now! What you will do in this role: You will be delivering patient care based on the physical, psychosocial, cultural, safety and learning needs of the individual patient. You will be demonstrating
your advanced knowledge, skills and understanding of all aspects of the population served in the care of your patients.
You will be providing safe and appropriate care within our Values and Standards of Nursing Practice. requirements Current licensure in the State of Colorado as a Registered Nurse, or current active multi-state Registered Nurse license. Basic Life Support certification through the American Heart Association or American Red Cross. Graduate from an accredited school of nursing. Acute care RN experience preferred The Medical Center of Aurora, the first community hospital in the Denver Metro area to receive three-time Magnet designation for nursing excellence by the American Nurses Credentialing Center (ANCC), is a 346-bed acute care hospital located in Aurora, Colorado.
Our hospital is comprised of six campuses in Aurora and Centennial, Colo. including the Main Campus, located at Interstate 225 and Mississippi, the North Campus Behavioral Health and Wellness Center, Centennial Medical Plaza, Saddle Rock ER, Spalding Rehabilitation Hospital, Spalding Rehabilitation at P/SL, and a medical office building at Green Valley Ranch. The Main Campus facility is a Level II Trauma Center with Primary Stroke Certification and Chest Pain Center accreditation, and has an affiliation with Rocky Mountain Hospital for Children as well as the Sarah Cannon Cancer Institute.
The Medical Center of Aurora has received seven consecutive ‘A’ grades from The Leapfrog Group (Fall 2016 - Spring 2019, ) and they were Colorado’s only hospital to receive the Leapfrog Top General Hospital designation two years in a row (2016, 2017. ) In addition, the hospital was recognized as a Best Regional Hospital by U. S. News & World Report (2014-2015, 2017-2018, 2018-2019). The hospital was also named to Healthgrades 2020 America’s 250 Best Hospitals, putting TMCA in the top five percent of U.
S. hospitals for clinical outcomes. The Medical Center of Aurora is proud to be a part of the Health ONE system of hospitals. If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply. Come unlock the possibilities and apply today! HCA Health One Job ID #1-INFOR-410187. Posted job title: Registered Nurse Neuroscience For more details: jobs-search. org/insurance_aurora-c426830/job_i1969309241
