US Tech Solutions Columbia, South Carolina Duration: 3+ month’s Contract Job Description: Responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. Responsibilities: 40% Responds to written and/ |
US Tech Solutions Columbia, South Carolina Duration: 3+ months (Possible Extension) Job Description: CONTRACT ONLY 1 week onsite training then COMPLETE REMOTE WILL HAVE TO COME IN PERIODICALLY FOR MEETINGS/CLASSES AS NEEDED Interview VIA TEAMS LMSW or LISW with a Master’s degree if possible with a medical background Provide social work assistance of varying degrees to our members Communication skills, computer skills, familiarity with comm |
US Tech Solutions Columbia, South Carolina Duration: 12 Months (Possible extension) Job Description: Onsite 5 days a week, Monday through Friday Required Technologies: Microsoft Excel and Access VBA RSA Console Active Directory Reporting ServiceNow Nice To Have: Scripting & Reporting via Powershell Day to Day: 1. Process improvement experience: preferred working knowledge of Six Sigma and Lean methodologies. 2. Skilled in process analysis, |
US Tech Solutions Columbia, South Carolina Duration: 3+ Months Contract Job Description: Reviews and evaluates medical or behavioural eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of hea |
US Tech Solutions Columbia, South Carolina Duration: 6+ month’s Contract Job Description: Responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines. Responsibilities: 65% May perform any or all of the following in the enrollment of providers determines the acceptabil |