Customer Service Representative The Customer Service Representative is responsible for answering phone calls in a prompt and courteous manner to achieve contractual obligations. Responsible for answering Members and Providers questions with a quick and accurate response. They are
Credentialing Specialist Under the direct supervision of the Manager of Credentialing, responsible for credentialing of providers and associated activities in support of the credentialing process in accordance with established Health Plan credentialing policies following NCQA, Medicare,
Employer Service Representative The Employer Service Representative (ESR) serves within the Customer Service Department handling complex and escalated phone and written inquiries from internal and external customers. The ESR builds and maintains rapport with members, providers, account executives,
Pharmacist Position This is not a remote position - required to work in Wheeling - hybrid. Responsible for comprehensive knowledge of current pharmacotherapeutic principles, disease state and population management to help ensure the delivery of safe,
Claims Reviewer Under the direction of the Manager of Claims, the reviewer performs initial review of claims, including HCFA 1500 and UB 04 claims. Reviewer must meet or exceed production and quality standards and follow documented
Job Opportunity Interprets and applies WVUHS financial policies to make appropriate financial decisions and payment arrangements to ensure the financial viability of WVUHS. Prepares and presents fee estimates to current and potential patients. Provides financial education
