Jobs in San Juan, Puerto Rico

San Juan, PR Employment Information

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1000+ San Juan, Puerto Rico jobs found on Monster.

Jobs 1 to 20 of 1417
San Juan, PR
POSITION DESCRIPTION This position will be responsible of determination of adverse pre evaluated cases in Coverage Determination. This position will work closely with the Director of Pharmacy Operation developing and planning strategies to reach the optimum human resources and technology efficiency. Make recommendations to improve and assure an effective service delivery. EDUCATION AND EXPERIENC...
San Juan, PR, 00918
Join AXA Advisors, LLC – As an affiliate of AXA Equitable Life Insurance Company and a member of the AXA Group*, one of the world's most admired financial services organizations with 91 billion Euros in revenue as of December 31, 2010, AXA Advisors is positioned to offer highly motivated, achievement-driven individuals an opportunity to grow a thriving practice. Job Description · Analyzing fina...
San Juan, PR
The Corporate PIM Manager is accountable for the daily operations of assigned PIM Units - assuring that department, federal and state specific standards are maintained and that overall PIM processing accuracy is attained and maintained. Essential Functions • Lead all aspects of the Provider Information (PI) Department by ensuring processes are carried out timely and accurately. • Establish and ...
SAN JUAN, PR
ZARA ESTA BUSCANDO DEPENDIENTES, CAJEROS Y ALMACENISTAS PARA LA NUEVA TIENDA EN “THE MALL OF SAN JUAN”! ZARA esta buscando personas trabajadoras, llena de energía que tenga pasión por la moda para unirse a nuestro equipo en la nueva tienda de Zara en San Juan. Nos gusta que tengas experiencia pero, sobre todo, apreciamos tu interés por la moda y tus ganas de vivirla en directo. Inicia con nosotr...
San Juan, PR
Candidates must be bilingual to be considered for the position. Resolves issues and problems encountered in day-to-day claims processing, auditing and recovery. Is recognized by management and staff as an expert in issues related to claims processing, payment dispute resolution, cost containment, audit processes, recovery functions and contract interpretation. Plays a key role in training, proble...
San Juan, PR
Candidates must be bilingual to be considered for the position. Directly supervises daily activities/tasks performed by non-exempt and/or exempt employees. Monitors operations of Provider Information (PI) unit and actively assists, or provides direction to, subordinates as required using standard policies, procedures and guidelines. Essential Functions • Identify, interview and select candidate...
San Juan, PR
Must be fluent bi-lingual spanish / english Responsible for gathering, coordinating, and processing of data from the provider network for entry into the Provider Information Management System. Also responsible for development of policies and procedures, tracking of provider data, overseeing projects as requested by Director, Manager, Supervisor or Lead of Provider Network Administration unit. Es...
San Juan, PR, 00918
Our Client, a Company in the healthcare industry is looking for a Finance Leader responsible for daily operations of Finance and other divisions related to this position. Requirements: BA, Finance, Accounting or related field; advance training or experience in healthcare analytics MBA, MS in Finance, Accounting, or post graduate training in Finance 10 years progressive healthcare finance or an...
San Juan, PR
Job Summary Claims Processing of complex claims (stop loss, etc.) and adjudication and claims research when necessary. Must meet and/or exceed qualitative and quantitative production standards. Provides informational resource for employees, assist in training new staff, handle difficult claims. Essential Functions • Quality Standard - Meet and Maintain quality standard for position. • Claims A...
San Juan, PR
Job Summary Claims Processing and adjudication of more complex CMS 1500 claims as well as processing of UB claims for specific services. Assists with claims research when necessary. Must meet and/or exceed qualitative production standards. Essential Functions • Quality Standard - Meet and Maintain the quality rate. • Claims Adjudication - Meet and consistently maintain production standards. •...
San Juan, PR
Job Summary Under direct supervision, provides general administrative support to a department or group of professionals. Compiles and analyzes basic information for inclusion in reports or presentation materials,prepares charts, graphs, or tables as necessary. Receives and responds to routine correspondence following established procedures not requiring management review. Requires the ability to ...
San Juan, PR
Job Summary Provide in depth research and adjudication of underpaid and/or denied claims to ensure that all components, i.e., member, provider, authorization, claim and system are valid and correct for accurate processing. Interface with other departments and/or health plans to resolve outstanding issues affecting claims rework. Essential Functions • Researches tracers (if applicable), adjustme...
San Juan, PR
Job Summary Data entry and/or editing of claims related data, involving research on providers, member and coding when necessary. Must meet and/or exceed quality production standards. Essential Functions • Logging (Data Entry) and editing of claims via the Claims Editor and Claims Payment system, Research submitted claims if applicable. • Quality Standard- Must meet and maintain the quality rat...
San Juan, PR
Job Summary Resolves issues and problems encountered in day-to-day claims processing, auditing and recovery. Is recognized by management and staff as an expert in issues related to claims processing, payment dispute resolution, cost containment, audit processes, recovery functions and contract interpretation. Plays a key role in training, problem resolution, work floor optimization and process im...
San Juan, PR
Job Summary Entry level claims processing and adjudication of fee for service claims (CMS 1500 and basic UB04) and claims research when necessary. Must meet and/or exceed quality and production standards. Essential Functions • Quality Standard - Must meet and maintain the quality rate. • Claims Adjudication - Must meet and consistently maintain production standards. • Teamwork - Rating is bas...
San Juan, PR
AT&T: So Much More of What You Work For This is not your average Part-Time Opportunity! AT&Ts Part-Time Retail Sales Consultants earn a base salary plus commission and are eligible for competitive benefits packages. They are also crucial to serving our customers during peak hours, when sales are often higher. Looking for an opportunity where you can put your energy and enthusiasm to work to crea...
San Juan, PR, 00921
Entry Level Sales Looking for a company that cares more about your attitude and willingness to learn than your previous experience? Trying to find seasonal work that actually fits around YOUR schedule? Want a sales position that involves offering people products they actually want? You just might be looking for us. We’re Vector Marketing, a 33 year-old U.S. based company and we’re looking for se...
San Juan, PR
Spend more time wowing clients with Vistaprint Pro Advantage. We’re an exclusive print reseller program for creative professionals just like you. Sign up to get discounts on everything you order for your clients’ printing needs, including shipping. And then resell products at your own prices. All products and packages are unbranded and can be delivered direct to your clients, if you’d like. Whe...
San Juan, PR
Job Summary Responsible for the timely and accurate entry of provider demographic, contract affiliation, and fee schedule information into the health plan system. Must be able to accurately interpret request and configure provider data in such a way that ensures accuracy and claims adjudication is optimized. Essential Functions • Receives information from outside party(ies) for update of inform...
San Juan, PR
San Juan, Puerto RicoAccepting USA Nationwide applicationsRelocation available Candidates must be bilingual (Spanish / English) to be considered for the position. If you are interested…….. Please email me back for full job description and next steps Molina Healthcare is opening a brand new Claims Processing Center in San Juan, Puerto Rico Positions: Director (1) Job # 12054BRManager (2) Job # ...

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