Utilization Management Representative I
1 month ago
Title: Utilization Management Representative I Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations. The Utilization Management Representative I will be responsible for coordinating cases for precertification and prior authorization review. How you will make an impact: Managing incoming calls or incoming post services claims work. Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests. Refers cases requiring clinical review to a Nurse reviewer. Responsible for the identification and data entry of referral requests into the UM system in accordance with the plan certificate. Responds to telephone and written inquiries from clients, providers and in-house departments. Conducts clinical screening process. Authorizes initial set of sessions to provider. Checks benefits for facility based treatment. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. Minimum Requirements HS diploma or GED Minimum of 1 year of customer service or call-center experience; or any combination of education and experience which would provide an equivalent background. Preferred Qualifications Medical terminology training and experience in medical or insurance field preferred. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
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Utilization Management Representative I
3 weeks ago
Cincinnati, United States Elevance Health Full timeTitle: Utilization Management Representative I Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations. The Utilization Management Representative I will be responsible for coordinating cases for precertification and prior authorization review. How you will make an...
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Community Representative I
1 month ago
Cincinnati, United States Sentry Management Full timeJob DescriptionJob DescriptionSentry Management is an industry leader in full-service community association management. Our purpose is to nurture communities we are all proud to call home by putting our communities first, enhancing property values by supporting the board’s endeavors and improving the lifestyles of residents. Our community managers and...
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Field Service Representative I
2 months ago
Cincinnati, United States Breg, Inc Full timeAre you looking for an exciting opportunity? We currently have a full-time opening for a Field Service Representative in Greater Cincinnati . If you are looking for a fast-paced environment where you can make a difference every day, then this is the opportunity for you! The right person to join our team... Demonstrates ownership and...
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Field Service Representative I
2 months ago
Cincinnati, United States Breg Full timeAre you looking for an exciting opportunity? We currently have a full-time opening for a Field Service Representative in Greater Cincinnati. If you are looking for a fast-paced environment where you can make a difference every day, then this is the opportunity for you! The right person to join our team... Demonstrates ownership and accountability;...
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Field Service Representative I
2 months ago
Cincinnati, United States Breg, Inc. Full timeJob DescriptionJob DescriptionAre you looking for an exciting opportunity?We currently have a full-time opening for a Field Service Representative in Greater Cincinnati. If you are looking for a fast-paced environment where you can make a difference every day, then this is the opportunity for you! The right person to join our team...Demonstrates ownership...
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Automotive F&I District Manager
2 months ago
Cincinnati, United States EasyCare Recruiting Full timeJob DescriptionJob DescriptionAutomotive F&I District ManagerAPCO - Ohio MarketSummaryAs a District Manager with APCO, you will generate revenue growth by utilizing a consultative selling approach in the retention of current APCO accounts. Our District Managers nurture existing business relationships to achieve budgeted sales goals by developing and...
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Customer Service Representative I
3 weeks ago
Cincinnati, United States Thermo Fisher Scientific Full timeWork ScheduleStandard (Mon-Fri)Environmental ConditionsOfficeJob DescriptionAre you ready to embark on an exciting career as a Customer Service Representative I? Look no further than Thermo Fisher Scientific Inc.! We are a world-class company known for our exceptional products and services. Join our team and be a part of our ambitious mission of enabling our...
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Associate Director, Utility Services
2 days ago
Cincinnati, Ohio, United States University Of Cincinnati Full timeCurrent UC employees must apply internally via SuccessFactors - Founded in 1819, the University of Cincinnati ranks among the nation's best urban public research universities. Home to more than 50,000 students, 11,000 faculty and staff and 340,000 alumni, UC combines a Top 35 public research university with a physical setting The New York Times calls "the...
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Floater Teller/Member Service Representative I
4 weeks ago
Cincinnati, United States Cincinnati Police Federal Credit Union Full timeJob DescriptionJob DescriptionMember Service Representative / TellerCincinnati Ohio Police Federal Credit Union (COPFCU) is looking for a full-time Member Service Representative/Teller to provide service, information and exceptional customer service regarding all products and services offered by COPFCU.Do you have a friendly and helpful demeanor? Are you...
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Floater Teller/Member Service Representative I
2 months ago
Cincinnati, United States Cincinnati Police Federal Credit Union Full timeJob DescriptionJob DescriptionMember Service Representative / TellerCincinnati Ohio Police Federal Credit Union (COPFCU) is looking for a full-time Member Service Representative/Teller to provide service, information and exceptional customer service regarding all products and services offered by COPFCU.Do you have a friendly and helpful demeanor? Are you...
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Sales Representative
1 month ago
Cincinnati, United States Gateway Logistics, Inc. Full timeJob DescriptionJob DescriptionGateway Logistics, Inc. is a Third Party Logistics (3PL) company in Cincinnati, OH. We are fast-paced, supportive, fun and our mission is to help people move forward, one shipment at a time!Our team at Gateway Logistics, Inc. is looking to add confident, committed and collaborative Logistics Sales Representatives to our...
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Customer Service Representative
2 weeks ago
Cincinnati, United States Resurgence Management Full timeJob DescriptionJob DescriptionOur goals are simple. We want to accelerate the growth and notoriety of any brand we work with. We employ innovative techniques within a proven model that is specifically geared to provide a positive experience for consumers with each interaction. Our ability and proven track record allow for the highest possible customer...
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Customer Service Representative
3 months ago
Cincinnati, United States Resurgence Management Full timeJob DescriptionJob DescriptionOur goals are simple. We want to accelerate the growth and notoriety of any brand we work with. We employ innovative techniques within a proven model that is specifically geared to provide a positive experience for consumers with each interaction. Our ability and proven track record allow for the highest possible customer...
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Patient Access Specialist I
2 weeks ago
Cincinnati, United States Hueman PE Talent Solutions Full timeDescriptionBrightView Health is hiring a Patient Access Specialist I as a Full-Time job in Cincinnati, OH. As a Patient Access Specialist I, you will complete the day-to-day duties surrounding new patient intake, insurance verification and initial appointment scheduling. You will be responsible for assisting in the contact center, scheduling staff...
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Clinical Quality Specialist I/II
2 months ago
Cincinnati, United States Cincinnati Children's Hospital Medical Center Full timeClinical Quality Specialist I/II (Heart Institute)-152626 Description Expected Starting Salary Range: 37.80 - 47.89 Cincinnati Children’s Hospital, a nonprofit academic medical center established in 1883, is one of the oldest and most distinguished pediatric hospitals in the United States. We offer comprehensive clinical services, from treatments...
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Electrical Engineer
2 months ago
Cincinnati, United States Power System Engineering Inc Full timeJob DescriptionJob DescriptionLocation: Cincinnati OhioExcellence Through People! Take your engineering career to the next level by working with energetic, talented, and forward-thinking colleagues and clients who invest in the collective good, take a balanced approach to sustainable solutions, are flexible to the realities of complex changes, and provide...
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Associate Director, Utility Services
3 days ago
Cincinnati, United States University Of Cincinnati Full timeCurrent UC employees must apply internally via SuccessFactors - bit.ly/UCEMPLFounded in 1819, the University of Cincinnati ranks among the nation’s best urban public research universities. Home to more than 50,000 students, 11,000 faculty and staff and 340,000 alumni, UC combines a Top 35 public research university with a physical setting The New York...
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Store Manager 6102
2 months ago
Cincinnati, United States Hibbett Sports Full time06102 Cincinnati, OHLE_303 City Gear, LLC Job Title: Store Manager Department: Operation FLSA Status: Non-Exempt Reports To: District Sales Manager SUMMARY The Store Manager oversees and is responsible for the store’s sales efforts in each department in the store and supervises the store’s overall operation to ensure efficiency and...
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Quantitative Analyst I
2 weeks ago
Cincinnati, United States Fifth Third Full timeMake banking a Fifth Third better We connect great people to great opportunities. Are you ready to take the next step? Discover a career in banking at Fifth Third Bank. GENERAL FUNCTION: The Quantitative Analyst I is responsible for routine operational or tactical quantitative work. Day to day actions are focused on administering defined procedures, analyses...
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Patient Access Specialist I
2 months ago
Cincinnati, United States Hueman PE Talent Solutions Full timeDescription BrightView Health is hiring a Patient Access Specialist I as a Full-Time job in Cincinnati, OH. As a Patient Access Specialist I, you will complete the day-to-day duties surrounding new patient intake, insurance verification and initial appointment scheduling. You will be responsible for assisting in the contact center, scheduling staff...