3 customer service representative jobs found

At NorthBay Health, the Claims Analyst II is responsible for independently completing all tasks in claims adjudication, including processing adjustments. The position is co-responsible for the operational functions for the organization’s capitated hospital and medical group business, processing all claims, oversees customer service issues, researching/resolving payment issues and addressing corrections in the system with the Claims Specialist.    PRIMARY JOB RESPONSIBILITIES Generates Department reports that are utilized weekly by the Claims Specialist position to track timely payment of claims. Oversees the production of encounter data analysis and processing. Lead point of service intake for all claims issues. Claims preparation for determination of payment. Addresses corrections in the claim system and in operational processes. Oversees grievances and provider dispute resolutions in partnership with the Claims...

At NorthBay Health, The HR Benefits and Support Specialist is responsible for assisting in administering the company's employee benefits, key Human Resources programs, including some recognition programs, and for providing general administrative support to the Human Resources function and Human Resources leadership team.  The HR Benefits and Support Specialist is also responsible for providing comprehensive support in various HR functions including general HR support functions including but not limited to data entry, HR reporting and system support. This role requires a deep understanding of HR policies and procedures and the ability to handle sensitive and confidential information.          Primary Responsibilities                           Benefits Administration:...

At NorthBay Health, the Population Health RN Inpatient Case Manager (PHRNICM) is responsible for providing complex case management (CCM) to diverse groups of high-risk capitated populations. Complex case management is defined as the coordination of care and services for members who need help navigating the healthcare system to facilitate the appropriate delivery of the right care and services at the right place and time. These services are provided utilizing available resources across a continuum of care and in collaboration with members, caregivers, medical home providers, and ancillary health care providers. NBH utilizes a Population Health approach to identify diverse groups and to enhance member engagement and coordinate care delivery across populations to improve clinical outcomes. In addition to continuum of care responsibilities this position will assist within the inpatient case management department as needed. PRIMARY JOB DUTIES Identify...