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Operations Admin & Executive Assistant

Richmond, VA
Direct Hire
As the first person our guests meet at the front desk, it is important that our Admin Assistant projects a professional company image through both in-person and phone interaction. Responsible for planning, directing, or coordinating administrative supportive services to the Operations Department, CEO and President. Duties include general clerical, receptionist and project-based work. Primary Responsibilities: The essential functions include, but are not limited to the following: Provide support to Vice President of Operations’ day-to-day needs. Provide executive admin support to CEO and President, including but not limited to answering calls and emails, maintaining calendar and coordinating travel and meeting arrangements. Set-up and coordinate meetings and conferences where necessary. Meet and greet clients and visitors, preparing welcome message for expected guests. Retrieve and disseminate mail, fax and email each day. Sign for and distribute UPS/Fed Ex/Airborne packages. Answer telephone and respond to inquiries or transfer to appropriate staff member. Route requests to appropriate staff member. Monitor and order office supplies, equipment, and postage as necessary. Maintain and update organizational files. Responsible for the overall appearance and cleanliness of the office, as well as decorating for various holidays and occasions. Perform general clerical duties to include but not limited to: photocopying, faxing, mailing, filing, and shredding. Other duties and responsibilities: Assist Operations Department with New Hire activities as needed. Responsible for mailing birthday and holiday cards, and other correspondence to employees. Perform other duties related to administrative responsibilities as required and assigned by supervisor. Support office staff in assigned project-based work as needed. Act as primary caretaker for the office pet.   Skills and Qualifications: 1 – 2 years work experience with a small business or similar environment is preferred. High School Diploma, BA/BS Degree or related field preferred. 1+ years experience with data entry. Strong computer and writing skills, including proficiency with MS Office. HRIS system experience helpful. Strong interpersonal and professional skills. Must have a strong work ethic and be a dedicated team player. Demonstrated ability to organize and implement priorities, and manage multiple tasks and demands. Ability to work in a fast-paced environment and able to respond quickly and deliver results under pressure. Must be extremely organized, flexible and creative.

Staff Analyst

Glen Allen, VA
Contract
The Staff Analyst will be responsible for the completion of post-payment claims audits involving many different provider types, including personal care services providers, physicians, residential treatment centers, hospices, home health providers, and private duty nurses. The objective of these audits is to evaluate Medicaid claims for compliance with Virginia Medicaid regulations and policy. Essential Functions: Work as part of a team conducting post-payment audits and reviews of Virginia Medicaid claims for reimbursement Work with Senior Analysts in charge of each audit to ensure internal and regulatory deadlines are met Strive to exceed client expectations Research and apply Federal and State Medicaid reimbursement policies and regulations Effectively communicate with stakeholders, including client staff and provider staff Maintain security and confidentiality of all protected health information Prepare audit work papers in accordance with firm and professional standards Prepare and distribute analytical data reports and/or records Work within the defined scope of the project Work on multiple assignments with strict deadlines Additional responsibilities as assigned Requirements: Bachelor's degree in Accounting, Finance or related field required Prefer CPA and/or CFE, or candidate for either Internship or 1 year of audit experience required, preferably reviewing Medicaid claims Proficient use of applicable software programs, including Microsoft Word, Excel, Access, Windows Organized and detail oriented with strong problem solving skills Self-starter with the ability to work accurately and independently Demonstrated ability to effectively communicate verbally and in writing with all levels of an organization, both internally and externally Effectively multi-task with planning and efficiency Must be able to manage multiple deadlines and prioritize assignments Ability to work in a team environment Must be able to travel based on client and business needs

Customer Service Associate

Richmond, VA
Contract
***$24,300/yr to $31,000/yr starting pay rate based on skills and experience*** Do you want to work at one of the country's leading healthcare management companies? Develop your skills in the growing healthcare industry and position yourself for the future! This position is a frontline service position communicating to Client's members and providers; programs, policies, and procedures. Responsibilities include answering incoming calls on eligibility, benefits, claims, and Authorization of Services from providers and members. Responsibilities also include the administration of intake documentation in the appropriate systems. Overall, the Customer Service Associate is expected to provide outstanding service to our internal and external customers and strive to resolve member and provider needs on the first call. The CSA provides outstanding service while also achieving operating performance rating of meets or exceeds call center production standards. Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls. Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality. Resolves customer administrative concerns as the first line of contact - this may include claims resolutions and other expressions of dissatisfaction. Refers patients/EAP clients to the Clients Care Management team for a provider, EAP affiliate, or Facility.. Refers callers requesting provider information to Provider Services regarding Clients professional provider selection criteria and application process. Links or makes routine referrals and triage decisions not requiring clinical judgment. Provides information regarding Clients in-network and out of network reimbursement rates and states multiple networks to providers. Identifies and responds to Crisis calls and continues assistance with the Clinician until the call has been resolved. Informs providers and members on Clients appeal process. Educates providers on how to submit claims and when/where to submit a treatment plan. Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs. Thoroughly documents customers comments/information and forwards required information to the appropriate staff. Performs necessary follow-up tasks to ensure member or providers needs are completely met. Lead or participate in Care Management Center activities as requested that help improve Care Center performance, excellence and culture. Support team members and participate in team activities to help build a high-performance team. Demonstrate flexibility in areas such as job duties and schedule in order to aid Care Management Center in better serving its members and help Client achieve its business and operational goals. Assist CMC efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies. Assume full responsibility for self-development and career progression. Proactively seek and participate in ongoing training (formal and informal) in all aspects of the Customer Service Associate role. Assist in the mentoring and training of new CSAs. Remain responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers. Required Qualifications: - High School Diploma/GED - Customer Service experience Preferred Qualifications: - College Degree - Call Center and/or Healthcare experience ***Located in Richmond, 8 hour shifts between 8am-8pm Monday-Friday*** *** Health benefits, and PTO (including paid holidays) offered*** *** Ask us about our REFERRAL and SIGN ON BONUS ***

.Net Programmer

Dauphin County, PA
Contract
Experience Migrating VB to .Net C# Required 2  Years Web Services development Required 5  Years Experince using WCF Required 1  Years Experience with XML Required 5  Years Experience with Visual Studio 2008 Required 2  Years Experience with .NET Framework Required 2  Years Experience with MS SQL Server 2005 DB Required 5  Years Experience writing T-SQL Stored Procedures Required 5  Years Experience using Rational Clear Case Highly desired 2  Years Experience using Rational Clear Quest Highly desired 2  Years Experience using Rational Req Pro Highly desired 2  Years Experience using Visual SourceSafe Highly desired 2  Years Experience using FileNet or Documentum Highly desired 2  Years   Short Description: Candidate will be working on the EDMS VB6 to .Net Migration Project. Complete Description: EDMS is a core infrastructure component and has an extensive inventory of EDMS VB6 modules that were developed to fulfill business requirements - several which support mission critical systems. The candidate will work on a team to migrate the following list of applications that utilize components identified for rewrite as part of this project: Automated Permit Routing Analysis System (APRAS) Engineering Construction Management System (ECMS) Bridge Management System (BMS) Crash Reporting System (CRS) Utility Relocation (UR) Grade Crossing (GC) Executive Correspondence Process (ECP) .Centric Vehicle Registration (VR) Driver Licensing (DL) Commercial Registration Online Registration Program (OLRP) Integrators The VB6 Code has reached end of life and is no longer supported by Microsoft. Additionally one of the modules (DOTImage) is a VB6 Application. This application is used by the Integrators to zip up (compress), encrypt, and transmit images to the Departments designated FTP site. This application resides on the various Integrators machines.

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