Highlights
We're seeking an experienced healthcare professional with a background in managed care/health plan operations to join our team in a Contract Hybrid role until April. Experience with Medicare Advantage, TRICARE, health insurance plans, claims, or member services is highly preferred.
Numbers & Facts
| Location | Portland, ME |
| Industry | Staffing/Employment Agencies |
| Company Size | 20 to 49 employees |
| Year Founded | 2009 |
| Website | http://www.topprospectgroup.com/ |
Description
We're seeking an experienced healthcare professional with a background in managed care/health plan operations to join our team in a Contract Hybrid role until April. In this role, you'll investigate, process, and resolve member grievances and appeals while ensuring compliance with regulatory requirements.
Qualifications:
- 3+ years of managed care or health plan experience
- Grievances and/or appeals experience required
- Knowledge of health plan benefits and claims processing
- Strong communication, research, and problem-solving skills
- Proficient in Microsoft Office
Experience with Medicare Advantage, TRICARE, health insurance plans, claims, or member services is highly preferred.
About Company
Top Prospect Group founders and management team offer more than 75 years of combined experience in Information Technology, Creative & Marketing, and Finance & Accounting staffing and solutions. Our fundamental goal is to build successful relationships resulting in accurate job and prospect representations. We meet with those we work with face-to-face to garner a better understanding of candidate or client requirements. By leveraging our experience and market insight, we are able to provide a more consistent recruitment process. Motivated by a partnership philosophy, our staff possesses a deep understanding of how to forge mutually beneficial long-term relationships. We believe in what we do and continuously strive for excellence.