16 member service representative ii jobs found

Job Description: Summary: This position is the primary representative for Physician, Ancillary and Facility reimbursement analysis. The incumbent's analyses include but is not limited to, contracting strategies; calculation and testing of provider rates; implementation oversight for all regions and monitoring of provider reimbursement. In monitoring provider reimbursement, the position analyzes financial deals to assess the implications of rate structures and payment methodologies across markets, addresses variations in processes and fees among region and systems with the aim of developing common approaches, and monitors provider billing trends to ensure cost and quality management goals are met. Essential Accountabilities: Level I • Supports reimbursement strategy and analysis through various duties included running data queries for analysis and evaluation of current to proposed reimbursement rates. • Works with Provider Contracting on reimbursement implementations to...

Job Description: Summary: This position is the primary representative for Physician, Ancillary and Facility reimbursement analysis. The incumbent's analyses include but is not limited to, contracting strategies; calculation and testing of provider rates; implementation oversight for all regions and monitoring of provider reimbursement. In monitoring provider reimbursement, the position analyzes financial deals to assess the implications of rate structures and payment methodologies across markets, addresses variations in processes and fees among region and systems with the aim of developing common approaches, and monitors provider billing trends to ensure cost and quality management goals are met. Essential Accountabilities: Level I • Supports reimbursement strategy and analysis through various duties included running data queries for analysis and evaluation of current to proposed reimbursement rates. • Works with Provider Contracting on reimbursement implementations to...

Job Description: Summary: This position is the primary representative for Physician, Ancillary and Facility reimbursement analysis. The incumbent's analyses include but is not limited to, contracting strategies; calculation and testing of provider rates; implementation oversight for all regions and monitoring of provider reimbursement. In monitoring provider reimbursement, the position analyzes financial deals to assess the implications of rate structures and payment methodologies across markets, addresses variations in processes and fees among region and systems with the aim of developing common approaches, and monitors provider billing trends to ensure cost and quality management goals are met. Essential Accountabilities: Level I • Supports reimbursement strategy and analysis through various duties included running data queries for analysis and evaluation of current to proposed reimbursement rates. • Works with Provider Contracting on reimbursement implementations to...

Monroe Community College Position Title: Program Coordinator II, Education and Human Services - Monroe Community College Location: Rochester, NY Category: Professional Staff Job Type: Full Time Posted On: Thu Jul 9 2026 Job Description: Function of Position: The Fieldwork Coordinator is responsible for overseeing all aspects of student fieldwork placements for Education and Human Services Department programs, including Alcohol and Chemical Dependency, Childcare Practitioner, Education Studies at the Adolescent, Childhood, and Early Childhood levels, Hospital and Community Mental Health Technician, and Human Services. Key duties include assessing student placement needs, establishing and monitoring placements, evaluating sites, and maintaining strong partnerships with agencies, schools, and transfer institutions to support fieldwork requirements. The position ensures compliance through the development and management of affiliation agreements,...

Job Description: Summary: Under the direction of the Assigned Management, upon successful completion of all phases of training, and in accordance with established HIPAA regulations the Enrollment Specialist performs enrollment core processing and servicing in accordance with the Health Plan Operation's enrollment regulations, Underwriting Guidelines and applicable government regulations. The focus of this role is to ensure prompt, accurate, and efficient servicing of all broker, member and group administrator inquiries for all product lines. Inquiries are received by the following but not limited to; telephone, email, written inquiries, lobby walk-in customers and through on-site visits with an employer group. The B version of this role will require the individual to be on the phone regularly. Essential Primary Responsibilities/Accountabilities: Level I: Responsible for Government Programs, Small, Mid, and Large Employer Group Subscriber Enrollment Operations. Responsible...

Job Description: Summary: This position assists the Health Plan in establishing a presence in the community through home visits and community outreach bridging the gap between members and the Clinical Operations Department. Community Connections Representatives educate members about accessing community resources and assists with navigating resources available and provide assistance with addressing SDoH barriers and care gaps. This position educates and assists with the enrollment and recertification process for Marketplace Facilitated Enrollment (MFE): On and Off Marketplace health insurance products, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC), Essential Plan (EP) and the Individual Market - Qualified Health Plan (QHP). This position requires working occasional evenings and weekends for outreach and community events. Essential Accountabilities: Level I • Educates Medicaid, Medicare, and Commercial members on healthcare benefits, and community...

Job Description: Summary: This position assists the Health Plan in establishing a presence in the community through home visits and community outreach bridging the gap between members and the Clinical Operations Department. Community Connections Representatives educate members about accessing community resources and assists with navigating resources available and provide assistance with addressing SDoH barriers and care gaps. This position educates and assists with the enrollment and recertification process for Marketplace Facilitated Enrollment (MFE): On and Off Marketplace health insurance products, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC), Essential Plan (EP) and the Individual Market - Qualified Health Plan (QHP). This position requires working occasional evenings and weekends for outreach and community events. Essential Accountabilities: Level I • Educates Medicaid, Medicare, and Commercial members on healthcare benefits, and community...

Job Description: Summary: Under the direction of the Assigned Management, upon successful completion of all phases of training, and in accordance with established HIPAA regulations the Enrollment Specialist performs enrollment core processing and servicing in accordance with the Health Plan Operation's enrollment regulations, Underwriting Guidelines and applicable government regulations. The focus of this role is to ensure prompt, accurate, and efficient servicing of all broker, member and group administrator inquiries for all product lines. Inquiries are received by the following but not limited to; telephone, email, written inquiries, lobby walk-in customers and through on-site visits with an employer group. The B version of this role will require the individual to be on the phone regularly. Essential Primary Responsibilities/Accountabilities: Level I: Responsible for Government Programs, Small, Mid, and Large Employer Group Subscriber Enrollment Operations. Responsible...

Job Description: Summary: Under the direction of the Assigned Management, upon successful completion of all phases of training, and in accordance with established HIPAA regulations the Enrollment Specialist performs enrollment core processing and servicing in accordance with the Health Plan Operation's enrollment regulations, Underwriting Guidelines and applicable government regulations. The focus of this role is to ensure prompt, accurate, and efficient servicing of all broker, member and group administrator inquiries for all product lines. Inquiries are received by the following but not limited to; telephone, email, written inquiries, lobby walk-in customers and through on-site visits with an employer group. The B version of this role will require the individual to be on the phone regularly. Essential Primary Responsibilities/Accountabilities: Level I: Responsible for Government Programs, Small, Mid, and Large Employer Group Subscriber Enrollment Operations. Responsible...

Job Description: Summary: This position assists the Health Plan in establishing a presence in the community through home visits and community outreach bridging the gap between members and the Clinical Operations Department. Community Connections Representatives educate members about accessing community resources and assists with navigating resources available and provide assistance with addressing SDoH barriers and care gaps. This position educates and assists with the enrollment and recertification process for Marketplace Facilitated Enrollment (MFE): On and Off Marketplace health insurance products, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC), Essential Plan (EP) and the Individual Market - Qualified Health Plan (QHP). This position requires working occasional evenings and weekends for outreach and community events. Essential Accountabilities: Level I • Educates Medicaid, Medicare, and Commercial members on healthcare benefits, and community...

Job Description: *Based on the scope of the role, onsite/in-person expectations and business needs, we're exclusively seeking candidates who reside in Albany, NY / Capital Region. Summary: Level I The Client Manager I is an entry-level professional role with some prior client management or client servicing experience. The Client Manager I will have some understanding of service, support, sales and retention concepts with clients or prospects of limited scope and complexity with management oversight. The Client Manager I will serve as the internal servicer supplementing external sales executive or account executive responsibilities. The Client Manager I will have a dedicated focus given to client deliverables including education and presentation materials, and internal escalations. The Client Manger I will be the primary liaison between the Commercial Growth department and other internal departments. The Client Manager I will work in a team environment with management...

Job Description: *Based on the scope of the role, onsite/in-person expectations and business needs, we're exclusively seeking candidates who reside in Albany, NY / Capital Region. Summary: Level I The Client Manager I is an entry-level professional role with some prior client management or client servicing experience. The Client Manager I will have some understanding of service, support, sales and retention concepts with clients or prospects of limited scope and complexity with management oversight. The Client Manager I will serve as the internal servicer supplementing external sales executive or account executive responsibilities. The Client Manager I will have a dedicated focus given to client deliverables including education and presentation materials, and internal escalations. The Client Manger I will be the primary liaison between the Commercial Growth department and other internal departments. The Client Manager I will work in a team environment with management...

Job Description: Summary: The Document Solutions team focuses on the design and creation of correspondence and transactional statements using various software programs. The Publishing Systems Engineer operates in a business analyst/document-generation specialist role as part of the Document Solutions team. This role focuses on programming within the various systems utilized by our Solutions Team. Essential Primary Responsibilities/Accountabilities: Level I: Develops code; analyzes, researches, and resolves system issues for electronic publishing-related problems. Creates, maintains, and follows all documented processes and standards. Builds new and updates existing workflows and documents using xml and text data in variable data composition systems based on the requirements and functional specifications. Documents functional specifications and solutions for work to be performed. Develops or assists in the development of systems testing and implementation plans. Reviews...

Job Description: Summary: The Document Solutions team focuses on the design and creation of correspondence and transactional statements using various software programs. The Publishing Systems Engineer operates in a business analyst/document-generation specialist role as part of the Document Solutions team. This role focuses on programming within the various systems utilized by our Solutions Team. Essential Primary Responsibilities/Accountabilities: Level I: Develops code; analyzes, researches, and resolves system issues for electronic publishing-related problems. Creates, maintains, and follows all documented processes and standards. Builds new and updates existing workflows and documents using xml and text data in variable data composition systems based on the requirements and functional specifications. Documents functional specifications and solutions for work to be performed. Develops or assists in the development of systems testing and implementation plans. Reviews...

Company Description It started with a simple idea: what if surgery could be less invasive and recovery less painful? Nearly 30 years later, that question still fuels everything we do at Intuitive. As a global leader in robotic-assisted surgery and minimally invasive care, our technologies-like the da Vinci surgical system and Ion-have transformed how care is delivered for millions of patients worldwide. We're a team of engineers, clinicians, and innovators united by one purpose: to make surgery smarter, safer, and more human. Every day, our work helps care teams perform with greater precision and patients recover faster, improving outcomes around the world. The problems we solve demand creativity, rigor, and collaboration. The work is challenging, but deeply meaningful because every improvement we make has the potential to change a life. If you're ready to contribute to something bigger than yourself and help transform the future of healthcare, you'll find your purpose here....

Company Description It started with a simple idea: what if surgery could be less invasive and recovery less painful? Nearly 30 years later, that question still fuels everything we do at Intuitive. As a global leader in robotic-assisted surgery and minimally invasive care, our technologies-like the da Vinci surgical system and Ion-have transformed how care is delivered for millions of patients worldwide. We're a team of engineers, clinicians, and innovators united by one purpose: to make surgery smarter, safer, and more human. Every day, our work helps care teams perform with greater precision and patients recover faster, improving outcomes around the world. The problems we solve demand creativity, rigor, and collaboration. The work is challenging, but deeply meaningful because every improvement we make has the potential to change a life. If you're ready to contribute to something bigger than yourself and help transform the future of healthcare, you'll find your purpose here....