Jobs at Doctors HealthCare Plans, Inc. (Now Hiring) — 4 open
Member Services Representative (Healthcare)
Coral Gables, Florida, United States · On-site
Mid level
Onsite | Full-Time | Consistent Schedule Make a Difference—Every Day If you enjoy helping people, solving problems, and being part of a supportive team, this role is for you. As a Member Services Representative, you’ll h…
Skills: English Fluency, Spanish Fluency, Customer Service, Call Center Operations, Healthcare Benefits Administration
Fraud, Waste & Abuse (FWA) Coordinator
Coral Gables, Florida, United States · On-site
Mid level
Provide operational and administrative support that enables FWA leadership, investigators and analysts focus on fraud investigations, case management and regulatory compliance. The ideal candidate is polished, highly org…
Skills: Case Management, Regulatory Compliance, Fraud Investigation, Medical Records Coordination, Reporting & Analytics
EDI Encounter Specialist
Coral Gables, Florida, United States · On-site
Mid level
The EDI Encounter Specialist is responsible for the administration, monitoring, validation, and support of healthcare encounter data submitted to state (AHCA) and CMS, as well as those received from clearinghouses and bu…
Skills: EDI Encounter Management, HIPAA X12 Standards, SQL, Data Validation, Healthcare Claims Processing
Case Manager RN
Coral Gables, Florida, United States · On-site
Mid level
Position Purpose: Nurse Case Manager who is responsible for coordinating the continuum of care activities for assigned patients and ensuring optimum utilization of resources, service delivery and compliance with medical …
Skills: Case Management, Care Coordination, Patient Assessment, Medication Reconciliation, Clinical Guidelines