Review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise and administrative policies to assess and coordinate medical necessity and support members managing their health.
Responsibilities
Performs medical or behavioral review/authorization process.
Ensures coverage for appropriate services within benefit and medical necessity guidelines.
Evaluates outcomes of plans, eligibility, level of benefits, place of service, length of stay, and medical necessity regarding requested services and benefit exceptions.
May initiate/coordinate discharge planning or alternative treatment plans as necessary and appropriate.
Ensures accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits.
Requirements
Associates in a job-related field
Graduate of Accredited School of Nursing or 2 years of job-related work experience
Office Manager for a charter school in Whiteville, North Carolina, overseeing administrative functions, personnel records, student data, and campus events.
Responsibilities
Oversees and monitors the state student database, PowerSchool
Oversees staff attendance records and reports data to Headmaster, Finance, and HR
Manages personnel records and ensures documentation is up-to-date
Schedules campus-wide events
Monitors dress code for staff and students
Requirements
Associate's degree or equivalent
Nice to have: Experience supporting a high level administrator
Participates as a member of the health care team in cooperation with and under the direction of a physician
Offers complex, diversified office support within the clinic setting
Provides a variety of key services guiding the patients through the continuum of care between physician services, diagnostic services and hospitalizations
Requires advanced administrative skills and knowledge of physician outpatient clinic operations, knowledge and experience with insurance plans and benefit designs, and pre-authorization procedures, and some knowledge of CPT and ICD coding
Work is generally performed independently requiring judgment and problem-solving skills under limited supervision
Requirements
Completion of a medical assistant program or successful completion of a formal medical services training program of the United States Armed Forces, or higher education (such as LPN or RN)
Seeking native Italian speakers to join an international team for training Artificial Intelligence technologies through verbatim transcription and data labeling.
Compensation
Pay: Per minute (of source audio)
Responsibilities
Create verbatim transcriptions of audio content
Create written records of audio files
Data classification and data labeling according to defined criteria
Grading of linguistic content
Requirements
Nice to have: Experience with Verbatim transcriptions
Nice to have: Data labeling
Nice to have: Data classification
Nice to have: Grading and evaluation of linguistic content
Assist individuals and families with determining initial and ongoing eligibility for SNAP benefits and other applicable assistance programs, conducting interviews, and managing case records.
Locations (4)
Holyoke, Massachusetts, United States
Greenfield, Massachusetts, United States
Pittsfield, Massachusetts, United States
Springfield, Massachusetts, United States
Responsibilities
Assist individuals and families with determining initial and ongoing eligibility for SNAP benefits and other applicable assistance programs.
Complete case actions through an action-based, first-available-worker process, ensuring timely, accurate, and thorough completion of assigned tasks.
Supplemental Nutrition Assistance Program (SNAP) Case Worker - Northern Region - Continuous Posting
Commonwealth of Massachusetts · Posted Nov 9, 2026
Connecting individuals and families in Massachusetts with essential food assistance benefits and resources that promote stability and economic self-sufficiency.
Locations (3)
Quincy, Massachusetts, United States
Roxbury, Massachusetts, United States
Boston, Massachusetts, United States
Responsibilities
Assist individuals and families with determining initial and ongoing eligibility for SNAP benefits and other applicable assistance programs.
Complete case actions through an action-based, first-available-worker process.
Conduct client interviews by telephone and through other approved communication methods to gather, review, and verify information.
Maintain accurate client records, process case updates, and ensure compliance with established policies and procedures.
Scheduling Coordinator will handle all aspects of scheduling to include, OR time with proper procedure listed. Working rotating day, evening, and weekend hours.
Compensation
$18.96 - $25.59
Responsibilities
Handle all aspects of scheduling to include OR time with proper procedure listed
Maintain employee calendars
Schedule call sign ups as needed
Answer all scheduling calls from staff and offices
Requirements
High School diploma or equivalent education
Nice to have: Two years of surgical care experience
Processes, compiles, researches, and analyzes information, and prepares and verifies reports, correspondence, and other documents utilizing applicable software
Provides comprehensive customer service, including delivery of accurate, prompt, and courteous assistance on complex policies, guidelines, and standard practices to internal and external customers
Performs a variety of specialized research and reporting in assigned area of responsibility and resolves related discrepancies or erroneous data to ensure compliance
Participates in maintaining or designing web page(s) for assigned area of responsibility
Enters, verifies, and reconciles information and data; may develop spreadsheets, databases, or reports
Requirements
Graduation from High School, or G.E.D.
College level course work in a related field may substitute for up to one year of experience
Conduct client interviews by telephone and through other approved communication methods to gather, review, and verify information using agency eligibility systems.
Maintain accurate client records, process case updates, and ensure compliance with established policies and procedures.
Explain eligibility determinations, program requirements, and available benefits clearly and professionally.
Requirements
Nice to have: customer service
Nice to have: interpersonal skills
Nice to have: organizational skills
Nice to have: time-management
Nice to have: proficiency with computer-based applications
Assist individuals and families with determining initial and ongoing eligibility for SNAP benefits and other applicable assistance programs.
Complete case actions through an action-based, first-available-worker process, ensuring timely, accurate, and thorough completion of assigned tasks.
Conduct client interviews by telephone and through other approved communication methods to gather, review, and verify information using agency eligibility systems.
Maintain accurate client records, process case updates, and ensure compliance with established policies and procedures.
Explain eligibility determinations, program requirements, and available benefits clearly and professionally.
Requirements
Nice to have: Strong customer service and interpersonal skills
Nice to have: Excellent organizational and time-management skills
Nice to have: Proficiency with computer-based applications, data entry, and electronic recordkeeping systems
Nice to have: Ability to conduct client interviews, gather relevant information, review documentation, and make accurate, informed determinations
Nice to have: Ability to interpret, apply, and clearly explain laws, regulations, policies, and procedures
RN Managed Care Coordinator INewBlueCross BlueShield of South Carolina · Remote, US
Office ManagerNewClassical Charter Schools of America · Whiteville, US
Clinic Assistant Medical AssistantNewLegacy Health · Tualatin, US
Supplemental Nutrition Assistance Program (SNAP) Case Worker - Western Region - Continuous PostingNewCommonwealth of Massachusetts · Holyoke, US+3 more