performance. Manage relationships with multiple vendors and business partners to ensure seamless integration of Fallon Health... or Insurance setting. Fallon Health provides equal employment opportunities to all employees and applicants for employment...
. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits...; and attendance. Responsible for resolving a high volume of claims edits for all lines of business. Thorough knowledge of Fallon...
member and provider inquiries received through Fallon Health's 1-800 numbers, as well as providing direction on Plan policies... About Fallon Health: Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse...
assessment and performance improvement procedures Fallon Health provides equal employment opportunities to all employees...
division of insurance support all Fallon Health Products Experience in managing health care and support personnel, as well.... Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits...
, PowerPoint, and Access). Fallon Health provides equal employment opportunities to all employees and applicants for employment... in related position, preferably in health care. Experience in a managed care or call center setting or physician’s office...
’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits...
proactive follow-up activities with provider and/or Fallon Health staff. Validate data received by providers and update... and procedure (i.e., Fallon Health Service Level agreements) issue resolution timeframes, PUNKS, QNXT case inventory/assignments...
, Credentialing, IT, Finance).Promote behavioral health integration across Fallon Health and partner organizations. Communicate... with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants...
and community providers to assist with treatment planning as needed Works with Fallon Health Provider Relations and Carelon... on workflows as appropriate Strictly observes HIPAA regulations and the Fallon Health policies regarding confidentiality of member...
copies of all denial letters and related documents are kept in the Fallon Health core application and/or the organization...’s security accessed drive(s) Acts as a liaison between Providers, vendors, facilities, members/families, and Fallon Health...
Fallon Community Health Plan Mission, Values and Vision. Specific competencies essential to this position: Adaptability... and diplomatically with staff at all levels Fallon Health provides equal employment opportunities to all employees and applicants...
environments Commitment to pursuing actuarial credentials with the Society of Actuaries and professional development Fallon... Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination...
represents Fallon Health when meeting in-person with customers for eligibility and premium related inquiries. Enters...’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits...
’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits...
, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees...
Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits... and keeping current with Fallon products, policies and procedures. Responsible for documenting the results of all outbound calls...