Health Insurance Manager

hace 1 mes


Tijuana, México USA Clinics Group A tiempo completo

**Responsibilities**:

- Monitor and manage productivity and performance of assigned employees including daily/weekly/monthly department metrics to Senior Leadership and provide reporting and action plans for improvement.
- Maintains positive leadership and gives frequent performance feedback to team members and invites two-way communication.
- Coaches established employees when needs are identified, holding employees accountable for results through coaching and development of action plans.
- Monitor Prior Authorization and Eligibility automation processes
- Assist IT team in developing new automation processes for authorization submission/tracking and insurance verification
- Work closely with billing team for claim denials related to authorization and eligibility
- Produces productivity and error reports to assess staff.
- Prioritize work to maximize turn-around time.
- Contacts insurance plans to determine eligibility, prior authorization and obtain coverage and benefit information.
- Documents findings thoroughly and accurately.
- Performs training with organizational staff on procedures for requesting, documenting, and processing prior authorizations.

**Requirements**:

- High school diploma or equivalent required.
- Bachelor’s degree preferred.
- 3 years of BPO experience preferred
- Strong background and experience in Process improvement LEAN preferred
- 4+years in a leadership role preferred
- Ability to lead a team by demonstrating a positive attitude, openness to change, willingness to help, and respect for others and their ideas
- Excellent verbal and written communication skills
- Detail oriented, reliable, and able to multi-task in a fast-paced, high-volume work environment
- Demonstrated computer literacy and excellent math skills
- Ability to maintain a high level of confidentiality and professionalism
- ** Fluent in English and Spanish required**

**Benefits**
- IMSS 100%
- Vacations (after the first year)
- Christmas bonus
- Weekends off
- Paid Training
- Mexican Holidays off
- IND1


  • Health Insurance Manager

    hace 1 semana


    Tijuana, México USA Clinics Group A tiempo completo

    **Responsibilities**: - Monitor and manage productivity and performance of assigned employees including daily/weekly/monthly department metrics to Senior Leadership and provide reporting and action plans for improvement. - Maintains positive leadership and gives frequent performance feedback to team members and invites two-way communication. - Coaches...


  • Tijuana, México USA Clinics Group A tiempo completo

    **Responsibilities**: - Monitor and manage productivity and performance of assigned employees including daily/weekly/monthly department metrics to Senior Leadership and provide reporting and action plans for improvement. - Maintains positive leadership and gives frequent performance feedback to team members and invites two-way communication. - Coaches...

  • Call Center Manager

    hace 2 meses


    Tijuana, México USA Vein Clinics A tiempo completo

    USA Clinics Group is Hiring! We are looking for an **Insurance Manager** (Operations Manager) with knowledge on Health Insurance Providers (Medical Insurances) from the U.S. and their policies. - **Responsibilities**:_ - Overseeing the hiring and training of the staff. - Efficiently managing the insurance department. - Planning and structuring the...

  • Insurance Manager

    hace 2 meses


    Tijuana, México USA Clinics Group A tiempo completo

    Clinical documentation improvement specialists - Administrative staff and clerks **Responsibilities**: - Monitor and manage productivity and performance of assigned employees including daily/weekly/monthly department metrics to Senior Leadership and provide reporting and action plans for improvement. - Maintains positive leadership and gives frequent...

  • Insurance Manager

    hace 2 meses


    Tijuana, México USA Clinics Group A tiempo completo

    Job Description: - Clinical documentation improvement specialists - Administrative staff and clerks **Responsibilities**: - Monitor and manage productivity and performance of assigned employees including daily/weekly/monthly department metrics to Senior Leadership and provide reporting and action plans for improvement. - Maintains positive leadership and...

  • Insurance Advisor L-s

    hace 2 meses


    Tijuana, México 3rss A tiempo completo

    **Vacante para la empresa 3rss en Tijuana, Baja California**: Responsible for receiving calls from clients for Scan Health Plan to assist them in matters regarding their medical, pharmacy and / or dental insurance. Pre-qualify prospective clients to improve their health coverage benefits **JOB OFFER** Monday through Friday from 8:15 a.m. to 6:15...

  • Insurance Manager

    hace 2 meses


    Tijuana, México USA Clinics Group A tiempo completo

    **Responsibilities**: - Monitor and manage productivity and performance of assigned employees including daily/weekly/monthly department metrics to Senior Leadership and provide reporting and action plans for improvement. - Maintains positive leadership and gives frequent performance feedback to team members and invites two-way communication. - Coaches...


  • Tijuana, México USA Clinics Group A tiempo completo

    **Responsibilities**: - Handle insurance benefit verification process (phone calls and online) - Write medical necessity using established forms and procedures - Handle prior-authorization process for office procedures - Handle insurance calls - Ensure/analyze an efficient flow of work utilizing Electronic Health Records (EHR) software to keep track of task...


  • Tijuana, México hpñ A tiempo completo

    **Vacante para la empresa hpñ en Tijuana, Baja California**: **Insurance Salesperson Moons to Friday **Actividad** Responsable de recibir llamadas de clientes de Scan Health Plan para asistirlos en asuntos relacionados con su seguro médico, de farmacia y/o dental. Precalificar a clientes potenciales para mejorar sus beneficios de cobertura de...


  • Tijuana, México PCM Corporativo - GOTTA A tiempo completo

    Importante empresa líder en su giro solicita **Health and Safety Manager** **Responsabilidades**: - Análisis de causa raíz de incidentes. - Apoya en el cumplimiento de los estándares de seguridad. - Realiza evaluaciones de riesgo según sea necesario. - Supervisa el cumplimiento de las políticas y procedimientos en las operaciones de manera...


  • Tijuana, México GOTTA A tiempo completo

    Importante empresa líder en su giro solicita **Health and Safety Manager** **Responsabilidades**: - Análisis de causa raíz de incidentes. - Apoya en el cumplimiento de los estándares de seguridad. - Realiza evaluaciones de riesgo según sea necesario. - Supervisa el cumplimiento de las políticas y procedimientos en las operaciones de manera...


  • Tijuana, México Integon Service Co. A tiempo completo

    Be the voice of Integon Service Co! We’re looking for people who are energized, engaged and empowered to help execute on company goals by helping our policyholders! You are a problem-solver and brand ambassador for a fast growing, customer-centric personal lines insurance company. Our goal is to provide WOW service to each and every customer and...


  • Tijuana, México Integon Service Co. A tiempo completo

    This position is responsible for providing and maintaining a safe working environment for our co-workers, visitors, suppliers, and contractors, minimizing, and eliminating unnecessary risks for Integon operation by developing and implementing EH&S (Environmental, Health and Safety) objectives, policies, programs, procedures, and risk prevention programs....


  • Tijuana, México Barbachano International, Inc. A tiempo completo

    **THE COMPANY** Our client, a worldwide leader in electronic consumer good products recognized for innovation and quality serving the automotive, health, military, and residential and professional markets, currently seeks a Senior Human Resources Manager to provide leadership to a large manufacturing site (two buildings) in Tijuana, Mexico with over 2200...

  • Project Manager

    hace 2 días


    Tijuana, México Qualitas Insurance A tiempo completo

    **Puesto: Project Manager** Objetivo: - Asistir en la administración de los proyectos de implementación de sistemas, así como dar seguimiento a la parte operativa. Finalmente, será la persona encargada en el día a día de administrar todas las solicitudes de cambios a sistemas existentes y nuevos proyectos. Principales roles y responsabilidades: -...


  • Tijuana, México Tres R A tiempo completo

    **Vacante para la empresa Tres R en Tijuana, Baja California**: PERSONAL BILINGÜE servicios receiving calls from clients for Scan Health Plan to assist them in matters regarding their medical and / or dental insurance. ¤Mayor de edad ¤ Inglés avanzado o nativo ¤Experiência en callcenter Lunes a Viernes 8:00 am 17:30hrs. pagos semanales por...

  • Revenue Cycle Manager

    hace 2 meses


    Tijuana, México USA Vein Clinics A tiempo completo

    The Revenue Cycle Manager will collaborate with physicians, the SVP of the Revenue Cycle, and other members of the management team to serve as a critical link between providers, payers, and patients. This position will directly oversee and manage the following roles: - Billers - Administrative staff and clerks. **Responsibilities**: - Supervising the...

  • Project Manager

    hace 1 mes


    Tijuana, México Creative Software International, Inc. A tiempo completo

    ¡Únete a nuestro equipo como **Project Manager**! **Modalidad**: Presencial. **Ubicación**: Tijuana, Baja California. Como **Project Manager**, serás responsable de administrar una cartera de proyectos de tamaño mediano y grande. **Requerimientos**: - Experiência de 3 a 5 años en gestión de proyectos de software. - Se prefiere una licenciatura en...

  • Revenue Cycle Manager

    hace 4 días


    Tijuana, México USA Vein Clinics A tiempo completo

    The Revenue Cycle Manager will collaborate with physicians, the SVP of the Revenue Cycle, and other members of the management team to serve as a critical link between providers, payers, and patients. This position will directly oversee and manage the following roles: - Billers - Administrative staff and clerks. **Responsibilities**: - Supervising the...


  • Tijuana, México Integon Service Co. A tiempo completo

    **Primary Purpose**: Responsible for daily supervision, managing employee satisfaction, and coaching and developing their team while maintaining and growing a relationship between Company policyholders and independent agents. **Essential Duties and Responsibilities**: - Following is a summary of the essential functions for this job. Other duties may be...