Sterling Health Plans - Atlanta, GA
Duties and Responsibilities: 1.Develop new software applications to support business requirements (examples include: processing claims, premiums, commissions, leads, system integrations, and data warehousing). Development responsibilities include: •Participation in feasibility st...
Sterling Health Plans - Bellingham, WA
Summary:The Database Administrator works with senior database administration staff to design, implement, administer, troubleshoot and develop database resources to meet company and departmental goals and standards for availability, capacity and security. POSITION CAN BE LOCATED A...
Sterling Health Plans - Brentwood, TN
The Quality Reporting Analyst role is to support corporate and plan-level strategies and goals by effectively applying both business knowledge and technical expertise to solve problems through use of data-driven solutions. The candidate must be comfortable producing data sets, re...
Sterling Health Plans - Brentwood, TN
POSITION DESCRIPTION, DUTIES & RESPONSIBILITIES: •Drives most marketing department projects relative to annual product launch and ongoing activities supporting available election periods at direction of VP of Marketing. •Supports all product lines under combined Medicare Advantag...
Director of Home Health Clinical Operations
Sterling Health Plans - Nashville, TN
?Daily oversight and directions of the clinical and DME teams to assure compliance with departmental policies and procedures, compliance with specific payor requirements, and clinically sound decision making •Daily oversight and direction of the Quality Coordinator and the Qualit...
Sterling Health Plans - Brentwood, TN
Responsibilities/ Projects 1.General acquaintance to Medicare Advantage (Part C) claims operations 2.Sharpen analytical skills in development of Medicare coverage and pricing decision database that will be published and shared with internal and external customers 3.Review, identi...
Sterling Health Plans - Brentwood, TN
POSITION DESCRIPTION, DUTIES & RESPONSIBILITIES: •Serve as primary compliance subject matter expert and point of contact for assigned departments •Review departmental policies and procedures for completeness and adherence with CMS and other applicable regulatory guidelines •Provi...
Medicare Advantange Claims Manager
Sterling Health Plans - Brentwood, TN
Job Title:Manager, MA Claims FLSA:Exempt Reports to:VP, Administration and Claims Summary: Leads, motivates and manages large, first dollar claims processing and adjudication department. Assures accurate and timely processing of claims, within CMS guidelines, for all Medicare Adv...
Sterling Health Plans - Brentwood, TN
Department: Case & Disease Management Position reports to: Senior Manager, Case & Disease Management FLSA Status: Exempt Pay Basis: Salary Classification: Full-time Supervises Others: No Number of Positions: 1 Location of Position(s): Brentwood, TN POSITION DESCRIPTION, DUTIES & ...
Sterling Health Plans - Brentwood, TN
Department: Medicare Revenue Enhancement Position reports to: AVP, Medicare Revenue Enhancement FLSA Status: Exempt Pay Basis: Salary Classification: Full-time Supervises Others: No Number of Positions: 1 Location of Position(s): Brentwood, TN POSITION DESCRIPTION, DUTIES & RESPO...
Sterling Health Plans - Brentwood, TN
Summary: Installs, configures, and maintains desktop computer hardware, software, peripherals. Provides end user support, including but not limited to, password resets, account creation, and hardware and software issues. Provide enterprise call center maintenance and support. Pro...
Sterling Health Plans - Bellingham, WA
Job Title:Insaide Sales AgentFLSA:Exempt Reports to:Manager, Direct SalesClass:F1 Summary:Sells Sterling Life Insurance products exclusively as an employee of Sterling in accordance with the Sales Agent Employment Agreement. Duties and Responsibilities: 1.Procure applications for...
Sterling Health Plans - Nashville, TN
Summary:The Telecommunications Analyst II performs operational support, capacity planning, configuration management (move, adds changes) and call center administration for the company?s, IP and traditional telephony infrastructure to meet company and departmental goals and standa...
Sterling Health Plans - Brentwood, TN
POSITION DESCRIPTION, DUTIES & RESPONSIBILITIES: Overall responsible to monitor, review, and interpret correct coding initiatives from regulatory sources to include CMS, AMA-CPT, HCPCS, AHA, AHIMA and ICD-9-CM and assure compliance with such in Windsor Medicare Advantage cost con...
Sterling Health Plans - Brentwood, TN
Duties and Responsibilities: 1.Develop new software applications to support business requirements (examples include: processing claims, premiums, commissions, leads, system integrations, and data warehousing). Development responsibilities include: •Participation in feasibility st...
Sterling Health Plans - Brentwood, TN
As one of the nation's most, progressive and dynamic insurance organizations, Windsor Health Group is a Health Specialty Management Company comprised of Windsor Health Plan, Sterling Insurance, and Olympian Health Partners. Collectively we offer a full range of products and servi...
Sterling Health Plans - Bellingham, WA
Summary:The Network Engineer ensures the organization's LAN and WAN systems are maintained and operating in line with company standards and are delivering required services to end-users. The Network Engineer II works under the supervision of IT management and more senior network ...
Sterling Health Plans - Atlanta, GA
Job Title: UNIX Engineer FLSA: Exempt Reports to: Manager, Service Delivery Summary: The UNIX Engineer works with fellow IT Staff to plan, design, implement, and manage UNIX, Linux, and storage platforms to meet company and departmental goals and standards for availability, capac...
Sterling Health Plans - Brentwood, TN
POSITION DESCRIPTION, DUTIES & RESPONSIBILITIES: •Supervise the day-to-day operations of the premium billing process in accordance with internal policies and state and federal laws •Oversee and implement the premium billing process; ensure premium billing is completed accurately ...
Sterling Health Plans - Nashville, TN
POSITION DESCRIPTION, DUTIES & RESPONSIBILITIES: •Plan, organize, and conduct training programs for Service Center employees. •Assist in identifying training and development needs for Service Center personnel. •Coordinate the creation and development of material for new training ...