The Member Service Representative I is proficient in routine benefits, claims, and general inquiries. They have a general knowledge of the following: systems,…

The Technician, Enrollment I is responsible for ensuring that members are accurately enrolled into CareFirst member enrollment systems in a timely manner, and…

Under direct supervision, reviews and adjudicates paper/electronic claims. Determines proper handling and adjudication of claims following organizational…

Responsible for answering member, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions…

The Business Associate Analyst is responsible for supporting business continuity and operational risk programs designed to provide planned disaster response and…

The Specialist, Quality Assurance I is responsible for examining and evaluating the accuracy of transactions in accordance with regulations and company…

Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization…

Responsible for answering member, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions…

The Specialist, Funding I perform funding administration for TPA. Functions include client fund transfers, email/draft funding notifications, reconciliation of…

Responsible for answering member, provider & broker inquiries pertaining to Medicare Advantage Individual and Group information, benefits, claims resolution,…