Claims Resolution Specialist II Job at Baptist Health (Florida) (Jacksonville)

People Operations Specialist II, I-9 Compliance

The primary and immediate focus of this role will be I-9 outbound appointments a...

Location

United States

Salary:

30.70 - 46.05 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Typically requires 2 years of experience in Human Resources (or 6 years in customer service)
Previous experience with hiring/onboarding new hires is a plus
Bachelor’s degree in business, Human Resources, Compliance, or Technology related field or equivalent experience
Attentive listening skills with the ability to ask probing questions to aid in problem solving and issue escalation
Ability to work effectively in high-pressure situations that require sound decision making and may involve confidential or sensitive matters
High sense of urgency for meeting commitments and completing assignments
Demonstrate knowledge and understanding of relevant HR content areas including but not limited to: payroll, leave, compliance, compensation, data management, benefits, onboarding, and core HR operations
Critical thinking and multi-tasking in a high-volume environment
Ability to consistently deliver high quality customer service in a professional manner
Excellent decision making, critical thinking, communication, presentation, and interpersonal skills. Ability to build/foster strong trusting relationships, influence leaders and develop solutions to achieve results

Job Responsibility

Handling the I-9 process for new hires in a timely and customer-focused manner
Meeting federal guidelines with the I-9 process
Scheduling and completing I-9 appointments with new hires
Ensure all documentation is completed with accuracy
Identify process improvement opportunities and participate in knowledge management efforts such as SOP updates, case documentation, and training content
Participate in cross-training in multiple content areas to support business continuity and enhance team agility
Monitor case queues, prioritize workload, and follow through on open items to drive resolution and accountability
Deliver a high-quality teammate experience by providing professional, empathetic and solution-oriented support
Partner with internal teams such as HR Business Partners, Centers of Excellence, and Payroll to ensure seamless end-to-end service delivery
Interpret and apply HR policies, procedures, and workflows across assigned cases, ensuring consistent and accurate execution

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Care Management Specialist II, D-SNP Team

The Care Management Specialist II utilizes clinical skills and training to perfo...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing for Registered Nurses OR Master's Degree in Social Work for Licensed Clinical Social Workers
Minimum of 3 years of recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments
Experience providing care management with complex/catastrophic conditions
Current knowledge of clinical standards of care and disease processes
Critical thinking skill
Excellent customer service skills
Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and implement the most effective member-centered interventions
Ability to triage immediate member health and safety risks
Ability to sensitively manage member or family responses associated with high acuity cases and support effective coping
Strong verbal and written communications skills to consult effectively with interdisciplinary teams, coordinate care with members and their families, and other internal and external stakeholders

Job Responsibility

Utilizes clinical skills and training to perform essential functions of care management for identified and assigned member population according to Health Insurance Portability and Accountability Act (HIPAA) guidelines
Manages a specified caseload across the entire continuum of programmatic levels including those within National Committee for Quality Assurance (NCQA) scope or otherwise Complex/Catastrophic cases
Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and facilitating member access to care in a timely and cost-effective manner
Collaborates and communicates with member, family, and interdisciplinary health team to promote wellness and member empowerment, while ensuring access to appropriate services across the healthcare continuum and maximizing member benefit
Serves as clinical advocate for members, active interdisciplinary team member, liaison with other departments and external health care team
Provides direction and assistance to Care Coordinators and to Community Health Workers (CHW) of members needs including the need for special educational mailings, reminder calls, satisfaction surveys, incentives or any additional service needs according to specific program guidelines
Uses claims processing and care management software to look up member information, document contacts, and track member progress
Applies clinical knowledge and experience to evaluate information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider’s utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary to meet the member's needs
Conducts Care Management services for the most complex and vulnerable members including: engaging in member centric communication which includes the interdisciplinary team, providers and family or authorized representatives
reviewing member claims histories and identifies intervention opportunities through the professional standards of practice

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Product Manager – Operations & Regulatory

Beazley’s data reflects the complexity of our business. We are committed to buil...

Location

United Kingdom , Birmingham

Salary:

Not provided

Social Value Portal Ltd

Expiration Date

Until further notice

Requirements

Ability to define and drive data product strategy aligned with business objectives
Experience in designing and operationalising data policies, principles, and strategic frameworks
Strong understanding of relevant insurance / data domain
Experience in influencing and aligning senior leaders across business and technology
Proven track record of leading high performing data product teams
Degree in Data Science, Computer Science, Business Analytics, or related field
advanced degree desirable
Demonstrable experience of data product management or analytics product leadership within insurance or financial services
proven delivery at scale
Domain Expertise: Strong understanding of the specialist area (Ops/Reg, Dist/Marketing, or Policy/Claims) and adjacent functions (pricing, risk, finance)

Job Responsibility

Own product vision, domain strategy, portfolio roadmap, value outcomes, and cross-product alignment. Sets standards, prioritization criteria, and governance expectations. Accountable for adoption and benefits
Lead / Partner with Product Owners to translate strategy into prioritized backlogs, acceptance criteria, and release plans
Ensure delivery practices (Agile/Scrum/Kanban), NFRs (performance, governance, resilience, privacy-by-design), and control frameworks (quality, metadata, lineage) are embedded
Identify opportunities for data-driven innovation across the underwriting lifecycle including, claims, pricing, and customer engagement
Quantify and measure outcomes (e.g., loss ratio improvement, leakage reduction, campaign ROI uplift, cycle-time reduction)
Maintain product-level scorecards and dashboards tracking usage, quality, SLA performance, and business impact
Ensure partner deliverables meet standards, SLAs, and regulatory controls
participate in QBRs and corrective action plans
Maintain clear RACI and handoffs across build/run
Ensure clear RACI and handoffs across build/run between internal and partner teams

What we offer

Attractive base compensation and discretionary performance related annual bonus
Private medical insurance coverage for both you and your dependents
Company paid life assurance and long term disability insurance
Pension with 10% employer contribution, plus a further matched contribution up to 2.5%
25 days of annual leave (prorated for 1st calendar year of employment), plus public holidays, with the ability to flex the religious bank holidays to suit your religious beliefs, subject to approval. Additional annual leave purchase is also available up to a maximum of five additional days per year
Up to 2.5 days matched paid leave for volunteering at a charity of your choice and 5 days paid leave to provide or arrange care for a dependent with a long term care need annually
Up to £550 reimbursement towards home office setup
Free in-office lunch and monthly lifestyle allowance
Monthly travel allowance or annual season ticket
The opportunity to save for, and purchase, shares of Beazley stock

Fulltime

Pharmacy Technician

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Towson

Salary:

16.50 - 25.00 USD / Hour

CVS Health

Expiration Date

May 18, 2026

Requirements

Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
Regular and predictable attendance, including nights and weekends
Ability to complete required training within designated timeframe
Attention and Focus: Ability to concentrate on a task over a period of time
Ability to pivot quickly from one task to another to meet patient and business needs
Ability to confirm prescription information and label accuracy, ensuring patient safety
Customer Service and Team Orientation: Actively look for ways to help people, and do so in a friendly manner
Notice and understand patients’ reactions, and respond appropriately

Job Responsibility

Living our purpose by following all company SOPs at each workstation to help our Pharmacists manage and improve patient health
Following pharmacy workflow procedures at each pharmacy workstation (i.e., production, pick-up, drive-thru, and drop-off) for safe and accurate prescription fulfillment
Contributing to positive patient experiences by showing empathy and genuine care: creating heartfelt and personalized moments while serving patients at pick-up, drive-thru, and over the phone
keeping patients healthy by offering immunizations and other services at the register and over the phone
and demonstrating compassionate care by solving or escalating patient problems
Completing basic inventory activities, as permitted by law, and as directed by the pharmacy leadership team, such as accurately putting away medication deliveries and completing cycle counts, returns-to-stocks, waiting bin inventories, etc.
Contributing to a high-performing team, embracing a growth mindset, and being receptive to feedback
actively seeking opportunities to expand clinical and technical knowledge needed to better assist patients
Remaining flexible for both scheduling and business needs, while contributing to a safe, inclusive, and engaging team dynamic
voluntarily traveling to stores in the market to work shifts as needed by the business

What we offer

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility

Fulltime

Accounting Clerk

Are you detail-oriented, organized, and experienced in handling financial data? ...

Location

United States , Oakland

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 1 year of relevant experience in accounts payable, invoicing, or general accounting support
Proficiency in QuickBooks is required
Strong attention to accuracy, particularly when handling financial data and documentation
Ability to prioritize and manage multiple tasks in a fast-paced environment
Excellent written and verbal communication skills to collaborate with team members and vendors effectively

Job Responsibility

Review, match, and verify invoices against purchase orders to ensure accuracy and compliance with company policies
Accurately input financial transactions into QuickBooks and maintain up-to-date records
Identify and resolve discrepancies between invoices and purchase orders
Communicate with vendors or internal teams as needed
Organize and maintain physical and digital records of invoices, purchase orders, and related documentation
Assist with other general accounting and clerical tasks as needed, such as account reconciliations and report generation

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan
free online training

Business Development Executive

As Global-e continues to expand across North America, we are looking for a highl...

Location

United States , New York, NY

Salary:

Not provided

Global-e

Expiration Date

Until further notice

Requirements

Ability to collaborate, learn from & support fellow team members while working independently towards individual targets
Experience in Sales/Business Development, ideally in SaaS, eCommerce or cross-border tech is a plus
Proven ability to prospect, qualify, and engage senior decision-makers (Director, VP, C-Level) across multiple verticals
Familiarity with sales tech stack is a plus
Strong communication skills – clear, concise, and persuasive
Organized, detail-oriented, and interested in a fast-paced, target-driven environment
Ability to commute to NYC office 3x per week

Job Responsibility

Own the early stages of the sales cycle: Qualify target accounts/prospects, prepare high-fit leads for outreach using BDE Tech Stack & generate active pipeline for the North American Sales Team (Tech Stack: HubSpot, LinkedIn Sales Navigator, SimilarWeb, UserGems, etc)
Research and identify prospective brands that match Global-e’s Ideal Customer Profile (ICP)
Engage decision-makers through innovative multi-channel outreach (email, phone, LinkedIn, events, etc.) to generate interest and secure qualified product demos
Analyze each prospect’s current cross-border strategy, checkout experience, and shipping/tax setup to tailor outreach and uncover business pain points
Approaching deals with intent, signals & organizational changes to drive outreach engagements
Maintain accurate and up-to-date CRM records, ensuring data hygiene and sales readiness
Collaborate with Sales and Partnerships to align on pipeline development strategies and market trends
Deliver consistently on monthly demo and pipeline generation KPIs, with a priority focus on Pipeline Generation
Share insights on industry trends, competitor positioning, and best practices to bring value to conversations with team

Fulltime

Cloud Solution Architect - AI Apps

We are looking for a Cloud Solution Architect (CSA) to help customers bring thei...

Location

Canada , Toronto

Salary:

96000.00 - 177600.00 CAD / Year

Microsoft Corporation

Expiration Date

Until further notice

Requirements

Bachelor's Degree in Computer Science, Information Technology, Engineering, Business, Liberal Arts, or related field AND 4+ years experience in cloud/infrastructure technologies, information technology (IT) consulting/support, systems administration, network operations, software development/support, technology solutions, practice development, architecture, and/or consulting OR equivalent experience
4+ years experience working in a customer-facing role (e.g., internal and/or external)
4+ years experience working on technical projects
Technical Certification in Cloud (e.g., Azure, Amazon Web Services, Google, security certifications)

Job Responsibility

Engage with customer IT and business leaders to understand their application, data, and AI priorities, and design secure, scalable solutions that drive business value and customer satisfaction
Lead technical engagements across architecture design, Proof of Concepts (POCs), and Minimum Viable Products (MVPs) to accelerate adoption of Azure AI, App Services, GitHub, and data platforms
Own the end-to-end technical delivery results, ensuring completeness and accuracy of consumption and customer success plans in collaboration with the CSAM
Drive next best actions and generate incremental pipeline from each engagement, aligning with Unified Enterprise Support (ES) priorities
Deliver repeatable intellectual property (IP) and contribute to centralized IP development to accelerate deployment and achieve targeted outcomes
Provide delivery oversight and escalation support for key Factory engagements across AI and App Innovation projects
Lead the health, resiliency, security, and optimization of mission-critical workloads, ensuring readiness for production-scale AI use cases
Act as the Voice of the Customer by sharing insights and feedback with engineering teams to influence product improvements and remove adoption blockers
Support customer skilling through technical workshops, readiness activities, and recommendations that ensure solution performance, maintainability, and reliability
Maintain deep technical expertise and stay current with Azure, AI, GitHub, and cloud-native development trends, while contributing to internal and external technical communities

Fulltime

Doctor of Occupational Therapy Faculty

Join Old Dominion University in Shaping the Future of Occupational Therapy! Old ...

Location

United States , Norfolk

Salary:

Not provided

Old Dominion University

Expiration Date

Until further notice

Requirements

Earned PhD, OTD, or other relevant doctoral degree from an accredited institution
Initial certification with the National Board for Certification in Occupational Therapy (NBCOT)
Licensed or eligible for licensure as an occupational therapist in Virginia
Clinical practice experience in occupational therapy
Evidence of teaching, advising, and scholarly activities

Job Responsibility

Teaching, scholarship, mentorship, and service
Contribute to the program’s continued growth and innovation

Fulltime

Claims Resolution Specialist II

Baptist Health (Florida)

Location:
United States , Jacksonville

Category:
Finance

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
February 20, 2026

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