Top 17686 Advanced technical service representative Jobs

Supervisor, Focused Review
Delta Dental of Michigan —Okemos, MI
- Full-time
- Hybrid work
- 5 years
- Word processing
- Research
- Dental insurance
- Opportunities for advancement
Advanced Technical Support Representative - Email Archiving Specialization
Tangent Inc —Burlingame, CA
- $60,000 a year
- Full-time
- Software troubleshooting
- English
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Technical Service Representative
Minerals Technologies —Phoenix, AZ
- Full-time
- Mid-level
- 3 years
- Ability to lift 50 pounds
- Disability insurance
- Health insurance
RF SIGINT Technical Analyst
Vantor Services Inc. —Reston, VA
- $99,000 - $145,200 a year
- Full-time
- Research
- Analysis skills
- Math
- 401(k) matching
- Pet insurance
Quick Apply
11d
Electro / Mechanical Technical Service Representative - Autonomous Systems
Dane Technologies —Maple Grove, MN
- 8 hour shift
- Customer service
- Mid-level
- High school diploma or GED
- Health savings account
- Health insurance
Quick Apply
Tier 1 Technical Support Representative (REMOTE IOWA)
Aureon —West Des Moines, IA
- Remote
- Computer literacy
- Basic math
- Research
- Health insurance
- 401(k)
Quick Apply
Cloud Service Administrator I (Night Shift)
CloudWave —Remote
- $55,000 - $60,000 a year
- Weekends as needed
- 1 year
- Entry level
Quick Apply
Tier 1 Technical Support Representative (REMOTE WISCONSIN)
Aureon —La Crosse, WI
- Remote
- Computer literacy
- Basic math
- Research
- Health insurance
- 401(k)
Quick Apply
Cloud Service Desk Representative
Nationwide IT Services —Washington, DC
- $60,000 - $110,000 a year
- Full-time
- Remote
- Windows
- 8 years
- Bachelor's degree
Quick Apply
Claims EDI Helpdesk Support
RADcube —Remote
- Full-time
- Remote
- Background check
- High school diploma or GED
- 1 year
Advisor - Technical Lead Scientist - Advanced Therapies Manufacturing
Lilly —Lebanon, IN
- $129,000 - $189,200 a year
- Full-time
- Bachelor of Science
- 3 years
- Bachelor's degree
- Health insurance
- Dental insurance
Senior Service Desk Technician
SALT Dental Partners —Franklin, TN
- From $75,000 a year
- Full-time
- Microsoft Outlook
- Computer Science
- 5 years
- AD&D insurance
- Health insurance
Advanced Product Marketing-Remote
Yoh, A Day & Zimmermann Company —Santa Clara, CA
- $100 - $120 an hour
- Contract
- Remote
- Marketing
- Writing skills
- Master's degree
- Health savings account
- Disability insurance
Quick Apply
9d
Call Center Remote Customer Service Representative
VIMO INC —Nevada
- $17.00 - $18.50 an hour
- Full-time
- Remote
- Background check
- 18 years or older
- Spanish
- Paid training
- Paid time off
Quick Apply
Call Center Remote Customer Service Representative
D&A CONSULTING SERVICE LLC —Virginia
- $17.00 - $18.50 an hour
- Full-time
- Remote
- Background check
- 18 years or older
- Spanish
- Paid training
- Paid time off
Quick Apply
Tier 1 Technical Support Representative (REMOTE IOWA)
Aureon Contact Center —Cedar Rapids, IA
- Remote
- Computer literacy
- Basic math
- Research
- Health insurance
- 401(k)
Quick Apply
Technical Support Representative III
Surf Internet —La Porte, IN
- $28 - $30 an hour
- Call employer
- 3 years
- High school diploma or GED
- Analysis skills
Quick Apply
Customer Service Representative - Remote
NeoPollard Interactive —Lansing, MI
- Remote
- Windows
- High school diploma or GED
- Travel
- Profit sharing
- Paid parental leave
Quick Apply
Client Support Representative I (Product Support Representative I) -REMOTE
Net Health —Pittsburgh, PA
- $19 an hour
- Weekends as needed
- Remote
- Oracle
- Salesforce
- High school diploma or GED
- Health insurance
Quick Apply
Customer Service Representative
Atosa USA, Inc. —Flowery Branch, GA
- $20 an hour
- English
- Mid-level
- 2 years
Quick Apply

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Supervisor, Focused Review

Delta Dental of Michigan -
Okemos, MI

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Job Details

Full-time

Benefits

Dental insurance
Opportunities for advancement

Qualifications

Contract documentation review
Healthcare financial misconduct investigations
Contract review
Word processing
Spreadsheets
Contract interpretation
Research
Internal investigations
Health insurance knowledge
Healthcare billing investigations
Insurance investigations
Presentation preparation
Productivity software
Insurance (Financial sectors)
Technical Proficiency
Data analysis software

Full Job Description

Job Title:

Supervisor, Focused Review

Number of Positions:

Location:

Okemos, MI

Location Specifics:

Hybrid Position

Job Summary:

At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation.

At Delta Dental, we celebrate our All In culture. It’s a mindset, feeling and attitude we wrap around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community.

Position Description:

Plans, organizes, and supervises the Provider Auditor Focused Review Special Investigation Unit (SIU) , including oversight of data research and review, and audit and investigation activities. E nsures all team operations align with corporate and departmental goals and objectives, maintains compliance with applicable standards and policies, and supports continuous improvement in Focused Review processes.

Primary Job Responsibilities:

Supervises and monitors the daily administrative and technical functions of the Focused Review SIU teams, data research and review, and audit and investigation activities to ensure efficient, compliant operations that support departmental and corporate goals and objectives.
Supports staff recruitment, onboarding, and development by assisting with interviewing, training, mentoring, and evaluating team members to promote accountability and achievement of individual and team objectives.
Oversees staff engaged in data research, report development, and analytics, serving as a resource for audit and research questions and providing guidance to internal and external stakeholders on reporting issues, provider agreements, processing policies, client contracts, and regulatory compliance for both commercial and government programs.
Implements and enforces policies, procedures, and standards for audits and investigations, and assists in preparing departmental reports and analyzing business processes to ensure compliance with regulatory requirements for both commercial and government programs.
Facilitates communication with law enforcement and legal representatives by supporting the preparation of documentation and responses to subpoenas, and assisting with administrative or judicial proceedings related to fraud, waste, and abuse.
Builds and maintains collaborative relationships with business partners to provide operational support, clarify requirements, and promote effective use of SIU services and solutions.
Acts as a liaison for staff and internal departments, providing expertise and interpretation of dental policies, procedure codes, and processing guidelines related to claims adjudication, fraud, waste, and abuse activities.
Assists in developing and implementing departmental strategies, goals, and objectives to support continuous improvement and operational excellence.
Supports budget monitoring and resource allocation for the Focused Review SIU teams as directed by management.

Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.

#LI-Hybrid

Minimum Requirements:

Position requires a bachelor’s degree in business administration , criminal justice, or related field a nd five years of experience conducting investigations, audit s, or complex data analy sis within the insurance industry. Previous leadership experience is preferred , as well as experience reviewing claims activity, provider behavior, or group contract compliance. Will accept any suitable combination of education, training, or experience.

Position requires advanced knowledge of the insurance industry operations; strong investigative skills related to fraud, waste, and abuse; proficiency with analytic al tools, word processing, spreadsheet, and presentation software skills; strong verbal and written communication skills, strong organizational and analytical skills; the ability to lead investigative teams ; the ability to interpret contract language and identify indicators of fraudulent activity ; the ability to manage multiple assignments with competing deadlines; and the ability to resolve complex problems using independent judgment. Professional certifications such as CFE, CIA, AHFI are preferred .

The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.

Apply Now

Refine Your Search

advanced technical service representative jobs

Supervisor, Focused Review

Advanced Technical Support Representative - Email Archiving Specialization

Technical Service Representative

RF SIGINT Technical Analyst

Electro / Mechanical Technical Service Representative - Autonomous Systems

Tier 1 Technical Support Representative (REMOTE IOWA)

Cloud Service Administrator I (Night Shift)

Tier 1 Technical Support Representative (REMOTE WISCONSIN)

Cloud Service Desk Representative

Claims EDI Helpdesk Support

Advisor - Technical Lead Scientist - Advanced Therapies Manufacturing

Senior Service Desk Technician

Advanced Product Marketing-Remote

Call Center Remote Customer Service Representative

Call Center Remote Customer Service Representative

Tier 1 Technical Support Representative (REMOTE IOWA)

Technical Support Representative III

Customer Service Representative - Remote

Client Support Representative I (Product Support Representative I) -REMOTE

Customer Service Representative

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