The Developer III position at CGS Administrators involves analyzing systems specifications, programming applications, debugging, testing, and maintaining software. The role requires collaboration with team members to deliver quality technical solutions and supporting production systems.

Responsibilities include accurate and timely claims processing, verifying procedure and diagnosis codes, resolving claims errors, and coordinating with internal departments. Requires strong analytical skills and basic math skills.

The Developer IV is responsible for analysis, design, programming, and implementation of complex applications. Duties include project deliverables, testing and modifying programs, and providing technical guidance. The role requires collaboration with customers and team members to align technical solutions with business strategies.

Responsible for analysis, design, programming, and implementation of complex applications. Collaborate with stakeholders to develop solutions, conduct testing, and provide support. Lead projects and guide junior team members while ensuring compliance with architectural standards.

The Business Systems Analyst II is responsible for defining customer needs in both technical and business contexts. The role involves documenting user requirements, guiding the development of systems, facilitating knowledge transfer, and ensuring the accurate deployment of solutions. The analyst will also validate business needs and assist in producing documentation and training materials.

The Splunk Technology Analyst will support federal customers in managing a Splunk Hybrid environment, conducting technical interviews, analyzing technology lifecycles, and establishing best practices for operational units. The role requires independent work with a portfolio of technologies and involves excellent communication and research skills to maintain effective vendor and stakeholder relationships.

The Enrollment Representative is responsible for processing member enrollment applications, managing membership transactions, responding to customer inquiries, and preparing necessary contracts and benefit documents. This role requires good organizational skills and effective communication while maintaining confidentiality and handling sensitive information.

The Analyst, Claims Policy II interprets directives and policies to establish processing guidelines and works with the systems department to implement edits and audits for the claims system. This role also involves reviewing claims, approving changes, and leading project initiatives while serving as a subject matter expert for claims processing.

Responsible for the accurate processing of claims, verifying procedure and diagnosis codes, and resolving claims errors. Additionally coordinates with internal departments to maintain patient and provider information as needed.

The Recruiter oversees efficient recruitment activities for high volume roles, campus recruiting, internships, and entry-level positions. They manage staffing plans, assess candidates, advise management on recruitment strategies, and ensure compliance with policies and laws.

The Claims Processor II reviews and adjudicates complex claims, ensuring proper coding and compliance with regulations. They assist in training new staff and handle claims processing errors, communicating with various support areas to resolve issues efficiently.

The Business Systems Analyst II at Palmetto GBA is responsible for defining customer needs, ensuring proposed solutions meet objectives, and documenting business requirements. This role involves guiding technical and non-technical departments, validating business needs, and assisting in the development of training materials.

The Appeals Specialist is responsible for performing non-medical reviews, processing redetermination letters, and ensuring accuracy and timeliness in their work. They will collaborate with other departments, prepare reports, analyze workload issues, and support legal documentation as required.

The Provider Enrollment Analyst will handle the provider enrollment process, ensuring application accuracy and compliance, and maintaining provider file integrity. Key responsibilities include data verification, application processing, customer service communication, and contributing to special projects related to provider files.

Responsible for promoting effective quality management systems according to ISO 9001:2015 standards. Duties include coordinating internal audits, monitoring corrective actions, supporting process development, ensuring document control, providing external audit support, and conducting training.

The Administrator, Contract Oversight role involves drafting and managing contracts related to goods and services. Responsibilities include reviewing agreements, conducting negotiations, and ensuring compliance with legal requirements. The position requires coordinating with internal and external stakeholders, problem-solving issues that arise in contract execution, and generating reports for management.

The role involves reviewing and adjudicating complex claims, ensuring accuracy in processing according to guidelines, and training new staff. Responsibilities include verifying claims, correcting errors, and responding to correspondence related to claims.

The job involves processing claims accurately and promptly, coordinating with internal departments to resolve errors and validate procedures. The position requires analytical skills for research, as well as strong communication for interacting with stakeholders.

Responsible for processing claims accurately and timely, including auditing, resolving errors, and coordinating with departments. Requires strong communication and analytical skills, along with proficiency in Microsoft Office.

The Claims Processor I position involves researching and processing claims following regulations and internal standards. Responsibilities include verifying codes, resolving claims errors, and coordinating with other departments to update necessary patient and insurance files.