Job Schedule :
- Effective knowledge of HMO marketing/business development
- Prompt submission of monthly capitation
- Appropriate adjudication, negotiation of claims
- Timely treatment of pre-authorization requests and codes
- Sufficient and effective deployment of monitoring/quality assurance tools
- Effective provider visitation and proper reporting of visits and Quality Assurance tools utilized in weekly report.
- Effective use of computer to analyze report and submit reports.