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If you're looking for a career and not just a job..........................
Posted 2 days ago
The Pharmacy Production Support Specialist is responsible for performing various client on line look ups and validation procedures that support the production and distribution of client audits in the Pharmacy Division. The role involves organizing, storing and processing both digital and paper information. The person selected must be comfortable using digital hardware and software, so they can tot
Posted 2 days ago
Identify, qualify, and open files for the Workers Comp and Subrogation departments by, researching correspondence with insufficient information using multiple systems and making outbound calls as necessary to get the correct information. Review insurance claim data from client systems and validate the accuracy of the liens we are building. ESSENTIAL DUTIES & RESPONSIBILITIES Access client sy
Posted 3 days ago
The Auditor is responsible for closing the required number of audits per day based upon the audit type with a 100% quality score. The Auditor investigates claims data to identify overpaid/incorrectly paid claims and initiates the recovery of that money for our clients. The position requires extensive online research in clients’ claims systems, internal research materials, internet resources
Posted 3 days ago
The Auditor is responsible for closing the required number of audits per day based upon the audit type with a 100% quality score. The Auditor investigates claims data to identify overpaid/incorrectly paid claims and initiates the recovery of that money for our clients. The position requires extensive online research in clients’ claims systems, internal research materials, internet resources
Posted 3 days ago
The Recovery Analyst is responsible for collecting refunds from healthcare providers on existing files. This position must be able to explain Medicare and Commercial primacy rules and/or Workers' Compensation rules to healthcare providers and other commercial carriers in order to facilitate refunds. The Recovery Analyst is also responsible for handling other administrative duties in order to f
Posted 6 days ago
Queue management – review team queues and identify where changes would benefit the individual and team as a whole including the team’s client mix Monthly individual queue reviews – review individual team member queues to assist them with any issues or requests that need special attention that have not been identified earlier in the month Complete quality reviews on a monthly basi
Posted 7 days ago
Do you have a knack for building applications that directly impact an organization? Are you a wizard with C#, .Net and Angular JS then The Rawlings Group is looking for you!!! All applications are proprietary and are used in house only. Candidates should be uniquely skilled and have the ability to think outside the box. We are looking for Senior Level Software Developers who are passionate about j
Posted 7 days ago
The Overpayment Tracking Coordinator is responsible for the successful submission of overpaid claims that Rawlings is pursuing through monitoring of file submissions and response files to and from our clients, and resolving all issues from the submission process. ESSENTIAL DUTIES & RESPONSIBILITIES Internal & Client correspondence dealing with the correction/update of overpaid claims Mon
Posted 9 days ago
If you're looking for a career and not just a job.....
Posted 10 days ago
This position will be responsible for validation and prioritization analysis of file openings to assist with quality control efforts. This can include openings from investigation letter responses, ISO, or other sources as required. ESSENTIAL DUTIES & RESPONSIBILITIES All duties and responsibilities are to be performed in accordance with The Rawlings Company's policies, procedures, guidel
Posted 16 days ago
Under the direction of the Manager of the Data Integrity Group, the ETL (Extract, Transform & Load) Developer will design, develop, test, and implement ETL and reporting programs for the Data Integrity Group to provide business solutions for The Rawlings Group. Successful candidate will have 6 8 years of IT experience with 4+ years of experience as an ETL Developer. ESSENTIAL DUTIES AND RESPON
Posted 23 days ago
Candidates must have experience with Information Technology Agile Development Method, TFS, MS Visual Studio and automated testing abilities. WRITING A SQL QUERY IS A MUST!!! Individuals who do not have SQL experience need not apply. POSITION SUMMARY Support business units by performing all quality control testing on software development to ensure no adverse impact on customers, financials, operati
Posted 24 days ago
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