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Medical Top Level Nursing Executive

Directs, through managers, supervisors or head nurses, activities of nursing staff. Administers nursing program in hospital or other medical institution to maintaining standards of patient care. This is the highest level position in patient care.: Plans and organizes activities in nursing services, such as obstetrics, pediatrics, or surgery, or for two or more patient-care units to ensure patient needs are met in accordance with instructions of physician and hospital administrative procedures. Coordinates activities with other patient care units. Advises medical staff, department heads, and hospital administrator in matters related to nursing services. Recommends establishment or revision of policies, and develops organizational structure and standards of performance. Interprets policies and objectives of hospital nursing services to staff and community groups. Performs personnel management functions. Plans and organizes orientation and in-service training for unit staff members, and participates in guidance and educational programs. Assists in formulating budget. Engages in studies and investigations related to improving nursing care. May direct activities of school of nursing.

Data Entry Operator Lead

Guides data entry operators in the data entry process and in solving work problems. Operates computer or other data entry device to enter data in computer-readable format. Inputs accounting or statistical data from source documents into computer, using data entry device, such as keyboard or optical scanner, and following format displayed on screen.: Compares data entered with source documents, or re-enters data in verification format on screen to detect errors. Deletes incorrectly entered data, and re-enters correct data. Keeps record of work completed. Compiles, sorts, and verifies accuracy of data to be entered. May assist in role of group leader as required.

Information Technology Supervisor Data Entry

Supervises data entry operators engaged in inputting data into various storage media, manipulating existing data, editing data, and proofing new entries into database for accuracy. Interprets company policy to employees and enforces company policies and practices. Analyzes and resolves work problems, or assists employees in solving work problems. Ensures work is performed within established policies, procedures, and standards.: Consults with data processing personnel on ways to expedite workflow and improve productivity. Confers with user departments to implement controls and schedules and resolve delivery problems. Advises management on problems relating to data entry. Responsible for data entry improvements in quality and efficiency. Compiles, sorts, and verifies accuracy of data to be entered. May recruit, hire, train staff, evaluate employee performance, and recommend or initiate promotions, transfers, and disciplinary action.

Enrollment Representative (Entry)

In an entry level capacity, responds to incoming calls and verifies enrollment status, makes changes to records, and researches and resolves enrollment system rejections.: Processes enrollment mail while learning to respond and resolve enrollment issues. Investigates data errors. Orders identification cards and responds to routine questions and problems regarding eligibility or membership changes, issues or concerns. Processes inquiries from providers and members. Updates member accounts and terminations. This is an entry level position.

Claims Adjudicator (Entry)

Adjudicates or processes health and dental benefit claims for payment.: Under direct supervision, reviews and adjudicates claims. Determines whether to return, suspend, deny or pay claims within established policies and procedures. Compares claim application and/or provider statement with plan file and other records to evaluate completeness and validity of claim. Analyzes and answers inquiries regarding claim adjudication, including method of payment, co-pay or deductible amounts, and or reason for denial. Requests information from internal or outside sources to ascertain completeness and validity of claim including coordination of benefits information. Compares data on claim application, death certificate, or physician's statement with policy file and other company records to ascertain validity and to adjudicate the claim. Routes claims requiring additional information or high-level decision-making. Researches claims as needed. Communicates with agents and claimants to correct errors or omissions on claim forms. This is an entry level position and typically does not require previous claims processing experience.

Level Glass Forming Machine Operator

Tends battery of automatic machines that flame-cut and form vials for level from glass tubing: inserts tubing in holder to feed machine. Replenishes tubing and replaces fill catch boxes. Examines formed glasses for defects, such as unclosed bottoms, elongated tops or misshapen vials, and notifies machine adjuster of machine malfunctioning. Removes formed glasses to workbench and files points from glasses to leave opening for filling, using half-round file.

Level Glass Vial Filler

Tends equipment that fills glass vials with alcohol or ether solution and leaves air bubble to form vials used in tools and instruments to determine levelness: fills rack with vial-filled cups and lowers rack into tank of solution. Lowers weighted glass cover and moves lever to turn on air pressure. Sets timer for designated time cycle. Shuts off air and raises cover when bell rings. Compares bubbles in random sampling of filled vials with master vial for conformance to size. Refills vials or lets vials stand to evaporate excess fluid to regulate size of bubble. Pours solution from jug into tank to replace used fluid.

Member Services Representative (Entry)

Under direct supervision, provides customer service to plan members, providers and employer groups by answering inquiries about member eligibility, plan benefits, claims status and demographics. This is an entry level position that typically does not require previous related experience.: Under direct supervision, provides customer service to plan members, providers and employer groups by answering inquiries about member eligibility, plan benefits, claims status and demographics. Provides customer service to plan members, providers and employer groups by answering questions about plan benefits, resolving issues and educating callers. Receives inquiries from members via the internet, telephone and in writing regarding covered benefits. Provides assistance in resolving problems such as finding physicians, arranging transportation, ordering identification cards, changing primary care case managers, filing appeals, resolving billing errors and accessing payment. Maintains records of all contacts and results. Provides claim status, payment amounts and/or denials for processed claims. Reports successive claims payment issues or member issues to management for appropriate intervention. Assists providers with standard electronic claims submission questions and works with providers to resolve problems in filing electronic claims. Mails out provider directories and new member packets. Assists providers and members in accessing information via the organization’s online services directory. This is an entry level position that typically does not require previous related experience.

Key Entry Operator

Enters data into computer using various data entry devices. Enters lists of items, alphabetic, numeric, or symbolic in computer-readable format.: Compares data entered with source documents, or re-enters data in verification format on screen to detect errors. May compile, sort, and verify accuracy of data to be entered. May manipulate existing data, edit current information, or proofread new entries in database for accuracy. May utilize optical scanners. May keep record of work completed.



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