Telephonic Quality Outreach Professional Jobs

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider refunds and returned checks. May handle customer service inquiries and problems. Perform adjustments across all dollar amount level on customer service platforms by using technical and claims processing expertise. Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process. Performs claim re-work calculations. Follow through completion of claim overpayments, underpayments, and any other irregularities. Process complex non-routine Provider Refunds and Returned Checks. Review and interpret medical contract language using provider contracts to confirm whether a claim is overpaid to allocate refund checks. Handle telephone and written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals. Ensures all compliance requirements are satisfied and that all payments are made following company practices and procedures. Review and handle relevant correspondences assigned to the team that may result in adj

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This position is open to candidates located in Arizona. The work schedule is Monday through Friday, from 8:30 AM to 5:00 PM Arizona time. The Care Management Associate (CMA) supports comprehensive coordination of medical services that include intake and outgoing calls for medical services. We work closely with both case management team and utilization management team. The Care Management Associate will review eligibility and benefits and open pre-certification cases and either approve or send to nursing staff for review. Additional responsibilities include but not limited to the following: - Evaluates patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff, and coordinate the required services by the benefit plan. - Communicates health care service delivery as required based on outcomes/reviews noted by the nurse or medical director - Performs non-medical research pertinent to the establishment, maintenance, and closure of open cases. - Provides support services to team members by answering telephone calls from providers and members, taking accurate messages, supporting electronic transmission review and referrals as appropria

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. ** Candidates MUST live in the state of CA, and be a licensed pharmacy technician with the CA Board of Pharmacy (BoP). ** Position Summary The Pharmacy Technician – Clinical Support Services position is responsible for utilizing their clinical knowledge and excellent customer service skills to provide our patients with the smooth service and delivery of medication and supplies to their homes. You will make a difference by bringing your personal touch and clinical experiences that will support our patient’s one on one care. Coram CVS/specialty infusion is a national leader in the home infusion field. As part of the team, you will have an important, uniquely rewarding role putting your Pharmacy Technician skills and experience to work in a closed-door practice setting. Responsibilities Partner closely with pharmacists to coordinate and process new patient referrals, prescription renewals, and ongoing refill management. Serve as a primary point of contact for patients, prescribers, and healthcare providers through frequent telephone communication regarding specialty medication refill scheduling, therapy continuation, and service coordination. Verify insurance coverage and ensure all requirements for dispensing and shipping, including prior authorization approvals when applicable, are in place before medication fulfillment. Contact

Role Summary : A Customer Support Analyst Level II works within the Customer Support Center to meet the needs of GHX's important customers. The CSA-II will develop a strong working knowledge of our leading edge GHX Internet B2B exchange system and growth products, the Customer Support knowledge base, and Customer Support administrative tools. With this knowledge and tools, the CSA-II will answer customer's questions, assist customers in using the functions of the system, and help them when they have problems in using or connecting to the system. Extensive collaborative troubleshooting and problem solving may be required at times. CSA-II will perform these activities with the help of guidelines to assure efficiency, reliability, and quality. The CSA- II works on problems of diverse scope where analysis of situations requires technical expertise and the use of logical diagnostic skills, including a strong working knowledge of EDI-X12. Roles & Responsibilities: Acts as a primary point of contact at GHX for its customers who reach out to GHX via telephone, email, and the GHX Community Web Portal. Works directly with customers to help meet their needs and solve their problems, including systems, specific products, and general information. Works cooperatively with other team members and departments to develop effective and timely solutions for customers. Utilizes Customer Relationship Management System ‘Salesforce’ to record and research customer information and to record all the customer's questions, problems, and solutions. Uses the Customer Support Knowledge Base to assist customers and provide immediate resolution to their problems. Contributes to the Customer Support Knowledge Base in order to provide symptom and resolution information about new issues and update information for known issues. Understands the roles and skillsets of peers and extended departments in order to effectively escalate issues that cannot be resolved during live customer call. Provides ass

At Bolna, we’re building tools that change the way teams leverage Voice AI. We’re looking for a Founding Machine Learning Engineer to own the end-to-end lifecycle of building, evaluating, deploying, and improving models that power millions of production conversations. This is a high-impact, high ownership role where you won’t just work on Bolna’s ML stack—you’ll help build the foundation it scales on. Our team includes IIT alumni with experience at Bain, Atlassian, Uber, Zomato, and LinkedIn, and is backed by leading investors. Responsibilities: Build the data engine - Design pipelines to source and clean conversational voice data across Indian languages, accents, and telephony conditions. Fine-tune models that ship - Fine tune and train models to improve accuracy, speed, and reliability across different use-cases. Define what "good" means - Build evaluation datasets and benchmarks for transcription accuracy, voice naturalness, interruption handling, latency, and end-to-end conversation quality. Set up human-in-the-loop pipelines to capture subjective quality at scale. Ship to production - Work with the engineering team to deploy models into a latency-sensitive, high-volume system. Monitor performance in the wild, debug regressions, and iterate fast. Required Skills: 3+ years of hands-on ML experience with deep practical real-world experience in training models. Strong Python and PyTorch fundamentals with exposure in distributed training, and modern fine-tuning techniques (LoRA, QLoRA, DPO, RLHF, etc.). Training data as a first-class problem. Experience designing data pipelines from collection, cleaning, labeling, deduplication, augmentation and treating data quality as a core engineering discipline. Rigorous about evaluation. You know that "looks good in a demo" is not a benchmark. You build the evals before you trust the model. Speech model experience is a plus with real-time / streaming inference experience where you would have contributed to latency optimization

At Bolna, we’re building tools that change how businesses leverage voice AI. We’re looking for a Software Engineer to build reliable, scalable systems that power millions of production conversations across languages, industries, and telephony environments. This is a high-impact, high-ownership role where you’ll work on core platform problems across distributed systems, real-time communication, developer infrastructure, and customer-facing products. Our team includes IIT alumni with experience at Bain, Atlassian, Uber, Zomato, and LinkedIn, and is backed by leading investors. Responsibilities Build systems that operate at scale: Design and build backend services that support high-volume, real-time voice AI conversations with strong reliability, performance, and fault tolerance. Own features end to end: Take problems from product requirements and technical design through implementation, testing, deployment, monitoring, and iteration. Improve platform reliability: Build systems that are observable, resilient, and easy to debug. Identify bottlenecks, reduce failure rates, and improve system availability. Work on real-time infrastructure: Solve problems across telephony, streaming audio, webhooks, queues, scheduling, concurrency, and low-latency communication. Build for developers and customers: Improve APIs, SDKs, integrations, dashboards, and internal tools that make the Bolna platform easier to use and operate. Raise the engineering bar: Contribute to technical design reviews, code quality, testing standards, documentation, incident response, and engineering best practices. Required Skills Strong engineering fundamentals: Solid understanding of data structures, algorithms, databases, networking, operating systems, and distributed systems. Backend development experience: 2+ years of experience building and operating production backend systems using Python, Go, Java, Node.js, or a similar language. Production ownership: Experience shipping software to production and own

Telephonic Care Coach (Maternal-Child Health) — 2 Locations. Apply via Workday.

Become a part of our caring community The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Care Manager, Telephonic Behavioral Health 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Reports to the Regional CM Manager. Use your skills to make an impact Required Qualifications Must have an active, unrestricted SC Licensed Masters Social Worker (LMSW), Licensed Professional Counselor (LPC) OR an active, unrestricted compact Registered Nurse (RN) license . 2 or more years of experience working as a behavior

General Cleaner / Helper in the Restaurant (Male Only) ! CV Selection or Telephonic Interview ! 1. Cleaner / Helper (10 Nos): $1650 for 9 Hrs + OT 3 Hrs $250 2. Waiter (15 Nos): $700 for 9 Hrs + OT 3 Hrs $1300 3. Cook (10 Nos): $750 for 9 Hrs + OT 3 Hrs $1350 4. Paratha Master (5 Nos): $1750 for 9 Hrs + OT 3 Hrs $350 5. Heavy Driver (10 Nos): $1700 for 9 Hrs + OT 3 Hrs $375 Qualification: 10th (must understand English) Age: 21 to 40 Years Free Food & Free Accommodation Visa Duration: 2 Years Processing Time: 30 Days Air Ticket: Included

Telecalling is the practice of making phone calls to potential or existing customers to generate sales or leads, or to provide customer service. Telecallers, also known as telemarketing executives, telesales representatives, or telesales agents, are company representat ives who perform telecalling. As the name suggests, Tele calling is to initiate the telephonic conversation with the potential or existing clients to generate leads or sales. Thus, Tele callers are the representative of the company, who works on behalf of the third party to contribute to generating sales for the company.

Become a part of our caring community The Transition Coordinator (Care Coach 2) evaluates member's needs and requirements. This evaluation aims to achieve and/or maintain an optimal wellness state. The Coordinator does this by guiding members/families toward resources and facilitating interaction with them. These resources are appropriate for the care and wellbeing of members. The Care Coach 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Position Responsibilities: Support the ongoing member transitions in and out of the Indiana Medicaid programs, the Contractor's enrollment, and among care settings. Complete transitions and assists with the planning and preparation for them, and the follow-up care after. Works with the Member Advocate Coordinator and other member-focused departments of the plan. This collaboration ensures continuity and coordination of care and member and provider communication through the initial transition, ongoing benefit plan, and MCE transfers. Ensure the transfer and receipt of all outstanding prior authorization decisions, utilization management data, and clinical information such as prevention and wellness programs(s), care management and complex case management notes. Help with transitions from the custodial setting to the home and community-based setting. We ask that you have telephonic and in-person meetings within an assigned region. The purpose of these meetings is to work with various stakeholders, including long-term care members, hospital/rehab staff discharge planners, family members/POA's, PCP's, and other healthcare professionals. The ultimate goal is to prevent custodial placements whenever possible. Assess and evaluate member's needs to establish a member specific car

... Address: TATA Consultancy Services Limited International Tech Park Explorer Bldg. 11th Floor Whitefield Road Bangalore Karnataka - 560066 Facility: TCS - Explorer Qualification: 10th Experience: 1 - 2 years Source: Sodexo India | Job Code: IJP574119

... Facility: TCS - L CENTRE Qualification: Graduate Job Code: IJP567219 | Source: Sodexo India

Talkdesk is seeking a Sr. Technical Support Engineer who thrives at the intersection of deep technical troubleshooting and high-level customer consulting. In this role, you aren’t just closing tickets; you are a strategic partner to our clients, an advocate for their needs internally, and a developer of tools that make our entire support engine run smoother. You will be the bridge between our customers and our Engineering, Product, and Professional Services teams, ensuring that complex technical challenges are met with elegant, scalable solutions. Key Responsibilities Technical Leadership & Triage Advanced Troubleshooting: Lead Talkdesk’s most intricate support tasks. Outline reproduction steps, drive issues to resolution, and manage customer expectations with clarity. Escalation Management: Serve as the definitive point of contact for issues escalated from Tier 1 or Client Services, ensuring timely resolution. Developer Advisory: Act as the primary technical contact for partner and user developers, comfortably navigating and advising on custom solutions and integrations. Efficiency & Innovation Tool Development: Identify recurring manual tasks and develop internal tools or scripts (JavaScript, etc.) to automate the team’s most time-consuming workflows. Process Optimization: Leverage strong technical acumen to dynamically identify processes and technical solutions for unexpected or high-pressure situations. Customer Advocacy & Success Voice of the Customer: Identify and synthesize customer feedback to act as a strategic advocate to internal Product and Engineering teams. Strategic Consulting: Develop trust with client leadership to remove roadblocks, formulate best practices, and document functional/technical requirements. Risk Mitigation: Work closely with customers to track work progress and create strategies for risk mitigation and contingency planning. Feature Demonstrations: Conduct engaging demos of feature enhancements for both new and existing cu

Do you thrive in a fast-paced environment, where you gain a tremendous amount of responsibility? Do you want to be part of an exceptional entrepreneurial team with young, motivated and extremely driven people? And are you curious or passionate about sales? If so, you might be our next Business Development Executive. About us Retail Insights is Northern Europe’s leading retail forum. We are strengthening the retail ecosystem by building a platform for insights, inspiration, and networking, connecting more than 3,000 leaders yearly from more than 15 countries. Retail Insights is part of United Media ( https://www.united-media.com/ ) which focuses on building large scale industry media and conferences products in sectors such as insurance, HR, private equity, retail, etc. As of today, we have organically launched 8 media companies and acquired one. What we offer you As our Business Development Executive you'll have the unique opportunity to be part of building and scaling a company. By providing you with the ownership of our telemarketing, we want to constantly push you out of your comfort zone. You’ll be working out of our HQ in Copenhagen and to ensure a never-ending growth curve, we provide you with: An opportunity for getting operational experience in a start-up where both your work and the results are highly tangible and matters to the business A chance to work closely together with the CEO on our sales execution Unlimited growth potential in our company - we strongly believe in and have a track record of promoting internally Your Responsibilities Given our global expansion, the Business Development Executive role is strategically important to place us as the market leader in the industry. As we start to amass a large client base which needs an extra touch of care and nurture, this will give you an opportunity to build relationships with C-Level execs and SME business owners in the financial and technology sectors. What we expect from you You possess an unpa