Membership Representative Lead

  • Monitors the unit’s schedule for sufficient coverage. Reviews aging of forms, while continually re-prioritizing based on departmental needs.
  • Participates in the establishment and review of departmental goals and implements procedures and performance standards. Ensures goals are communicated to staff.
  • Prepares reports and documentation concerning departmental activities. Reviews weekly auditing reports.
  • Monitors processing, tracks and delegates work based on departmental goals, backlogs and ensures equitable distribution.
  • Reviews weekly auditing reports for accuracy and maintains accuracy and production tracking logs.
  • Works with staff to reconcile audit discrepancies and resolve eligibility questions. Reviews/analyzes returned audit tickets. Identifies training/performance gaps.
  • Ensures action plans are in place to reduce backlog and effect resolution to ongoing issues.
  • Mentors and trains new associates. Advises and/or counsels staff members on correct procedures.
  • Responds to phone calls from other service centers and internal units.
  • Encourages associates in the units to assist other units as necessary.

Education/Experience:

  • Associate’s Degree in Business or Health Care or related experience is preferred.
  • Four years membership accounting or related experience.
  • Previous experience with vendor oversight/leading a team strongly preferred
  • Intermediate Excel skills strongly preferred
  • Knowledge of medical insurance and/or medical terminology strongly preferred
  • Healthcare or healthcare insurance experience preferred

Orthopedic Surgery

  • Reviews all medical records and addresses each question posed by the client utilizing client-specific criteria or other nationally recognized evidence-based criteria
  • Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
  • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
  • Provides copies of any criteria utilized in a review with the report in a timely manner
  • Returns cases on or before the due date and time
  • Makes telephone calls as mandated by the state and/or client specifics
  • Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
  • Attends all required orientation and training
  • Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits

Finance Assistant

  • Collect information for and prepare payroll payments for employees
  • Assist the financial director in creating financial reports on a regular basis
  • Adhere to the company’s or organization’s financial policies and procedures
  • Answers question and provide assistance to stakeholders, customers, and clients as needed
  • Attend finance department and company-wide meetings, sometimes assisting with financial reporting to managers and senior executives
  • Suggest changes or improvements to increase accuracy, efficiency, and cost reductions.

Requirements:

  • Excellent mathematical skills
  • Understanding of data privacy standards
  • Integrity, honesty
  • Customer-service skills
  • Solid communication skills, both written and verbal
  • Familiarity with business principles and practices
  • Superior attention to detail, organizational skills, planning skills,

Data Acquisition Specialist

Core Responsibilities 

  • Gain a working knowledge of the construction industry and key players
  • Learn to develop relationships and gain expertise in specific data sources
  • Research, collect, verify, and maintain project data through various means, including outbound phone calls, emails, and digital research with guidance from manager
  • Ensure timely, accurate, and comprehensive data entry for all assigned projects and use this data to create or update Dodge Reports on the DCN platform
  • Maximize project coverage by collecting information on as many active projects as possible within the assigned regions
  • Complete formal documentation required to support data collection processes
  • Maintain accountability for performance metrics, ensuring accurate, punctual, and thorough data collection

Skills and Qualifications 

·          High School Diploma or GED 

·          6 months of outbound call experience 

·          Data entry experience 

·          Experience in the construction industry preferred 

·          Proficient in all Microsoft areas 

·          Exceptional attention to detail 

·          Excellent written and verbal communication 

·          Excellent reading comprehension 

·          Excellent internet research skills 

·          Able to work effectively in an independent, remote environment 

·          Comfortable working in a fast-paced role/production driven environment 

·          Strong typing skills 

·          Critical thinker and problem solver 

Clinical Data Abstractor

  • 2+ years direct NSQIP Registry Abstraction experience for a Health System or Hospital
  • Must hold a current SCR certification
  • Current abstracting experience. Actively abstracting within the past 12 months highly preferred
  • Experience and knowledge of several medical registries with relevant clinical background
  • Knowledge of basic medical terminology, proficiency in EMR, and exposure to a healthcare environment is appropriate. 
  • Ownership approach to workload, ability to work independently 
  • Organized with a high attention to detail and commitment to accuracy
  • Excellent communication skills. 
  • Team player who is collaborative and can work in an independent environment.  
  • Remote training and onboarding compatible 
  • Wants to grow with the company and believes in the mission

Responsibilities: 

  • Data collection and entry for multiple registries for Carta Healthcare clients
  • Collaborate with nurse practitioners, physician assistants, physicians, other medical professionals to complete patient encounters
  • Ensure quality submission of all data in specified registries maintaining a high accuracy threshold.
  • Communicate with Carta team and reporting hospitals to streamline data management
  • Provide data analysis to reporting hospital managers, as appropriate
  • Keeps up to date on mandated regulatory/publicly reported data requirements as specified by federal, state, payer and other agencies.