Revenue Integrity Coding Billing Specialist

by Kay Tay | Oct 11, 2023 | Uncategorized

Under the direction of the Director of Revenue Integrity, the Revenue Integrity Coding Billing Specialist provides revenue cycle support services through efficient review and timely resolution of assigned Medicare and third party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. This position is 100% remote.

Daily duties for this position include:

• Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific Revenue Integrity Hold Codes in the hospital billing scrubber. Tasks associated with this work include resolving standard billing edits such as:
• Correct Coding Initiative (CCI)
• Medically Unlikely Edits (MUE)
• Medical Necessity edits
• Other claim level edits as assigned
• As needed, review clinical documentation and diagnostic results as appropriate to validate and apply applicable ICD-10, CPT, HCPCS codes and associated coding modifiers.
• Responsible for daily resolution of assigned claims with Revenue Integrity specific denials in the Guidehouse METRIX℠  system.
• Ensures coding and billing practices are in compliance with Federal/State guidelines by utilizing various types of authoritative information.
• Maintains current knowledge of Medicare, Medicaid, and other third party payer billing compliance guidelines and requirements.
• Other duties commensurate with skills and experience as determined by the Director of Revenue Integrity.

What You Will Need: 

• AAPC or AHIMA coding certification. 
• Experience in ICD-10, CPT and HCPCS Level II Coding.
• Expertise in determining medical necessity of services provided and charged based on provider/clinical documentation.
• Knowledge, understanding and proper application of Medicare, Medicaid, and third-party payer UB-04 billing and reporting requirements including resolution of CCI, MUE and Medical Necessity edits applied to claims.
• Proficiency in determining accurate medical codes for diagnoses, procedures and services performed in the outpatient setting. For example: emergency department visits, outpatient clinic visits, same day surgeries, diagnostic testing (radiology, imaging, and laboratory), and outpatient therapies (physical therapy, occupational therapy, speech therapy, and chemotherapy)
• Knowledge of current code bundling rules and regulations along with proficiency on issues regarding compliance, and reimbursement under outpatient grouping systems such as Medicare OPPS and Medicaid or Commercial Insurance EAPG’s.
• Knowledge and understanding of hospital charge description master coding systems and structures.
• Strong verbal, written and interpersonal communication skills.
• Word/Excel proficient.
• Ability to produce accurate, assigned work product within specified time frames.

What Would Be Nice To Have:

• 5 years experience in Revenue Integrity Coding and Billing
• Hospital medical billing and auditing experience
• Associates Degree

As a member of the Guidehouse Comprehensive Revenue Cycle Management (CRCM) team, the Revenue Integrity Coding Billing Specialist combines subject matter expertise with Guidehouse technology solutions to investigate, track and resolve health care claim billing errors and denials.

This position contributes to the mission of the Revenue Integrity Program to help improve compliance with government, managed care and other third party payer billing and reporting requirements. Through collaboration between the CRCM project team and client stakeholders, the Revenue Integrity Specialist contributes to continuous process improvements to meet and/or exceed established Revenue Integrity Key Performance Indicators (KPI).  The annual salary range for this position is $50,600.00-$91,100.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

Guidehouse is a leading global provider of consulting services to the public sector and commercial markets, with broad capabilities in management, technology, and risk consulting. By combining our public and private sector expertise, we help clients address their most complex challenges and navigate significant regulatory pressures focusing on transformational change, business resiliency, and technology-driven innovation. Across a range of advisory, consulting, outsourcing, and digital services, we create scalable, innovative solutions that help our clients outwit complexity and position them for future growth and success.

APPLY HERE

Menu Specialist

by Kay Tay | Oct 11, 2023 | Uncategorized

ezCater is the most trusted provider of corporate food solutions and is purpose-built for business. ezCater’s corporate food platform and flexible, scalable food solutions allow organizations to centralize and track their food spend, and fulfill everything from daily employee meals to client meetings and company all-hands. ezCater backs this up with business-grade, best-in-class, customer service and an unmatched nationwide footprint. We’re backed by top investors including Insight, Iconiq, Lightspeed, GIC, SoftBank, and Quadrille.

ezCater menus are the beating heart of our marketplace. At the intersection of both sides of our platform, ezCater menus simultaneously guide our customers to place the perfect order and help our partners grow their catering businesses. Whether customers are looking for BBQ sandwiches for their team building seminar, vegan Korean noodles for their department outing, or a festive holiday meal for their office party, our carefully curated menus provide both the attention to detail and the streamlined experience that lead customers to say, time and time again, that we really do make their lives easier. 

Simply put, the ezCater Menu Team is responsible for transcribing & reviewing all of the great menus on our site. We’re a group of tech-obsessed foodies who move fast & also know how to beautifully define kimchi & tahini on the fly.  We’re driven & dedicated to bringing ezCater menus to the next level of excellence (and also love a good debate about the spiciest hot sauce while we’re doing it). 

It’s the job of our Menu Specialists to create and review menus for all of our new restaurant partners while balancing speed, efficiency, and quality. We support a wide variety of partners – from mom & pop indies to national enterprise chains – and ensure that they all have accurate, functional, and appealing menus.

As a Menu Specialist, you will: 

• Transcribe: You’ll work with websites, third party platforms, spreadsheets, and documents to compile, process, and transcribe items, prices, dietary information, and more in our homegrown tool.
• Review & revise: You’ll review menus and revise for quality aligned with our internal style standards.
• Meet high performance standards: Your key performance indicators will be based on the quantity and quality of the work you do transcribing and modifying menus.
• Collaborate: Solution-oriented feedback is our bread and butter. We’ll need your help with improving our processes and our tools.
• Advocate: We’ll expect you to be an internal advocate and champion for our amazing restaurant partners, and to seek out opportunities to create unparalleled experiences for them.
• Make an Impact: You’ll make an immediate impact on our company goals – you’ll be an essential part of the success of thousands of restaurant partners and help drive customer satisfaction.

To succeed as an Menu Specialist, you need to be:

• Devoted to details: Our quality standard is the highest in the business.
• A skilled wordsmith: You can easily type 75+ WPM while maintaining a high level of quality and accuracy.
• A big-picture thinker: Our team innovates as a group, and we’ll expect you to meet us two steps ahead.
• Hungry for change: If something isn’t working, we fix it. And then we fix it again. 
• A circus-level juggler: You’re comfortable with a high-volume list of varied tasks and prioritizing them feels like second nature to you.
• Tech-knowledgeable: You have experience with technical services and platforms and are eager to learn more (Zendesk proficiency is a huge plus!).
• Adaptable & Inquisitive: You’re a natural problem solver – constant change is your fuel and you thrive in ambiguous situations.
• Driven towards excellence: We’ll expect you to consistently meet or exceed expectations on quantity & quality performance objectives.
• A team player: You’ll work with teams across our department and will need to build relationships with internal stakeholders to ensure success for all parties.

Please include a cover letter, but throw everything that is ‘best practice’ about writing cover letters out the window, and please write as explicitly as possible what resonates with you about this job.

The national cash compensation range for this role is $45,000-$53,000*

*Please note: Final offer amounts are determined by multiple factors, including prior experience, expertise and region & may vary from the amount above. This range does not represent additional compensation benefits (such as equity, 401K or medical, dental or vision insurance).

ezCater does not sponsor applicants for work visas or legal permanent residence.

What You’ll Get from Us:

You’ll get a terrifically compelling opportunity, in an environment of radical transparency, open access to all the data, and collaborative colleagues at every level of our organization. You’ll also get sane working hours and great flexibility around work/life balance. 

Have people in your life – of any age – who always, often, or sometimes need your help? We make room for that. Have a bad thing or a good thing happen to you? We make room for that, too.

Oh, and you’ll get all this: Market salary, stock options that you’ll help make worth a lot, the usual holidays, all-you-can-eat vacation, 401K with ezCater match, health/dental/FSA, long-term disability insurance, remote-hybrid work from our awesome Boston or Denver offices OR your home OR a mixture of both home and office (you choose!), a tremendous amount of responsibility and autonomy, wicked awesome co-workers, cupcakes (and many more goodies) when you’re in one of our offices, and knowing that you helped get this rocket ship to the moon.

APPLY HERE

Web Support Specialist III

by Kay Tay | Oct 11, 2023 | Uncategorized

The USGS National Geologic Map Database (NGMDB) is a Congressionally mandated initiative. It is administratively within the USGS National Cooperative Geologic Mapping Program (NCGMP). The NGMDB’s mission is conducted in collaboration with the Association of American State Geologists (AASG, representing the State geological surveys), and with other USGS Programs as well as Universities. The NGMDB has, since its inception in 1995, been responsible for a wide range of technical, scientific, and managerial tasks. The anticipated needed assistance will support the NGMDB, enabling its staff to perform mission-essential functions and execute day-to-day tasks required to support this Congressionally mandated activity. The Congressionally mandated mission of the National Geologic Map Database (NGMDB), as stated in the Geologic Mapping Act of 1992, is to serve as the national archive of geoscience information created by the Nation’s geological surveys. The archive is cooperatively built by the USGS and State Geological Surveys. The database and Website are designed and maintained by the NGMDB.

Akima Systems Engineering is looking for 2 full time Web Support Specialist to support NGMDB tasks, that have strong problem-solving and analytical skills, as well as strong communication, teamwork, and collaboration skills. This position is eligible for remote work.

Job Responsibilities:

• Collect and analyze web traffic data- The candidate will collect and analyze web traffic data using analytic tools, programs, and existing workflows. The candidate will work to improve website analytics tracking to ensure accurate data collections.
• Use data visualization/dashboard technologies- The candidate will create contemporary web statistics dashboards to generate analytic reports and provide internal/external stakeholders insights related to user engagement with NGMDB public facing assets.
• Collaborate with back-end developers- The candidate will collaborate with back-end developers to capture web analytics data in NGMDB project databases (Postgre SQL).
• The candidate will work closely with other NGMDB team members to identify areas for optimization. Git control system will be used for version control and collaboration with other team members.
• Improve website search engine optimization- The candidate will work with other website developers towards improved Web SEO for the NGMDB.

Minimum Qualifications:

• Requires bachelor’s degree with 3-5 years’ experience in the field.
• Experience with PostgreSQL or similar SQL databases for data extraction and manipulation.
• Experience with web analytics tools such as Google Analytics or similar platforms.
• Familiar with Git version control system, as well as be familiar with best practices for web development, such as accessibility and performance optimization.
• Proficient in data visualization and presentation using tools like Tableau, Plotly, or Google Data Studio, and have an understanding of SEO and user behavior.

APPLY HERE

Client Audit Advisor

by Kay Tay | Oct 11, 2023 | Uncategorized

Our work matters. We help people get the medicine they need to feel better and live well.  We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Client Audit Advisor – Remote

Job Description Summary

Job Description

As a member of the Client Audit Management (CAM) team, the Client Audit Advisor is accountable for managing regulatory and/or client-initiated audits. This role maintains a thorough understanding of the purpose and protocols of various audit types and serves as a CAM process/subject matter expert supporting the navigation of the end-to-end audit process. The Advisor seeks and obtains additional expertise as indicated from respective Compliance and operational subject matter experts to meet the applicable regulatory, client, and/or functional audit expectations and provides mentorship, training and support to the Client Audit Specialists and/or Analysts. This role may also provide strategic advice and consultation regarding audit management to CAM and business partners.

Responsibilities

• Serve as internal expert for various regulatory and/or client-initiated audit types, processes and protocols; assess audit process documentation and data files and identify and consult on department enhancement initiatives to ensure accurate and thorough training and procedural materials are available and maintained; serve as trainer and mentor for the Client Audit Specialists  and Analysts
• Review and interpret audit requests to determine scope, impacted business areas and stakeholders, and evidence necessary to fulfill and manage the audit request; support CAM leadership in determining audit assignments, evaluating complexity, audit status and team capacity
• Develop and maintain key internal and external relationships to effectively provide audit management consultation regarding the streamlining of work activity, creation of efficiencies, and promoting consistent, timely and accurate completion, reporting, or submission of audit deliverables
• Monitor audit progress and proactively identify and mitigate risks (including performance guarantee implications) to audit completion; appropriately escalate to department leadership or operational stakeholders and provide remediation recommendations to prevent delays or future findings
• Ensure stakeholders have a thorough understanding of their audit-related responsibilities, are accountable to producing deliverables accurately and on time, and are informed of relevant audit status updates or changes
• Ensure thorough audit records are developed and maintained, with emphasis on accuracy, relevance, and timeliness; prepare necessary documentation for audit activities including deliverables, reports, findings and recommendations; provide clear and concise audit result communications to internal and external stakeholders and department leadership as necessary; serve as peer reviewer and provide quality checks for CAM staff
• Demonstrate high-level project management and organization capabilities by effectively communicating and leading audit strategy, deliverables, requirements, milestones and accountability, from the point of audit intake through the entire audit
• Conduct operational audit management training to support audit readiness throughout the organization and support CAM onboarding and staff development
• Other duties as assigned

Minimum Qualifications

• Bachelor’s degree in Business, Health Care Services or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required
• 5 years of relevant  work experience in compliance, operations, or external audit within a regulated environment
• Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

• Strong verbal and written communication, and presentation skills; ability to effectively distill complex information into clear and compelling presentations and leadership briefings
• Excellent interpersonal skills, with the ability to effectively facilitate meetings, resolve conflict, build consensus, establish rapport and collaborate effectively across departments, internally and externally, and at all levels within an organization; ability to confidently represent the business and interact with external entities
• Demonstrated critical thinking and analysis skills, with proven ability to navigate ambiguous, complex and challenging situations while maintaining professionalism, tact, and empathy
• Strong organization and prioritization skills, strong attention to detail, and the ability to simultaneously manage multiple, complex projects, under pressure and strict timeframes, without compromising quality
• Agility and adaptability to change and navigate in a dynamic, fast-paced, intense, and matrix environment
• Ability to use independent judgment and critical decision making in the analysis of audit processes and evidence
• Advanced proficiency in Microsoft Office Suite (Word, Excel, Power Point, Visio and Access)

Preferred Qualifications

• Health insurance/PBM operations and/or contract audit experience
• Experience with regulatory compliance for Medicare/Medicaid/Commercial or ACA drug benefit
• Project management experience
• Certification or licensure in a related area of expertise (e.g., Pharmacy Technician, CCEP or HCCA certification)

Minimum Physical Job Requirements

• Minimal travel may be required
• Ability to work a flexible schedule outside of Prime’s core business hours to occasionally accommodate different time zones and during critical client audits
• Constantly required to sit, use hands to handle or feel, talk and hear
• Frequently required to reach with hands and arms
• Occasionally required to stand, walk and stoop, kneel, and crouch
• Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Reporting Structure

• Reports to a Manager in the Compliance department

Responsibilities

Work Experience

Work Experience – Required:

Work Experience – Preferred:

Education

Education – Required:

Education – Preferred:

Certifications

Certifications – Required:

Certifications – Preferred:Potential pay for this position ranges from $73,100.00 – $109,500.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.

APPLY HERE

Customer Support Associate-(OR, WA, CO, HI)

by Kay Tay | Oct 11, 2023 | Uncategorized

you must live in the following states: Oregon, Washington, Colorado or Hawaii.

At Squarespace, Customer Operations empowers users to give voice to their ideas and make it easy for them when they need help. Our team runs 24/7 with about 400 people between New York, Dublin, Portland and a remote workforce. Customer Support Associates are on the front lines working with our customers every single day to ensure that issues with their account are resolved in a timely manner. You will leverage your system knowledge and commitment to delivering an exceptional customer experience to not only solve problems for our users, but be a positive advocate of our brand.

This remote role reports to a Customer Support Team Lead. You must be available to begin on Monday, October 30, 2023, and you must live in the following states: Oregon, Washington, Colorado or Hawaii.

You’ll Get To…

• Respond to customer-submitted live chats and email in a timely manner
• Queue-based, typing work will account for approximately 90% of the role.
• Live Chat is our primary channel of support in this role.
• Troubleshoot and guide customers through questions and issues with their Account, Billing, or other transactional inquiries
• Independently meet targets across Quality, Productivity and Customer Satisfaction, in email and live chat.
• Stay up to date on new product features and improvements
• Identify isolated customer experiences and escalate important issues.

Who We’re Looking For

• Open availability to work a 40 hour work week that spans weekends and holidays as our customers need us.
• 1+ years customer-facing experience required in a similar role (retail, hospitality, online support).
• Currently live in Washington, Oregon, Colorado or Hawaii.
• Expertise with written communication and the ability to spot spelling and grammar errors.
• Proficiency with decoding conversations, identifying the cause, and aligning on end goals.
• Capability of prioritizing competing requests.
• Familiarity with the Squarespace platform.
• Consistent and dependable WiFi and a personal workspace that allows you to be free from distraction and fully customer focused

Benefits & Perks

• A choice between medical plans with an option for 100% covered premiums
• Health Savings Account with Squarespace funding
• Fertility and adoption benefits
• Supplemental Insurance plans
• Headspace mindfulness app subscription
• Retirement benefits with employer match
• Flexible paid time off
• Up to 20 weeks of paid family leave
• Equity plan for all employees
• $100 per month remote Stipend
• Access to supplemental insurance plans for additional coverage
• Education reimbursement
• Employee donation match to community organizations
• 6 Global Employee Resource Groups (ERGs)

Cash Compensation Range: $35,800 – $43,000 USD

The base salary for this position will vary based on job-related criteria including relevant skills, qualifications, experience, and location, among other factors.

In addition to the cash compensation above (which includes base salary and, where applicable for eligible roles, may include on-target commissions or overtime pay), all Squarespace employees are eligible to receive equity in the company as part of their total compensation.

About Squarespace

Squarespace (NYSE: SQSP) is a design-driven platform helping entrepreneurs build brands and businesses online. We empower millions of customers in more than 200 countries and territories with all the tools they need to create an online presence, build an audience, monetize, and scale their business. Our suite of products range from websites, domains, ecommerce, and marketing tools, as well as tools for scheduling with Acuity, creating and managing social media presence with Bio Sites and Unfold, and hospitality business management via Tock. Our team of more than 1,700 is headquartered in bustling New York City, with offices in Chicago, Dublin, Ireland, Aveiro, Portugal, and coworking spaces in the UK, Netherlands, and Australia.

APPLY HERE