by twochickswithasidehustle | Mar 24, 2025 | Uncategorized
Description
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Applicants for this job have the flexibility to work remote from home. Candidate must live in Central or Eastern Time Zone.
Position Purpose: Accurately and promptly enter data into assigned AMISYS accounts. Responsible for data entry and entering/updating all configuration information in test and production environments in a timely fashion in order to meet team goal of 48 hour turnaround.
- Enter data and maintain AMISYS accounts.
- Maintain and coordinate configuration entry into test and production environments.
- Review and close IS Change Requests post production.
- Evaluate errors that appear on keying documents and work with Business Analysts to resolve those errors.
- Act as trainer and mentor to Configuration Data Entry Specialists.
Education/Experience: High school diploma or equivalent. 4+ years of data entry experience. Experience with Microsoft Word and Excel applications. AMISYS or healthcare data entry experience preferred.Pay Range: $15.58 – $26.73 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual’s skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
by twochickswithasidehustle | Mar 24, 2025 | Uncategorized
Ready to make a difference for hospitals while working from home? Start your next chapter at Revecore! For over 25 years, Revecore has been at the forefront of specialized claims management, helping healthcare providers recover meaningful revenue to enhance quality patient care in their communities. We’re powered by people, driven by technology, and dedicated to our clients and employees. If you’re looking for a collaborative and diverse culture with a great work/life balance, look no further.
Revecore Perks:
We offer paid training and incentive plans
Our medical, dental, vision, and life insurance benefits are available from the first day of employment
We enjoy excellent work/life balance
Our Employee Resource Groups build community and foster a culture of belonging and inclusion
We match 401(k) contributions
We offer career growth opportunities
We celebrate 12 paid holidays and generous paid time off
The Role:
Conduct search of multiple hospital systems for payments active on individual patients. Maintain appropriate records of actions.
As an Accounts Receivable Specialist, you will:
Verify payments for different regions and clients by signing into multiple hospital systems. Enters account data using 10-key.
Responsible for posting payment transactions obtained from multiple sources.
Understanding and applying the rules of Coordination of Benefits.
Closes and returns accounts that have been invoiced to the full extent.
Keeps track of checked hospitals. Updates connection passwords and other information as needed.
Assists fellow employees by training on specific systems such as payment poster as needed.
Resolves issues with troubled accounts.
Performs special projects as assigned.
You will be successful if you have:
Ability to communicate effectively verbally and in writing.
Working knowledge of computer functions including the internet, 10-key, and computer software such as Microsoft Office (Outlook, Excel. Word). Knowledge of or the ability to learn AcciClaim.
Proven ability to produce accurate work.
Must be able to prioritize responsibilities and adapt according to situational demands.
Demonstrated ability to analyze and effectively solve problems.
High school diploma or equivalent required.
Work at Home Requirements:
A quiet, distraction-free environment to work from in your home.
A secure internet connection is required.
Home internet with speeds >20 Mbps for downloads and >10 Mbps for uploads.
The workspace area accommodates all workstation equipment and related materials and provides adequate surface area to be productive.
Revecore is an equal opportunity employer that does not discriminate based on race, color, religion, sex or gender, gender identity or expression, sexual orientation, national origin, age, disability status, veteran status, genetic information, or any other legally protected status.
We believe that a diverse workforce fosters innovation and creativity, enriches our culture, and enables us to better serve the needs of our clients and communities. We welcome and encourage individuals of all backgrounds, perspectives, and abilities to apply.
Must reside in the United States within one of the states listed below:
Alabama, Arkansas, Delaware, Florida, Georgia, Illinois, Iowa, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Maine, Michigan, Minnesota, Missouri, Mississippi, Montana, North Carolina, Nebraska, New Hampshire, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, Wisconsin, and West Virginia
by twochickswithasidehustle | Mar 24, 2025 | Uncategorized
US-Remote | US-LA-Covington
Job ID 2025-3884 Category Claims Operations Posted Date 7 days ago(3/17/2025 11:23 AM) Type Full-Time
Overview
Now is the time to join us!
We’re Personify Health. We’re the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.
Responsibilities
Who are you?
The Stop Loss Specialist is responsible for supporting the coordination and filing of specifications, advance funding, and plan year-end closeouts. The incumbent is expected to communicate professionally and respectfully with peers, supervisors, subordinates, markets, customers, and the public. Courtesy and professionalism are key components of success in this role.
In this role you will wear many hats, but your knowledge will be essential in the following:
Prepare Stop Loss claims and applicable documents to determine Stop Loss filing eligibility applicable to the Excess Loss Policy.
Files submissions of spec claimants (running reports, gathering necessary documents and email correspondence), processing all submissions within established internal timeframes.
Coordinate Advanced Funding Requests, with the client and the Stop Loss carrier.
Maintains database of all specific reimbursement requests.
Creates initial Specific File for each claimant, files all submissions in our EDOCS platform.
Coordinates the release of Over Specific, System Hold “on hold” claims.
Acts as the liaison between the PBM’s and internal clients, as it pertains to our Stop Loss claimants.
Keeps immediate supervisor apprised of open or disputed items.
Contributes to daily workflow with regular and punctual attendance.
Performs related or other assigned duties as required or directed.
Monitors all reinsurance requests to ensure receipt of reimbursement.
Generates weekly outstanding reimbursement report and follows up with the Stop Loss carrier.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Qualifications
What you bring to the Personify Health team:
In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including:
High school diploma or general education degree (GED) required.
Knowledge of medical terminology, CPT, HCPCS and ICD-10 codes a plus.
Knowledge of insurance database system a plus.
Ability to read, analyze, and interpret common financial reports and legal documents.
Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Experience with claims/call center health insurance environment a plus.
Experience in self-funded plan administrations a plus.
You also take pride in offering the following Core Skills, Competencies, and Characteristics:
Must be computer literate and knowledgeable in Windows and Microsoft Office environment, including Word, Excel and Outlook.
Strong written and verbal communication skills.
Proficient in Word, Excel, and outlook.
Ability to organize, prioritize, and multitask in a fast-paced/deadline driven environment.
Demonstrate ability to work independently with excellent judgment.
A detail-oriented, analytical, financially minded approach.
Capacity to think creatively and strategically.
Claims processing experience or medical background a plus.
Ability to interact in a professional manner with coworkers, clients.
No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!
Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.
In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $17.00 to $22.00 per hour. Note that compensation may vary based on location, skills, and experience. This position is eligible for health, dental, vision, mental health and other benefits.
We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.
Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to [email protected]. All of our legitimate openings can be found on the Personify Health Career Site.
Application Deadline: Open until position is filled.
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