Clinical Appeals Specialist I – Remote

Overview

As a Mayo Clinic Clinical Appeals Specialist I – Remote, you will become a vital member of a dynamic team at one of the world’s most exceptional health care institutions. Our Nursing Care Model combines Relationship-Based Care with an evidence-based approach. This allows for a stronger connection between patient and caregiver, and a more individualized, appropriate type of care. You will also discover a culture of teamwork, professionalism and mutual respect, and—most importantly—a life-changing career.

Job Description

CityRochester

StateMinnesota

TelecommuteRemote

DepartmentFinanceDescription:Why Mayo Clinic
Mayo Clinic is the nation’s best hospital (U.S. News & World Report, 2021-2022) and ranked #1 in more specialties than any other care provider. We have a vast array of opportunities ranging from Nursing, Clinical, to Finance, IT, Administrative, Research and Support Services to name a few. Across all locations, you’ll find career opportunities that support diversity, equity and inclusion. At Mayo Clinic, we invest in you with opportunities for growth and development and our benefits and compensation package are highly competitive. We invite you to be a part of our team where you’ll discover a culture of teamwork, professionalism, mutual respect, and most importantly, a life-changing career!

Mayo Clinic offers a variety of employee benefits. For additional information please visit Mayo Clinic Benefits. Eligibility may vary.

Position description
Primary duties may include, but are not limited to, responsibility for reviewing assigned clinically related denials, payer audits, and payer correspondence as well as preparation of relevant appeal submission or audit responses. Utilizes clinical expertise and critical thinking in the evaluation of medical records against appropriate criteria and contract requirements and utilizes appropriate communication style to appeal or defend medically denied claims. Is a liaison and resource to revenue cycle, clinical practice stakeholders in defending clinically denied claims and providing relevant feedback to key stakeholders on denial prevention opportunities.

Qualifications
High School Diploma/GED and a minimum 3 years of relevant clinical experience required

Additional qualifications
Experience in denials and appeals, revenue cycle, audits or prior authorization preferred. Knowledge and use of payer medical policy and Medicare LCD/NCD criteria. Familiarity with Medicaid and Medicare claims denials and appeals processing and regulatory requirements. Knowledge of billing and coding requirements. Knowledge and experience in Epic. Must have the ability to effectively utilize Microsoft Office Suite and possess basic data entry skills. Must possess excellent verbal, written and interpersonal communication skills, and able to balance multiple demands and respond to time constraints. Must have high-level skills in organization as well as problem solving and analytical skills.

License or certification
Current active unrestricted LPN license or allied health licensure or certification (Radiology, Respiratory Therapy, Paramedicine, etc.)

Exemption status
Non-exempt

Compensation Detail
$27.95 – $37.74/ hour

Benefits eligible
Yes

Schedule
Full Time

Hours / Pay period
80

Schedule details
100 % Remote, can work from any site.

Must be able to work an 8 hour shift Monday through Friday between department business hours.

Weekend schedule
N/A

Remote
Yes

Site description
Mayo Clinic is located in the heart of downtown Rochester, Minnesota, a vibrant, friendly city that provides a highly livable environment for more than 34,000 Mayo staff and students. The city is consistently ranked among the best places to live in the United States because of its affordable cost of living, healthy lifestyle, excellent school systems and exceptionally high quality of life.

Recruiter
Veronica Bartz

EOE
As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.

APPLY HERE

Digital Image Reviewer

A Digital Image Reviewer’s primary responsibility will be reviewing in house and vendor supplied photography as well as 3D assets created by in house and outsource 3D modeling teams. A Digital Image Reviewer will review uploads, mark edits as necessary and supply feedback to the 3D and editing teams such as recurring problems and quality concerns. There is no experience necessary with 3D modeling or photo editing, this is a quality control position. This position can be remote or in office. A Digital Image Reviewer will report to the Quality Control Manager.  

Essential Duties & Responsibilities: 

  • Review all digital asset uploads daily. This includes images and 3D assets. 
  • Ensure digital assets accurately represent the product and match descriptions on the product page. 
  • Ensure digital asset quality matches brand standards and aligns with similar products across product categories and product lines. 
  • Ensure images requested by internal business partners meet their expectations. 
  • Ensure 3D assets display properly on both desktop and AR platforms. 
  • Document quality concerns for the in house and offshore 3D teams to base revisions on. 
  • Create and support quality standards for 3D assets in coordination with the 3D Team Manager and Quality Control Manager.  

We are looking for driven, motivated candidates who: 

  • Use critical thinking and take initiative to solve problems. 
  • Use professionalism when communicating verbally and in writing. 
  • Are attentive to detail and organized.  
  • Demonstrate the ability to work independently and efficiently. 
  • Can manage multiple responsibilities in a fast-paced environment. 
  • Have a passion for excellence and a drive to succeed! 

Telecommuting/Remote candidates must have: 

  • Access to a reliable and secure Cable or fiber high-speed internet connection.  
  • A dedicated home office space that is noise and distraction-free. The space should have strong wireless connection or a wired Ethernet connection (wired connection is preferred, if possible). 
  • A valid, physical address (apartment, suite, etc.); PO Boxes are not supported as a physical address is needed for you to receive your computer equipment. 
  • The desire and ability to work and communicate with other team members via chat, webcam, etc. 

Work from home benefits include:  

  • The essential computer equipment, such as hardware and software, needed to perform your job. 

As a WebstaurantStore remote employee, you’ll enjoy the same training and support to be successful in 

your position as employees at our physical corporate locations. We stay connected through video meetings, training sessions, and collaborative forums, and provide opportunities for you to connect with other employees from across the country both professionally and personally. 

Currently, we are employing legal residents of the following states: (AL, AZ, AR, DE, FL, GA, KS, KY, MD, MI, MS, NV, NC, OH, OK, PA, SC, TN, TX, VA, WV, WI or WY). H-1B Visa Sponsorship Not Available, W2 only. 

APPLY HERE

Content Moderation – Live Chats – Gaming

ModSquad has partnered with multiple top tier brands/clients across the globe and we need the best of the best in Content Moderation!  
Do you have a Content Moderation background?Do you enjoy work-from-home and flexible schedules?ModSquad is seeking Mod Contractors to join our network! 
If you want the chance to work gigs on the coolest of client projects…then ModSquad is the place for you!! Our clients are strictly Top Tier whose product offerings and services are hip, contemporary, and very current. You will instantly know who they are and very likely use them yourselves. Their customers expect the best service and support and that’s where we come in. 
Our Mods bring super skills, a positive attitude, and a great vibe to project work everyday. Mods assist and guide customers to the right answers, solve concerns and are the GPS for customers to understand and optimize the best use of a client’s product or services. Project gigs available now and more are on the horizon.
You will be doing live chat moderation for various video game publishers and streaming platforms.
No minimum hours commitment and the project hours vary per client.
Orientation Data:ASAPDepends on the number of events1 hour live orientation

What We Are Looking For:

  • Excellent ability to understand the context
  • Understands internet language and slang
  • Attentive and focused
  • Confident asking clarifying questions if needed
  • Quick action response time

Computer / Technology Specifications:

  • Reliable internet connection
  • Ability to run at least 6 tabs in Chrome or equivalent

WorkSpace Requirements:

  • Dedicated laptop or desktop computer with Windows 10 or above
  • Willingness to install MSQ security software and 2FA app on the phone

What’s In It For You:

  • The potential to work with some of the coolest clients around the world like the NFL, Vimeo, and Topps! 
  • Flexible self-scheduling
  • Access to ‘Hot Gigs’ postings exclusive to the Mod Network
  • Work from home
  • Competitive hourly rate – Discussed during your first interview
  • Paid orientation

***PRO TIP***: Take your time and make sure you do a thorough job in completing your application. Your responses should be grammatically correct and comprehensive. This will greatly increase the probability of scoring an interview!
Please note: A Chromebook is not sufficient for ModSquad projects.
Who is ModSquad?ModSquad is a global provider of managed digital engagement services. Our 10,000+ Mods chat with customers, moderate web content, manage communities, and buzz in social media for many of the world’s coolest brands, including the NFL, Zendesk, and Topps, to name a few. We bring companies closer to their customers than ever before. From global enterprises to international agencies to hip new startups, our clients have reaped the benefits of putting ModSquad’s expertise to work. With experienced Mods available in 50+ languages in 70+ countries, we’re your squad for the digital world.

APPLY HERE

Customer Support Specialist (Part time)

MuckRock is seeking a remote part-time Customer Support Specialist to join the Customer Support Team. The Customer Support Specialist will contribute to our existing customer-obsessed team by efficiently responding to user inquiries via Zendesk, making calls to government agencies, helping troubleshoot a range of technical and logistical questions, and helping maintain our database of agency contacts.

This position requires someone who is highly organized and detail-oriented with great communication skills, both written and over the phone. This applies to internal communication with staff and external communication with agency contacts. Building our agency database requires consistent follow-up and maintaining relationships with records offices, so we need someone who is skilled in persistent yet amicable communication, as well as someone who can learn and explain a wide range of software packages and help identify challenges users are having with software and come up with solutions on the spot.

While the hours are flexible, the majority of this work must be done during regular business hours Monday through Friday. The Customer Support Specialist will also need to be available during established times to check in with staff.

What you’ll do

The Customer Support Specialist, who reports to the Customer Support Manager, is responsible for the following:

  • Respond to user inquiries in a timely, helpful, and empathetic way via Zendesk.
  • Make outbound calls to government agencies.
  • Maintain agency contact log.
  • Improve the team’s productivity and efficiency.
  • Share feature requests with team members.
  • Inform users about new features and functionalities.
  • Gather user feedback and share it with the Customer Support Manager.

How success is measured

Success in this position is measured by the following key metrics:

  • Number of inquiry solves
  • Average handle time
  • Response time
  • Customer satisfaction rating

What we’re looking for

We are seeking candidates who are customer-obsessed, results-oriented, and have strong time management skills. You should have:

  • Some prior experience in a customer support role. SaaS, Helpdesk, or technology experience is a plus.
  • Strong written and verbal communication skills.
  • Two references who have worked with you in some capacity.
  • Experience with Zendesk or similar helpdesk software is preferred.

Compensation

This position is remote and part-time at 20 hours per week. Compensation starts at $20.00 per hour and does not include benefits. At this time we are only considering applicants based in the United States for this role.

Social Media Manager (3-4 hours/week)

Love FOIA, investigative journalism, and finding creative ways to get the public excited about both?

The MuckRock Foundation is seeking a part-time (generally around 3-4 hours per week) social media manager to help highlight our ongoing work, primarily via our existing social media accounts on Twitter and Facebook, as well as help identify and execute strategies to ensure that our public interest work reaches a wide audience and has lasting impact.

The social media manager must be able to gain a sense of the MuckRock style and tone, as well as the ability to identify and build on interesting angles within our ongoing reporting efforts to schedule a several dozen social posts per week. You’ll coordinate via Slack with our editorial, technology and operations teams to highlight efforts across the organization.

You should have an understanding of the key tenets of ethical, fact-based journalism, while also able to convey important stories in a way that is engaging, interesting and often fun. In addition to highlighting MuckRock’s own editorial efforts, you’ll also (with input and suggestions from our team) highlight other fact-based investigative work, transparency projects and key opportunities and events.

Key Responsibilities:

  • Help solicit and review potential material to highlight from the MuckRock team, including links to stories, trainings, resources and site news and updates;
  • Schedule out regular social media updates via Buffer; reviewing, proofreading and editing completed work before posting; and ensuring that key team members have an opportunity to review sensitive or high-impact posts before publication;
  • Help identify new opportunities to promote our editorial work and build a strong journalism and transparency community through our social media efforts.

This role is generally expected to take 3-4 hours per week. For special projects and major launches there may be opportunities to extend these hours on a week-by-week basis. Compensation starts at $20.00 per hour and does not include benefits.

APPLY HERE

Email Marketing Manager (Remote)

Criteria is a technology company that’s changing the way organizations find and hire great talent. Headquartered in Los Angeles with offices in New York, Brisbane, Melbourne, and Sydney, Criteria is a global company and we’re growing quickly. We’ve been featured on the Inc. 5000’s list of fastest-growing private companies in the U.S. for the last seven years and have been recognized as a Best Place to Work by Inc. and Built In LA.

Most importantly, people are at the heart of everything we do. Our mission is to help companies and job candidates connect to do fulfilling, meaningful work together. We hire with the same intention to provide a collaborative, inclusive, and balanced environment where every individual can bring their best selves to work.

About the Role:

The Email Marketing Manager will be a member of the Criteria Global Marketing team and is responsible for designing, executing, and tracking email marketing campaigns for customer acquisition, retention, reactivation, and nurture to drive demand and accelerate marketing sourced revenue. This role will report to the Director, Demand Generation.

What You’ll Do:

  • Leverage the company’s current marketing tech stack
  • Monitor all email campaign performance
  • Collaborate to develop drip/nurture campaigns to support campaign effectiveness
  • Move leads through lifecycle stages to MQL for hand-off to Sales
  • Work with Product, Customer Success our Customer Experience Analyst to segment, capture, and store customer feedback and deliver customer communications
  • Created engaging campaigns for reactivation and win-back
  • Planning and coordinating annual events (~10% of time)

What You Should Know/Have:

  • Experience conceptualizing, implementing, managing, and performance tracking of complex end-to-end email marketing programs.
  • Familiarity with Salesforce CMS and Pardot MAP.
  • Strong persuasive copy writing skills with an understanding of email design best practices; including list growth and maintenance, A/B testing (layout, format, frequency, images, etc.), delivery and deliverability issues, segmentation
  • Experience with executing campaign across the customer relationship lifecycle; including acquisition, retention, loyalty and referral, and reactivation.
  • Demonstrated ability to develop complex lead nurturing campaigns at different marketing funnel stages to attract and grow MQLs.
  • Demonstrated ability to design and execute lead nurturing campaigns to convert acquired leads to sales readiness.
  • Demonstrated ability to meet deadlines and manage multiple concurrent tasks, on time and within budget.
  • Demonstrated ability to form positive cross-functional and intra-team relationships.
  • Demonstrated ability to learn new information, willingness to adopt new ways of working and innovation-focused approach to continuous improvement.
  • Demonstrated ability to work both autonomously and collaboratively to deliver a planned program of work aligned to measurable KPI’s.
  • Data-driven with a strong analytical background
  • International email marketing and HTML experience a huge plus.

What Criteria Brings to the Table:

  • Excellent benefits package (including medical, dental, vision, life insurance, generous paid parental leave policy, and more!) 
  • 401(k) with employer match
  • Monthly technology (mobile phone/internet) allowance 
  • Flexibility to work fully remote, 100% in office, or hybrid
  • Equity options in a rapidly growing company 
  • And a competitive compensation package

Our Mission Around Diversity, Equity, and Inclusion

We firmly believe that working in a culture focused on diversity, equity, and inclusion spurs innovation, creates healthy and high-performing teams, and delivers superior customer experiences. We will create and nurture a global company culture where we confidently bring our authentic selves to work every day: where the only criteria for advancement are the quality of our work, the contributions we make to our teams and the business, and our ability to lead; and where our individual differences—whatever they may be—are valued, explored, and appreciated.

APPLY HERE