by twochickswithasidehustle | Apr 12, 2022 | Uncategorized
Quality Reviewer
Insurance Inspection Underwriting
Full-time and Part-Time opportunities available
Millennium Information Services is growing! We are a leading national provider of property inspection services and innovative process management solutions for property and casualty insurance companies.
Opportunity:
We are looking for detail-oriented individuals to review and process exterior & interior residential property inspections on either a full or part-time basis. This is a work from home position requiring a Windows computer and high-speed internet. Training will be done by webinar.
We offer $13.00-$13.50 per hour depending on experience. Experience working in the property insurance industry preferred, however we will train.
Description:
The Quality Reviewer’s primary focus is to review photographs and inspector reports to verify property condition, building type and materials, the home’s footprint, and any visible hazards before submitting the completed inspection to the client.
POSITION REQUIREMENTS
Skills:
Strong attention to detail
Excellent written communication skills
Intermediate PC skills
Basic understanding of building types & materials
APPLY HERE
by twochickswithasidehustle | Apr 12, 2022 | Uncategorized
JOB SUMMARY
Responsible for validating dispute reasons following Explanation of Benefits (EOB) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
- Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons. Coordinate with the Clinical Resource Center (CRC) for clinical consultations or account referrals when necessary,
- Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations.
- Follow specific payer guidelines for appeals submisson
- Escalate exhausted appeal efforts for resolution
- Work payer projects as directed
- Research contract terms/interpretation and compile necessary supporting documentation for appeals, Terms & Conditions for Internet enabled Managed Care System (IMaCS) adjudication issues, and referral to refund unit on overpayments.
- Perform research and makes determination of corrective actions and takes appropriate steps to code the DCM system and route account appropriately.
- Escalate denial or payment variance trends to NIC leadership team for payor escalation.
Qualifications:
Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.
KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Intermediate understanding of Explanation of Benefits form (EOB), Managed Care Contracts, Contract Language and Federal and State Requirements
- Intermediate knowledge of hospital billing form requirements (UB-04)
- Intermediate understanding of ICD-9, HCPCS/CPT coding and medical terminology
- Intermediate Microsoft Office (Word, Excel) skills
- Advanced business letter writing skills to include correct use of grammar and punctuation.
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience preferred to perform the job.
- High School Diploma or equivalent, some college coursework preferred
- 3 – 5 years experience in a hospital business environment performing billing and/or collections
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Ability to sit and work at a computer terminal for extended periods of time
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Call Center environment with multiple workstations in close proximity
JOB:AppealsPRIMARY LOCATION:Frisco, TexasJOB TYPE:Full-TimeSHIFT TYPE:Days
APPLY HERE
by twochickswithasidehustle | Apr 12, 2022 | Uncategorized
Location Type: Remote Additional Location: AL; AZ; AR; CA; CO; DE; DC; FL; GA; HI; ID; IL; IN; KS; KY; LA; ME; MD; MA; MI; MS; MO; NV; NH; NJ; NY; NC; ND; OH; OK; OR; RI; SD; TN; TX; UT; VT; WA; Puerto Rico; Schedule: Full_time Req: R-277857
Description
The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
ResponsibilitiesThis position is for Enclara Pharmacia, a Humana company. Enclara, is a wholly owned hospice and palliative care pharmacy business acquired by Humana in 2021. Enclara is the nation’s largest full-service pharmacy benefits manager (PBM) specifically for the hospice and palliative care sectors. Serving over 450 customers and nearly 100,000 patients nationally, Enclara works closely with hospices to reduce pharmacy costs, improve patient care and support caregivers through: digital innovations, flexible medication access, one-on-one clinical support, and excellent customer service.Schedule: Monday through Friday 2:30PM to 11:00PM ET, with every 4th weekend rotation (Sat & Sun – off by 8 PM ET)
Location: Remote USA – Pharmacy Technician license is required if the BOP requires licensing for techs in your state.
Essential Duties and Responsibilities:
- Assist in setting up and maintaining hospice/facility/pharmacy relationships under the direction of the Pharmacy Claims Team Leaders & the Pharmacy Claims (Support Services) Manager
- Assist pharmacies with claims adjudication
- Complete incoming tasks as assigned by the Pharmacy Claims Team Leaders and the Pharmacy Claims (Support Services) Manager
- Obtain all necessary information for facilities and their related pharmacies
- Assist the Call Center management team with projects to enhance the workflow and success of the Call Center
- Assist Customer Service team with claims research/resolution
RESPONSIBILITIES (include but are not limited to):
Billing:
- Assist pharmacies with claims adjudication by adjusting/correcting authorizations in dispensing systems and PBM systems
- Ensure timely adjudication of prescription claims through PBM systems
- Contact hospices for authorizations/approvals for submitted claims where necessary
- Ensure accuracy of patient profile data including related/not related status, authorization status, etc
- Research and correct pharmacy invoices from hospices
Required Qualifications
- Less than 2 years of technical experience
- Less than 5 years of data analysis & problem solving skills
- Comprehensive knowledge of all Microsoft Office applications, including Access, Word, Excel and PowerPoint
- Strong verbal and written communication skills, including the ability to tailor communication to audience
- Strong organizational and time management skills
- Ability to handle multiple tasks, meet deadlines, and follow-up timely
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
- High School Diploma or GED
- Previous experience with pharmacy benefits management
- Claims experience
- Knowledge/experience working with SQL (via MS SQL Server, Oracle, PL/SQL or other)
- Pharmacy Tech experience
Work-At-Home Requirements
WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Additional Information
COVID 19 Vaccination:
For this job, associates are required to be fully COVID vaccinated (preferred) or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
Provide proof of full vaccination or commit to testing protocols OR  Â
Provide proof of applicable exemption including any required supporting documentationÂ
​​Medical, religious, state and remote-only work exemptions are available.
by twochickswithasidehustle | Apr 12, 2022 | Uncategorized
Acorn Transcripts, LLC is growing and we are looking for independent contractors with experience transcribing digital audio files and are familiar with Court procedures and terminology. We are specifically looking for people who have had experience with both civil and criminal trials, as well as bankruptcy, juvenile and mental health hearings.
Our work is extremely diverse as we work with various Court systems throughout the United States. We are looking to add to our team of fast, accurate, knowledgeable, reliable and professional transcribers.
Requirements:
- Must be a citizen of the United States, residing in the United States, and able to fill out a W-9 form.
- Certified Electronic Transcribers (CET) preferred or three years of experience specifically in the legal field.
- Must type at least 80 words per minute.
- Must have a high-speed internet connection.
- Experience working with Microsoft Word and/or WordPerfect software programs.
- Must have excellent grammar and proofreading skills.
- Good quality headphones are recommended, (preferably noise canceling) and a foot pedal for audio playback.
- Must be a team player.
APPLY HERE
by twochickswithasidehustle | Apr 12, 2022 | Uncategorized
Description
Are you looking for another challenge and are passionate about social media? Do you want to help us take GetResponse to the next level? Great! Because we’re looking for someone who will help us grow our social media presence.
Responsibilities:
- Support managing our social media accounts for our SMB and Enterprise products
- Help to create editorial calendars with content that attracts new users and engages current ones
- Coordinate the creation of the visuals to be used across social media
- Engage in social listening and daily engagement
- Work closely with the Customer Support team to reply to customers’ questions, concerns, and reviews on social, media referral sites, and forums
- Continuously run experiments to optimize the social media strategy
- Engage in communities on social media platforms and forums such as Reddit and Quora
- Create reports and use that data to analyze what’s working and what’s not, make suggestions accordingly
- Collaborate with other teams within marketing, employee branding, design, and other internal teams to deliver the social medial strategy
- Conduct regular competitive research and share best practices with the team
- Make sure that design and messaging across the channels are always in-line with the branding
- Generate, edit, publish and share daily content to help to grow our social media base, and convert our brand fans into loyal customers with engaging, responsive, and captivating social media interactions
What do we expect:
- English (native/near-native level)
- BA/BS degree or equivalent working experience
- 2+ years of social media experience
- Good eye for design
- Strong communication skills (both written and verbal)
- Proficiency in creating short copy content related to posts
- Experience in creating reports and interpreting them to make actionable suggestions
Nice-to-haves:
- Community management experience, mainly Quora and Reddit
- Experience using Canva or making simple edits in Photoshop
- Experimentation and optimization of social media tactics
- SaaS / B2B social media experience
Extra Perks:
- remote work – learn more about our remote work culture right HERE
- home office subsidies – 400 PLN per month (or equivalent) to help with your home office expenses and to maintain your well-being
- home office set up – you’ll get a one-time bonus for a maximum of 1000 PLN (or equivalent)to help set up your home office space
- private medical care for employees and their family members
- employee referral program – up to 10 000 PLN for recommending a friend
- corporate life insurance
- employee pension program (PPE)
- ESOP (Employee Stock Option Plan)Â with a 4-year vesting period and unconditional buyback program
- flexible working hours and no meeting days – we want to help you to adjust your schedule to your activities
- wellbeing and mental health culture – mental health helpline, sports card, yoga classes, etc.
- modern equipment – most of our teams work on MacBooks
- language classes
- internal initiatives like webinars, knowledge sharing sessions, and more!
APPLY HERE
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