by twochickswithasidehustle | Apr 12, 2022 | Uncategorized
Major League Baseball (MLB) is seeking a Social Moderator to interact with and assist customers using social media and web chat. The ideal candidate needs to be tech savvy and have great communication and writing abilities. This individual should be a positive, outgoing and energetic to cheerlead and promote our brand. Duties include responding to support inquiries on social media, identifying trends and potential issues. Communicate any service changes or disruptions in a tactful manner. Questions will range from general service and subscription inquiries to technical troubleshooting. This is a seasonal position, must be available to work weekdays, weeknights, and weekends.
Social Media Responsibilities:
- Craft support content with an emphasis on customer care.
- Develop and follow established guidelines.
- Answer general and technical questions regarding MLB supported digital products.
- Help users troubleshoot basic technical issues in real-time.
- Manage any negative comments with positive responses and helpful information. Moderate discussions to promote constructive criticism.
- Escalate issues to the proper internal groups.
- Generate reports summarizing activity on social media interactions, trends, and key issues.
Desired Skills:
- Strong communication skills in order to help and instruct users on social media.
- Experience writing, editing, and crafting content in the social media space using company voice and following established guidelines.
- Positive personality and good interpersonal skills with the ability to maintain a pleasant disposition when faced with negative feedback or customer complaints.
- The ability to learn and remember technical instructions on short notice.
- Knowledgeable in the use of streaming applications and social platforms.
Requirements:
- One to two years of Customer Service experience with a focus on technology.
- One to two years of promotional or support social media experience.
- College degree with a focus on IT, and/or communication preferred.
- Familiarity with social media support strategies.
- Knowledgeable in the use and configurations of Internet Explorer, Firefox, Google Chrome, Safari.
- Knowledge of Windows, Macintosh, Android, and iOS operating systems.
- Experience with set-top streaming devices, game consoles, mobile devices and tablets.
All in-office and ballpark-based positions are subject to MLB’s mandatory Covid-19 vaccine policy
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by twochickswithasidehustle | Apr 12, 2022 | Uncategorized
Job Details
Description
Envision Radiology is looking for a Remote Full Time Data Entry Representative to join our team!
Open to CO, TX, OK, FL, VA, NC, AL, UT, WA, NE, AZ, LA, MO, ID & WI Markets.
Welcome to Envision Radiology, where we are passionate about improving lives through unmistakable quality and spectacular service in every community we serve. Our culture starts with understanding why we exist and our vision is to revolutionize diagnostic imaging and be the best in the world. We are looking for someone who is just as passionate about our culture as they are about the work they are doing in the business.
In 2019, US News named Colorado Springs in the top three most desirable place to live in the United States. Colorado Springs continues to grow and is the perfect place to call home.
Connect with us and discover your unique path to a fulfilling and rewarding career with Envision Radiology!
Summary/Objective
The Data Entry Representative performs all tasks required for data entry processing under the direction of Centralized Services Supervisor.
Essential Functions
- Enters, updates and verifies Patient Referral Data into various systems for use by all personnel.
- Reviews and verifies data entered into database to ensure accuracy.
- Processes all faxes in a timely and efficient manner.
- Confirms that medical scripts and referral documentation have the correct procedures listed.
- Effectively communicates with Center employees if additional information is needed to process request.
- Other duties as assigned.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Competencies
- Communication Proficiency.
- Technical Capacity.
- Organizational Skills.
- Time Management.
- Thoroughness.
Supervisory Responsibility
This position has no supervision responsibilities.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
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.
This is largely a sedentary role. While performing the duties of this job, the employee is regularly required to use hands and fingers to handle, feel or operate objects, tools or controls, and reach with hands and arms. The employee is frequently required to talk and hear.
Travel
No travel is expected for this position.
Job Qualifications
Minimum Qualifications/Experience:
- One plus year of experience in customer service/data entry – healthcare preferred
- Proficient speed and accuracy with data entry – 9,000+ KSPH
- Detail oriented, self-motivated, a problem solver and a team player
- Ability to navigate multiple computer screens and browsers quickly and accurately
- Ability to excel in a very fast-pace team environment
- Ability to continuously “exceed†company and customer expectation
- Strong communication skills & professional demeanor
Education/Certifications:
- Minimum of High School diploma or equivalent (GED) – continuing education preferred
Additional Eligibility Qualifications
None required for this position.
Compliance
Adheres to Envision’s Code of Conduct and Compliance Policies and attends annual Compliance training as set forth by the Company.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Other duties may be assigned as needed by supervision.
Position Pay Range $13.80 – $16.60
Company Benefits
Below is a list of benefits that are offered to employees, once eligibility is met.
Health Benefits: Medical/Dental/Vision/Life Insurance
- Company Matched 401k Plan
- Employee Stock Ownership Plan
- Paid Time Off + Paid Holidays
- Employee Assistance Program
OSHA Exposure Rating: 1
It is reasonably anticipated NO employees in this job classification will have occupational exposure to blood and other potentially infectious body fluids.
Envision Radiology is an equal opportunity employer (M/F/D/V). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law.
Qualifications
Education
Preferred
High School or better in General Education.
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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
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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
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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.
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