by twochickswithasidehustle | Jun 13, 2025 | Uncategorized
Description
From Intake to Outcomes, CareMetx is dedicated to supporting the patient journey by providing hub services, innovative technology, and decision-making data to pharmaceutical, biotechnology, and medical device innovators.
Job Title: Reimbursement Specialist
POSITION SUMMARY:
Under the general supervision of the operational program leadership, the Reimbursement Specialist is responsible for various reimbursement functions, including but not limited to benefit investigations, prior authorization support, and call triage. The Reimbursement Specialist responds to all provider account inquiries, appropriately documents all provider, payer and client interactions into the CareMetx Connect system and ensures that the necessary data for prior authorization request are obtained.
PRIMARY DUTIES AND RESPONSIBILITIES:
- Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program.
- Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.
- Completes and submits all necessary insurance forms in a timely manner as required by all third party payors for prior authorizations. Tracks and follow up on prior authorization request.
- Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
- Maintains frequent phone contact with provider representatives, third party customer service representatives, and pharmacy staff.
- Reports any reimbursement trends/delays to supervisor.
- Processes any necessary insurance/patient correspondence.
- Provides all necessary documentation required to expedite prior authorization request. This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians.
- Coordinates with inter-departmental associates as necessary.
- Communicates effectively to payors to ensure accurate and timely benefit investigations.
- Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action.
- Reports all Adverse Events (AE) disclosed in alignment with training and Standard Operational Procedures (SOP)
- Typically receives little instruction on day-to-day work, general instructions on new assignments.
- Other duties as assigned – Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.
Requirements
Qualifications
EXPERIENCE AND EDUCATIONAL REQUIREMENTS:
- High School, Diploma, or GED required
- Previous 1+ years of experience in a specialty pharmacy, medical insurance, physician’s office, healthcare setting, and/or related experience.
MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:
- Ability to communicate effectively both orally and in writing.
- Ability to build productive internal/external working relationships.
- Strong interpersonal skills.
- Strong negotiating skills.
- Strong organizational skills; attention to detail.
- General knowledge of pharmacy benefits, and medical benefits.
- Global understanding of commercial and government payers preferred.
- Ability to proficiently use Microsoft Excel, Outlook and Word.
- Ability and initiative to work independently or as a team member.
- Ability to problem solve.
- Strong time management skills.
- Customer satisfaction focused.
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.
- While performing the duties of this job, the employee is regularly required to sit.
- The employee must occasionally lift and/or move up to 10 pounds.
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.
The noise level in the work environment is usually moderate.
Schedule
- Must be flexible on schedule and hours
- Overtime may be required from time to time
- Must be willing to work weekends if required to meet company demands
CareMetx considers equivalent combinations of experience and education for most jobs. All candidates who believe they possess equivalent experience and education are encouraged to apply.
At CareMetx we work hard, we believe in what we do, and we want to be a company that does right by our employees. Our niche industry is an integral player in getting specialty products and devices to the patients who need them by managing reimbursements for those products, identifying alternative funding when insurers do not pay, and providing clinical services.
CareMetx is an equal employment opportunity employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race, color, sex, sexual orientation, gender identity, religion, disability, age, genetic information, veteran status, ancestry, or national or ethnic origin.
Salary Description
$30,490.45 – $38,960.02
by twochickswithasidehustle | Jun 13, 2025 | Uncategorized
Calling all Customer Support Representatives! ChurnZero is looking for a passionate, results-oriented individual to join our award-winning team. In this role, you’ll learn and leverage an industry-leading customer growth platform to empower customers to increase revenue and retention, accelerate their impact, and deliver the best possible experience to their customers. Led by Chief Customer and Product Officer Abby Hammer, one of 2024’s Top CS Strategists, you’ll have a career-defining opportunity to join a team named ‘Top Customer Success Team of 2024’ and consistently celebrated for excellence in customer value and partnership by SIIA CODiE, Appealie Awards, and Customer Success Collective. Join the ChurnZero customer support team and become an integral part of the journey.
Job Title: Customer Support Representative
Classification: Non-Exempt
Reports to: Manager, Customer Support
Location: Remote, US-based
Target Salary: $40,000 to $50,000 base, $47-55k OTE
Responsibilities
- Manage the queue of incoming support cases via email and zoom if necessary to ensure friendly, timely, and effective resolution of questions and issues
- Investigate and resolve product bugs, alone and through collaboration with other ChurnZero teams
- Productively respond to customer feedback; offer creative alternatives and best practice guidance whenever possible
- Provide accurate and complete information to customers and to other ChurnZero team members leveraging your tools and resources
- Collaborate with Customer Success, Product Management, and Development on possible ways to improve ChurnZero’s product, services and processes
- Reliably meet personal and team case handling targets and SLA expectations
- Contribute towards the development of a strong team environment by being energetic, enthusiastic, and relationship-focused; eager to make a positive impact with customers
Qualifications
- Undergraduate degree (BA/BS) or equivalent experience preferred
- 2+ years’ experience in Customer Service/Support roles, preferably at a SaaS organization
- Active listener, passionately communicative, and empathetic; able to put yourself in customers’ shoes and advocate for them when necessary
- Proactive problem-solver; confident at troubleshooting and able to investigate if you don’t have enough information to resolve customer issues
- Organized, articulate and reliable; strong diplomacy, tact, and poise when working through customer issues and escalations
- Aptitude for learning software; strong with business applications and data integrations and able to explain complex data relationships in non-technical terms
- Working knowledge of Zendesk strongly preferred
About ChurnZero
ChurnZero is the platform and partner for customer growth.
We provide game-changing software to understand, strengthen, and grow your customer relationships by connecting AI, analytics, and automation to the customer experience.
ChurnZero’s dynamic health and relationship scores, forecasting, reporting, trend tracking, and proprietary Customer Success AI™ tell you exactly what customers want and need, and why. Your team will be able to create hyper-personalized communications and strategic journeys at the touch of a button. Best of all, ChurnZero grows with your business, so you can increase revenue and retention, and succeed at scale.
by twochickswithasidehustle | Jun 13, 2025 | Uncategorized
Position Type
Overview
RN Tele-Triage (Fully Remote)
*Must have compact state RN licensure
*Remote Triage & Home Health RN experience highly preferred
*Potential Start Date: 6/30/2025
*Openings: 2 FT position available immediately
NEW Available FULL TIME Schedules:
Monday, Friday, & Saturday 2p-12:30a CST (3p-1:30a EST)
Tuesday, Wednesday, Thursday, Friday & Saturday 2p-10p CST (3pm-11pm EST)
This Registered Nurse provides On-Call and Triage for the assigned population in accordance with triage protocols. This position remotely develops/implements care plans for persons served in the area of responsibility. The Tele-Triage RN assesses health status, identifies problems and needs of person(s) served in their assigned caseload, develops nursing care plans in collaboration with operations RN’s. You will complete chart reviews and monthly host home reviews and perform On-Bound calling to assigned populations/locations. This RN performs data analysis in multiple systems.
Responsibilities
- Monitor assigned phone lines during service hours to ensure timely response for caller needs
- Triage all symptom-based calls and give recommendations according to the approved triage protocol
- Triage patients by assessing severity of symptoms and referral to appropriate setting or level of care
- Document in real time all care related recommendations and ensure local operations are notified of triage supports and outcomes
- Initiate contact with acute care setting to coordinate services for clients receiving care in the ED/Hospital and coordinate the discharge planning; Notify operations of triage recommendations
- Coordinate any medication orders with the assigned pharmacy and update MAR/QuickMar for appropriate administration
- Work assigned prior authorizations to ensure timely documentation and submit to assigned pharmacy for billing
- Complete/conduct assessment and reassessment of persons served as assigned
- Develop/update care plans and determine persons served needs and secure physicians orders as needed
- Communicate with beneficiaries primarily phone, text, online (web) chat, or email
- Ensure compliance with state/local/payer requirements through review of documentation
- Provide coaching and education related to the health and well-being of persons served
- Participate in performance improvement activities and maintain ongoing clinical knowledge through internal/external training programs
- Document above actions in Nurse’s Notes or Service Delivery Log
- Maintain time sheet log for weekly submission for productivity management to assigned supervisor
- Notify each practice, physician, and/or managed care client of all encounters with patients, parents, or managed care clients regardless of follow-up needs before office opening
- Notify designated leadership of operational concerns
- Actively participate in applicable meetings and committees as requested (e.g., IDT, HRC, Safety/Quality committee, and annual person served directed/active treatment plan meetings)
Qualifications
- Degree/certification from an accredited school of nursing
- Current licensure as a Registered Nurse (RN) in the state of practice, which is current and remains in good standing. Must have a compact state RN license.
- Clinical experience in providing services and supports to individuals with intellectual and developmental disabilities, home health and Hospice patients or related disorders
- One year Home Health nursing experience preferred
About our Line of Business
Starting Point Nursing Services, an affiliate of BrightSpring Health Services, is staffed 100% by a team of remote registered nurses trained to support the post-acute continuum with clinical advice and interventions. Our 24/7 On-Call and Triage team responds to physician practices, home health agencies, intellectual disability providers, and assisted living providers. Our services are tailored to our partners, including remote physical/chart assessments, predictive care modeling, clinical programming interventions for high-risk populations, emergent care coordination, and case management. For more information, please visit www.startingpointnursing.com. Follow us on LinkedIn.
Salary Range
USD $30.00 – $35.00 / Hour
by twochickswithasidehustle | Jun 13, 2025 | Uncategorized
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!
O.N.E Purpose:
- Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
- Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
- Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
The Opportunity:
CAREER OPPORTUNITY OFFERING:
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
- This position pays between $62,500- $119,700 based on experience
By embodying our core purpose of customer obsession, new ideas, and driving innovation, and delivering excellence, you will help ensure that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare.
The Project Office is critical to support Ensembles growth through flexible but structured Portfolio Project Management (PPM) best practices. The Project Manager II of the PMO team will oversee all aspects of assigned projects in one or more areas including technology, operations, clients, HR or process improvements. The responsibilities initially include successfully implementing projects for new and existing clients with a focus on vendor installations on-time, within budget and with the highest quality.
Key activities include establishing a clear charter/scope, project plans with deadlines, assigning responsibilities, monitoring and reporting accurate project health and progress.
Job Responsibilities:
Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
- Perform Project Management functions aligned with the PMO best practices for technology, client, vendor, strategic projects and others as needed
- Lead project teams through initiation, planning, executing/monitoring and controlling, and closing of designated projects with support from other Project Leaders in the PMO
- Ensure project work is well-defined and planned. This includes thorough scope definition, estimation, cost-budgeting, resourcing, scheduling, and placing under ongoing change control
- Ensure effective risk, issue, action, and change management, including timely decision making for risks and changes, timely issue resolution, and comprehensive action management
- Establish, maintain and execute an effective communications plan serving all stakeholder needs. Ensure team clarity on objectives, scope, and roles, and communicates the work plan with regular and meaningful reports on status and performance
- Monitor and manage project performance inclusive of cost and team performance
- Manage changes to the project scope, project schedule and project costs using appropriate verification techniques. Measure project performance using appropriate tools and techniques
- Adhere to enterprise PMO established best practices and tools for consistency across all projects
Experience We Love:
- 1 to 3 years’ experience
- Strong communication skills
Education:
- Bachelors Degree or Equivalent Experience
Required Certification:
- HFMA Certified Revenue Cycle Representative (CRCR) within 9 months of hire
#LI-LS1
#LI-REMOTE
Join an award-winning company
Five-time winner of “Best in KLAS” 2020-2022, 2024-2025
Black Book Research’s Top Revenue Cycle Management Outsourcing Solution 2021-2024
22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024
Leader in Everest Group’s RCM Operations PEAK Matrix Assessment 2024
Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023
Energage Top Workplaces USA 2022-2024
Fortune Media Best Workplaces in Healthcare 2024
Monster Top Workplace for Remote Work 2024
Great Place to Work certified 2023-2024
- Innovation
- Work-Life Flexibility
- Leadership
- Purpose + Values
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
- Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
- Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
- Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
- Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact [email protected].
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.
by twochickswithasidehustle | Jun 13, 2025 | Uncategorized
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!
O.N.E Purpose:
- Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
- Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
- Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
The Opportunity:
CAREER OPPORTUNITY OFFERING:
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
- This position pays between $46,900.00 – $89,850.00/based on experience
The primary role of the Contract Technician I is to support client needs relative to Insurance contract management. The specialist will be responsible for Interpretation of Insurance contract verbiage, govt payer reimbursement, and support functions such as file balancing, account/report review and peer audits.
Ideal Candidates will have Hospital or Physician Insurance contract build experience, Managed Care experience, as well as contract management platform experience related to reimbursement and contracted rates.
Essential Functions:
- Conduct file balancing and daily maintenance of contract management system Maintains a schedule of key update dates for expected reimbursement rules, such as Medicare OP quarterly updates, yearly Diagnostic Related Group (DRG) updates, and yearly increases for the Managed Care contracts utilizing such tools as a Smartsheet for tracking.
- Complete contract build testing to ensure accuracy prior to moving to a production environment.
- Complete contract audits on completed builds as required.
- Provide support to other revenue cycle areas regarding questions on calculations and reimbursement generated by the contract builds.
- Completes necessary training modules and work building sessions to become Coordinates and actively participates with other associates and leaders on the team to expand and grow their knowledge of managed care organizations, contracts and products.
- Participates with the Contract Management knowledge share opportunities to expand their knowledge base and role.
Requirements:
- High School Diploma or GED
2-4 years’ experience in healthcare industry relative to payer reimbursement to include:
- Hospital or Physician Insurance contract build experience
- Managed Care experience
- Interpretation of Insurance contract verbiage
- Contract management platform experience related to reimbursement and contracted rates.
- Revenue Cycle Management
Certifications:
- Must obtain CRCR certification within 9 months of hire – employer paid
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