Payer Enrollment Manager -Remote

Posting Details
Posted: May 29, 2024
Full-Time
Remote
LocationsShowing 1 location
Tacoma, WA 98402, USA
Job Details
Description
About Sound:

Headquartered in Tacoma, WA, Sound Physicians is a physician-founded and led, national, multi-specialty medical group made up of more than 1,000 business colleagues and 4,000 physicians, APPs, CRNAs, and nurses practicing in 400-plus hospitals across 45 states. Founded in 2001, and with specialties in emergency and hospital medicine, critical care, anesthesia, and telemedicine, Sound has a reputation for innovating and leading through an ever-changing healthcare landscape — with patients at the center of the universe.

Sound Physicians offers a competitive benefits package inclusive of the items below, and more:

Medical insurance, Dental insurance, and Vision insurance
Health care and dependent care flexible spending account
401(k) retirement savings plan with a company match
Paid time off (PTO) begins accruing immediately upon start date at a rate of 15 days per year, in accordance with Sound’s PTO policy
Ten company-paid holidays per year  

About the Role:

Under supervision of the Senior Director of Payer Enrollment & Credentialing, serves as the Payer Credentialing Manager to ensure payer credentialing applications are submitted to insurance carriers in a timely manner. This position provides a proactive interface between the provider, third party vendors, and the carrier and is integral to company’s revenue cycle.

The Details: This is a virtual, work-from-home role.

In this role, you will be responsible for:

Collaborating with department leadership on the development and maintenance of department processes and policies as needed
Maintaining a working knowledge of enrollment requirements of various health plans for multiple states
Serving as point-of-contact for escalated issues involving Payer Enrollment and communicating directly with payer representatives to resolve enrollment issues
Overseeing third party vendor resources involved in daily payer enrollment activities
Responding to unusual problems or delays in enrollment process (including claim denials)
Reviewing, updating and analyzing the provider enrollment reports from third party vendor weekly and reporting concerns and progress to the Senior Director
Providing training to internal team and external vendor staff on payer enrollment processes and utilization of technology resources as needed
Creating Write-Off Justifications and maintaining/updating spreadsheets as needed
Responding to unbilled problems as indicated by “holding report”
Submitting monthly rosters for associated delegated credentialing contracts for commercial payers
Providing regular evaluation of work product produced by third party vendor to the Senior Director to validate service level agreement compliance
Compiling reports and workbooks as needed
Completing assigned departmental audits
Directing and distributing special projects
Assessing daily/weekly workload of third-party resources and distributing based on volume
Leading weekly meetings with third party vendors– ensuring all functions are being completed in a timely manner
Providing cross coverage for other departmental leadership in their absence
Other duties as assigned

What we are looking for:

A successful candidate will have a demonstrated track record of a combination of these values, knowledge, and experience:

Values:

Resourceful: Proactive willingness to utilize available information and tools to figure things out
Adaptable: Demonstrates flexibility and a willingness to change as circumstances evolve
Collaborative: Demonstrates the ability to work well with others to accomplish a goal and get the work done; takes opinions of others into consideration; includes others in the decision-making process
Intellectually curious: Demonstrates a genuine interest in learning new things and wants to know the reason “why” behind the way things are done
Passionate: Demonstrates a genuine enthusiasm for and excitement about the work; gets others excited about work or projects they’re involved in and working on
Strategic thinker: Demonstrates the ability to look at the big picture and proactively develop a plan of action
Teamwork: Demonstrates the ability to pull people together into highly effective teams along with ability to work in a highly matrixed organization
Communication: The ability to speak, write, and listen clearly and consistently
Relationship Building and Maintenance: The ability to create and nourish healthy, strong relationships, as the face of Sound

Knowledge:

High School Diploma or Equivalent
Proficiency with Microsoft Office Suite
Working knowledge of provider enrollment structure and processes
Excellent organization abilities
Excellent written and oral communication skills

Experience:

Minimum 2-5 years’ experience in medical insurance, credentialing, payer enrollment or related field
Minimum 2 years in leadership role, with direct supervisory experience
Required: Advanced understanding/knowledge of computer data entry, Microsoft Excel and ability to navigate through any business related software

Sound Physicians is an Equal Employment Opportunity (EEO) employer and is committed to diversity, equity, and inclusion at the bedside and in our workforce. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, gender identity, sexual orientation, age, marital status, veteran status, disability status, or any other characteristic protected by federal, state, or local laws.

This job description reflects the present requirements of the position.  As duties and responsibilities change and develop, the job description will be reviewed and subject to amendment. 

Assistant Inventory Planner

About Misfits Market:

Misfits Market is a mission-driven, high-growth startup dedicated to reducing food waste and making shopping for sustainable, high-quality groceries easier and more affordable. We deliver organic produce, high-quality meats and seafood, plant-based proteins, dairy, bakery, wine, and other grocery items to nearly every zip code in 48 states at up to 30 percent off traditional grocery store prices. In 2022, Misfits Market acquired sustainable e-grocer Imperfect Foods and now leverages its in-house transportation network to deliver directly to consumers with one of the most carbon-efficient grocery delivery models on the market. By tackling inefficiencies in the food system, our passionate and motivated team of problem solvers helps save an average of 500,000 pounds of food per week from waste or lesser outcomes, with an all-time savings of 190+ million pounds of food. 

About the Role: 

The Assistant Inventory Planner is on the Planning & Analytics Merchandising team. They will be responsible for managing all distributor vendors (forecasts, and PO placement) as well as overseeing the entire end to end PO tracking process for the inventory planning team .  They will also support the team by running ad hoc reports and data entry tasks as needed.  This position reports to the Director of Inventory Planning, Grocery.

Responsibilities: 

  • Forecasting at the item and fulfillment center level quantities needed within assigned distributor vendors to meet sales plans, minimize shrink risk, and hit planned inventory level targets.
  • Purchase Order management.  This includes creating Purchase Orders, verifying all information on purchase orders is accurate, sending purchase orders to vendors, and tracking all purchase orders until they deliver to our fulfillment centers.  They will own updating the PO tracker for the entire team, following up directly with vendors and Operations teams, recapping status of POs and escalating vendor issues as needed to Inventory Planners and Category Managers.   
  • Assist finance with resolving all PO and invoice discrepancies. Coordinate with receivers to verify arrivals. Work with vendors to resolve any quality or quantity issues.  Escalate to Inventory Planner / Category Managers as needed to ensure timely resolution.
  • Demonstrate logical analytical abilities, creative problem-solving skills, and financially sound judgment to deliver conclusions and recommendations to the Director of Inventory Planning and cross-functional teams.
  • Consistently meeting quarterly metrics including sales and inventory plans based on on-time deliveries and in-stock rate.
  • Provide weekly and monthly reporting on forecast accuracy, sku count, shrink and in stock rate root cause. 
  • Support the weekly catalog process by ensuring that all POs planned to be sold are on time and have appointments at the FCs.  
  • Serve as point of contact for the Operations team for PO exceptions.  
  • Support the inventory planner team with data entry projects as needed.

Skills and Qualifications: 

  • 1-3 years experience in Merchandise Planning and Purchase Order Management.
  • Experience with quickly solving issues and working in a fast-paced environment.
  • Ability to manage multiple priorities and pivot as needed.
  • Proficient with Excel, Word, Google Sheets/Docs, and ERP systems 
  • Excellent interpersonal skills 
  • Bachelor’s degree

About You: 

  • You’re highly energetic and friendly attitude, ready to learn 
  • You’re extremely organized with strong attention to detail 
  • You’re able to prioritize and meet deadlines
  • You’re comfortable with ambiguity 
  • You love the opportunity to meet challenges and take preventative action for solutions 
  • You work well in a highly active team in a collaborative environment 
  • You’re passionate about our mission to eliminate food waste and create a better food system for all 

Details of Position & Benefits: 

  • Annual Salary range: $65k-$75k
  • Full-time exempt position
  • 100 % Remote Work
  • Salary and employee stock options commensurate with experience
  • Unlimited PTO
  • Multiple health, dental, and vision plan options
  • Life Insurance
  • 401K plan

Receipt Reviewer

Description
As a Receipt Reviewer, you will be responsible for overseeing the daily management of assigned pending sales receipt submissions. Your primary focus will be to maintain a high level of quality while ensuring a fast turnaround time of no more than 24 hours for end users. This requires balancing speed with accuracy to protect against fraudulent activity, as well as preventing backlogs of pending user submissions. Your attention to detail and commitment to consistent quality will be key to success in this role.

Goals/Objectives:

24 Hour Receipt Review
Accurate Reporting
Duties & Responsibilities:

Manage daily review of assigned pending sales receipt submissions
Maintain high quality while balancing speed of review
Protect against fraudulent activity
Ensure short wait times of <24hrs for end users
Prevent backlogs of pending submissions/rewards
Daily communication to the client’s Slack Channels to clarify discrepancies and uncover new insights
Requirements
Attention to detail
Commitment to quality
Ability to balance speed and accuracy
Problem solving skills
Communication Skills (written and oral)
Navigate between multiple windows/browsers with ease, perform extensive internet research, and type 45 WPM
Working knowledge of G-Suite and Microsoft Office products
System Requirements

At least 15mbps main internet and at least 10mbps for backup
A desktop or laptop that has an i5 processor with at least 8 GB RAM and an i3 processor for backup
Note: Back-ups should still be able to function when there is a power interruption
A webcam
Noise-canceling USB Headset
Quiet, Dedicated Home Office
Smartphone
Benefits
Join Our Dynamic Team: Experience our fun, inclusive, innovative culture that values your unique contributions and supports your professional growth.
Embrace the Opportunities: Seize daily chances to learn, innovate, and excel. Make a real impact in your field.
Limitless Career Growth: Unlock a world of possibilities and resources to propel your career forward.
Fast-Paced Thrills: Thrive in a high-energy, engaging atmosphere. Embrace challenges and reap stimulating rewards.
Flexibility, Your Way: Embrace the freedom to work from home or any location of your choice. Create your ideal work environment.
Work-Life Balance at Its Best: Say goodbye to stressful commutes and hello to quality time with loved ones. Achieve a healthy work-life integration to perform at your best.

Verification Researcher – Remote

About HireRight

HireRight is the premier global background screening and workforce solutions provider. We bring clarity and confidence to vetting and hiring decisions through integrated, tailored solutions, driving a higher standard of accuracy in everything we do. Combining in-house talent, personalized services, and proprietary technology, we ensure the best candidate experience possible. PBSA accredited and based in Nashville, TN, we offer expertise from our regional centers across 200 countries and territories in The Americas, Europe, Asia, and the Middle East. Our commitment to get it right every time, everywhere, makes us the trusted partner of businesses and organizations worldwide.

Overview

Researcher role is fundamental to the Service Delivery model of HireRight. Following processes set out in the SOPs, Researchers are verifying information provided by Candidates and inputting the outcome of their work into a Client facing report. Researchers are following processes in a professional and timely manner, adhering to guidelines from their Supervisors on the required productivity and quality of work. This role covers entry level and more experienced Researchers, as well as Verifications conducted in English, as well as other languages (as required)

Verification’s Researchers will be ensuring a first class Customer and Candidate experience through verifying (as applicable) standard education, employment and professional qualifications components of the screening package utilizing available resources such as telephone, email, internet, etc. Other duties may also be assigned.

Responsibilities

Duties

• Ensure that duties are carried out professionally and in line with the priority to help Candidates get hired
• Quickly and effectively research and verify facts provided by Candidates to ensure the screening process is completed in a timely manner 
• Process background reports according to current reporting guidelines and standards
• Maintain in-depth working knowledge of all current guidelines
• Complete escalated/rejected requests  requiring further investigation 
• Ensure accurate and prompt turnaround on all reports
• Enter achieved information and input thorough and accurate notes. Maintain accurate and up to date records of actions taken
• Provide timely follow-up and follow through on all requests, reports, and escalations
• Communicate with Candidates, with tact and diplomacy, to obtain missing information or to clarify details as quickly as possible 
• Collaborate with other teams to keep Clients informed of issues throughout the screening process 
• Maintain a “Continuous Improvement” state of mind and helps to suggest and implement changes
• Be open to cross training in other functions outside of immediate scope of responsibility 
• Ensure all actions comply with all applicable Data Protection legislations
• Assist team members and works as part of the team to ensure customers’ expectations are met 
• May assist with mentoring, training, and coaching of new team members within immediate team 
• May assist in ad hoc projects as and when required 
• Track and report issues with our business partners

• Conduct interviews with professional referees to verify Candidates’ employment history 

Qualifications

Education:

  • High School diploma or equivalent required
  • Bachelor’s degree in a related field is preferred

What do we offer

In exchange for your expertise, HireRight offers an excellent employee benefit package which includes:
•Medical
•Dental
•Vision
•Paid Life/AD&D Insurance
•Voluntary Life Insurance
•Short- & Long-Term Disability
•Flexible Spending Accounts
•401K
•Generous Vacation and Sick Program
•10 Paid Holidays
•Education Assistance Program
•Business Casual Attire
•Generous Referral Program
•Employee Discounts and Rewards
•And much more!

*All resumes are held in confidence. Only candidates whose profiles closely match requirements will be contacted during this search.

HireRight, LLC is an Equal Opportunity Employer
Minorities / Females / Veterans / Disabilities

HireRight does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of HireRight and HireRight will not be obligated to pay a placement fee.

Document Coordinator – Perdoceo Education Corporation

The Document Coordinator is responsible for collection, organization and monitoring required documentation which comprise an academic file as well as distribution of such information and documentation in alignment with standard operating procedures. The Document Coordinator is responsible for adhering to all University policies and procedures necessary for compliance with external standards as set by accrediting and licensing organizations, state and federal agencies, and other regulatory entities. Provides support to customers, both internally and externally, in a professional and timely manner that supports achievement of the University’s goals and objectives.

Principal Duties & Responsibilities

Principal Duties for both teams

Review student records and information, ensures adherence to all University policies and procedures outlined by the course catalog, student handbook, and standard operating procedures and understand and comply with the Family Rights and Privacy Act and other applicable laws and regulations to ensure the integrity of student records related to the department.

Data entry of student records and information.

Maintains and archives academic files and records; including control, collection, organization, documentation, evaluation, monitoring of academic files for students in accordance to deadlines.

Provide outstanding internal and external customer service by responding to all inquiries in a timely manner and maintaining availability for student questions during designated department hours.

Student Status Change & Assorted Process – Team

Processes a broad range of student records processes as initiated by the University such as: school grade changes, monitoring attendance, military portals, and course building in CampusVue, military portals.

Processes a broad range of student driven requests for processing such as: loan deferments, student directory changes, transcript requests, grade reports, diplomas and enrollment verifications.

Prepares data and monitoring of this data on a broad range of student records information such as: graduation, registration, term honors, and incomplete reports.

Student Transcript & Record Review – Team

Retrieves transcripts to complete student files for degree verification which includes performing outbound calls to schools and students.

Resolves student inquiries through inbound phone calls, live chat with students.

Verifies document validity and legitimacy.

Data entry of student records and information.

Specific additional functions may include academic evaluation of eligibility for specified grants and scholarships offered by the campus.

Knowledge, Skills and Abilities, Competencies

Basic computer skills – experience with Microsoft (WORD, Excel, Outlook) preferred

Possesses excellent verbal communication skills and good written communication skills

Persistence combined with a positive attitude and approach to work and others

Mature, positive and collaborative interpersonal skills

Learns to effectively utilize all applicable school systems, databases and tools effectively.

Ability to prioritize, competing demands and work within strict deadlines

Interact with other departments through a variety of means

Organizational and time management skills

Education and Experience: Minimum

High School diploma or its equivalent required

Entry level administrative experience

Education and Experience: Preferred

Associate Degree from an institution accredited by an agency recognized by the U.S. Department of Education (or international equivalent)

Administrative or Education Industry experience

What we offer*

Salary Range between $15 and $20 per hour
Paid time off
Paid sick leave
Paid holidays
Comprehensive medical, pharmaceutical, dental, and vision benefits
Health savings and flexible spending accounts
401(k) savings plan with company match
Employee Stock Purchase Plan (ESPP)
Company paid life insurance and disability insurance – subject to eligibility
Company paid tuition assistance – subject to eligibility and approval
Employee Assistance Program (EAP)
Prenatal and adoption assistance
Additional ancillary programs are available upon benefit enrollment eligibility
*Most benefits apply to full-time employees. Some benefits apply to part-time employees as well. Benefits may vary by location and position and are subject to change at any time. Ask your recruiter for full details and information about eligible dependents.