by twochickswithasidehustle | May 16, 2024 | Uncategorized
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines.
– Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise.
– Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process.
– Insures all compliance requirements are satisfied and all payments are made against company practices and procedures.
– Identifies and reports possible claim overpayments, underpayments and any other irregularities.
– Performs claim rework calculations.
– Makes outbound calls to obtain required information for claim or reconsideration.
Required Qualifications
Required 2+ years of Medical claims processing experience
Familiar with ICD and CPT coding
Ability to multitask while working independently
Preferred Qualifications
Required 2+ years of Medical claims processing experience
Familiar with ICD and CPT coding
Ability to multitask while working independently
Education
Request a minimum of an Associate’s degree which will be waived in lieu of medical claims processing experience.
Pay Range
The typical pay range for this role is:
$18.50 – $35.29
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
by twochickswithasidehustle | May 16, 2024 | Uncategorized
Job Description
Pay: $16.50/hr
Location: Remote or In-Office
Schedule: Schedules from 7 AM – 6 PM CST
Overview
As a Customer Support Specialist you will be tasked with supporting our Client Representatives and working with our internal teams to ensure a quality customer experience. You will research and resolve exceptions related to client data integrity. You will also be tasked with certain client and vendor interactions and requests, opening new client accounts, processing account number changes, and closing accounts within the Conservice systems.
Responsibilities
As a Customer Support Specialist, you will:
Research and resolve exceptions related to client data integrity
Open new client accounts
Closing client accounts
Processing account number changes
Collaborate with internal team members to resolve client related tasks
Preferred skills
Strong Computer Skills
Excellent email etiquette and an ability to deal effectively with co-workers.
Ability to apply critical thinking
Excellent research and problem solving skills with a strong attention to detail.
Time management and organization
Self-Starter
Able to build and maintain professional relationships
Passionate in providing superior client satisfaction
by twochickswithasidehustle | May 16, 2024 | Uncategorized
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills.
A Brief Overview
Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills.
What you will do
· Receives and monitors the completeness and accuracy of claims forms and supporting documentation submitted by healthcare providers.
· Enters claim information, such as patient information, provider details, procedure codes, and diagnosis codes, into the company’s claims processing system.
· Documents relevant information for the eligibility of the claim, determining coverage and benefits, and assessing the validity and medical necessity of the services rendered.
· Calculates claim payments based on the approved reimbursement rates, fee schedules, or contracted rates with healthcare providers.
· Communicates claim status updates to healthcare providers, policyholders, or other stakeholders to provide transparency and ensure any additional information is resolved quickly.
· Assists in resolving discrepancies or issues related to claims by researching and investigating claim-related inquiries, collaborating with internal teams or departments, and coordinating with healthcare providers to resolve claim processing errors or discrepancies.
· Provides customer service support by addressing inquiries and resolving issues related to claims processing.
· Ensures that all claims processing details and notes are inputted into the company systems database.
· Assists in data entry tasks related to claims data management, such as updating claim statuses, maintaining accurate records, or ensuring proper documentation of claims processing activities.
Required Qualifications
· 6 months work experience
· Working knowledge of problem solving and decision making skills
Preferred Qualifications
· Certified Billing and Coding Specialist (CBCS) preferred.
Education
High School Diploma or equivalent GED
Pay Range
The typical pay range for this role is:
$17.00 – $28.45
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits
We anticipate the application window for this opening will close on: 05/31/2024
by twochickswithasidehustle | May 16, 2024 | Uncategorized
Requisition #: 19307
Functional Area: Audit/Risk/Compliance; Office/Clerical
Employment Type: Full-Time
Work Options: Remote / Work from Home in the US #LI-Remote
Work Hours: Monday – Friday 1130am – 8pm CST
About J. J. Keller & Associates, Inc.
J. J. Keller & Associates, Inc. is a family-owned company founded in 1953 and our purpose is to protect people and the businesses they run. Today, serving 500,000+ companies across North America, our associates are proud to make a larger impact than ever. Transportation, construction and industrial organizations of all sizes rely on our expert insights to create safe work environments and simplify complex government regulations.
Position Summary
J. J. Keller has a REMOTE – Document Processor opening in one of our fastest growing departments called Managed Services. This department is comprised of fleet and regulatory compliance experts who clients rely on to off-load the time consuming / complex tasks of managing driver safety and vehicle compliance. As a Document Processor you will be responsible for auditing various documents on behalf of our clients and notating discrepancies in the system. This is a great position for an individual who enjoys repetitive work, thrives in an independent environment and doesn’t desire customer interaction.
This position will work Monday – Friday 11:30 a.m. – 8:00 p.m. CST after a 6-week training period of Monday – Friday 8am – 430pm CST. This position is eligible for a $1.00/hr. shift differential for the second shift hours worked.
This position has the flexibility to work 100% from home or hybrid or onsite for local candidates.
Job Responsibilities
Audits driver qualification documents and drug & alcohol information for clients.
Identifies discrepancies, checks systems for pertinent information, and enters information into applicable systems.
Works with Client Service Specialists to obtain and/or validate client information. Updates information in all applicable systems.
Maintains knowledge of the applicable local, state, and federal regulations that pertain to our service offerings.
Maintains confidentiality of client information under the FCRA, HIPAA, and other regulatory entities. Adheres to the department’s data security policies pertaining to Personal Identification Information.
Qualifications
Experience/Education:
High School Graduate or General Education Degree (GED).
1+ years of experience in a general office setting.
In lieu, will consider a combination of experience and post-secondary education.
Experience in highly regulated industry a plus or ability to learn complex regulatory standards.
Other Skills/Qualifications:
Must be proficient in the use of a PC and have the ability to navigate between multiple screens and computer programs.
Strong organizational skills and attention to detail.
Benefits and Perks
$17/hr.
17 days of PTO + 8 Paid Company Holidays + 1 Paid Floating Holiday
Annual Reviews + Merit Increases + Quarterly Bonus Program
New Hire On-the-Job Training
Medical + Dental + Vision Insurance
401(k) with Employer Match + Company-funded Profit Sharing
Physical Requirements
Work is performed primarily in a standard office environment. Work involves operation of personal computer equipment for extended periods of time.
We Protect People & The Businesses They Run™
Every associate at J. J. Keller makes a difference by creating safer, more respectful workplaces. Whether serving our customers directly with expertise in safety and regulatory compliance or supporting the business with specialized skills, together we contribute to better workplaces for people across North America.
J. J. Keller History: November 1, 2023, marked 70 years of business for J. J. Keller & Associates, Inc. Click HERE to take a tour through three generations of this family-owned business – from our founding as a one-man consulting firm through decades of delivering on our purpose of protecting people and the businesses they run.
J. J. Keller Career Stories: Click HERE to hear from our associates about what they have to say about life as an associate at J. J. Keller.
J. J. Keller Earns 7th Great Place to Work Certification™: Click HERE to find out what makes J. J. Keller great.
J. J. Keller Certified as a Top 100 Most Loved Workplace® in America: Click HERE to find out why our associates LOVE working at J. J. Keller.
2023 Top Company for Women to Work for in Transportation: Click HERE to learn more about this prestigious recognition.
J. J. Keller provides a competitive benefit package which includes the following (eligibility requirements apply): Medical, Dental, and Vision Insurance, 401(k) and Profit Sharing Plan, etc. The compensation range for this role is $17.00 to $17.50 which varies depending on factors including, but not limited to, a candidate’s overall experience and geographic location. Note that J. J. Keller is not currently recruiting employees to work in California.
If you experience system-related issues or need assistance with the online application, please call (920) 720-7700.
Professional Referral Program: Not the right role for you, but know someone who could be a great fit? Click HERE to refer them to us through our Professional Referral Program and you will earn a cash payment if your referral is hired.
J. J. Keller & Associates, Inc. is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
Nearest Major Market: Oshkosh
Nearest Secondary Market: Appleton
Job Segment: Compliance, 2nd Shift, Law, Clerical, Consulting, Legal, Night, Administrative, Technology
by twochickswithasidehustle | May 16, 2024 | Uncategorized
Everyone loves cash.
You’re joining the nation’s largest, highest-rated consumer group. All collecting cash for their data. We call it Fair Trade Data®. And, we’re happy you’re here.
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