American Specialty Health Incorporated is seeking a focused Claims Examiner to work in a production environment. This position is responsible for the accurate review, input, and adjudication of claims in accordance with regulations, ASH standards and contractual obligations of the organization. Claims is an integral department of American Specialty Health’s offerings to empower people to live longer and healthier lives. We are responsible for tracking the receipt of claims, adjudication, and payment of claims. Due to the nature of the business and always evolving rules and guidelines, Claims is a fun and fast-paced team that enjoys working side by side, developing new ideas for efficiency, and prioritizes a strong focus on exceeding regulatory and contractual standards. Our driving mission is to offer world-class customer service (and expedited reimbursement) to healthcare providers on behalf of our members. Claims offers a career path progression that begins upon hire and allows development-focused staff to achieve two promotions in just one year. We succeed as a team and we prioritize professional development, considering ourselves an operational springboard to spring talented and driven employees toward their future goals.
Remote Worker Considerations
Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 10 Mbps upload speed).
Remote Worker Considerations:
Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment.
Responsibilities
Processes claims accurately and efficiently.
Reviews all incoming claims to verify necessary information.
Determines that correct member and provider records are chosen and utilized to process claims.
Enters claims data and information into the computerized Claims Processing System.
Maintains all required documentation of claims processed and claims on hand.
Adjudicates claims in accordance with departmental policies, procedures, state and accreditation standards and other applicable rules.
Maintains production standards; for direct data entry claims this includes processing an average of 31 claims per hour, with an accuracy rate of 98.5% over each pay period.
Verifies data of scanned paper claims at stated standards.
Provides backup for other examiners within the department.
Promotes a spirit of cooperation and understanding among all personnel.
Attends organizational meetings as required.
Adheres to organizational policies and procedures.
Maintains confidentiality of all claim files, claims reports, and claims related issues.
Qualifications
High school diploma required.
6 months data entry experience with 10 key and word processing; minimum 10,000 keystrokes per hour required.
Experience processing medical claims and knowledge of medical billing terminology and coding strongly preferred.
Proficient in MS Office.
Core Competencies
Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
Ability to effectively organize, prioritize, multi-task and manage time.
Ability to work and maintain production in a work-from-home (WFH) environment
Demonstrated ability to show self-discipline to meet production goals.
Demonstrated accuracy and productivity in a changing environment.
Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions, and to utilize constructive criticism to improve.
Ability to exercise strict confidentiality in all matters.
Mobility
Primarily sedentary, able to sit for long periods of time.
Physical Requirements
Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.
Environmental Conditions
Work-from-home (WFH) environment.
American Specialty Health is an Equal Opportunity/Affirmative Action Employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.
Please view Equal Employment Opportunity Posters provided by OFCCP here.
If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.
ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.
Brock & Scott, PLLC is a full service law firm with extensive experience serving the financial sector. With offices across Alabama, Florida, Georgia, Maryland, Michigan, Kentucky, North Carolina, New Jersey, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, Rhode Island, Connecticut, Maine, Massachusetts, New Hampshire and Vermont. We deliver legal service with the utmost integrity and operational efficiency through our highly skilled team of attorneys and support staff.
EXPERIENCE
Brock & Scott, PLLC has been the default services and recovery leader for over 20 years. We have over 20 offices across nineteen states with highly qualified attorneys and professional staff providing full coverage and significant years of legal experience in each of our states.
EFFICIENCY
It is our commitment to provide exemplary service to our clients with a comprehensive suite of practice area offerings. By utilizing Brock & Scott, our clients gain the full benefit of our extensive regional coverage while experiencing that ‘hands on’ approach and physical presence in each individual state.
INTEGRITY
The firm has demonstrated our ability to meet the most strict industry standards for handling default and collection related legal work. We maintain advanced levels of physical and data security that are integrated into our Compliance Division for quality control and audit review across all of our offices.
EOE STATEMENT
We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.
DESCRIPTION
JOB PURPOSEOperate data entry device, such as keyboard while working in various lender systems. Duties may include verifying data, opening and/or processing files, completing backups and preparing materials for printing as well as completing milestones and uploading documents to Caseware and to the various lender systems.JOB RESPONSIBILITY SUMMARYRead source documents and enter data in specific data fields, using keyboards or scanners.Compile, sort and verify the accuracy of data before it is entered.Compare data with source documents, or re-enter data in verification format to detect errors.Store completed documents in appropriate on line locations.Locate and correct data entry errors, or report them to supervisors.Maintain logs of activities and completed work.Select materials needed to complete work assignments.
POSITION REQUIREMENTS
REQUIRED KNOWLEDGE, SKILLS, & ABILITIESTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily with or without accommodation. The requirements listed below are representative of the knowledge, skills, and ability required.Education/Licensure/Credentials Required: High school diploma or equivalentExperience Required: 1-2 years of data entry experienceSpecial Knowledge/Skills Required: Excellent communication skills – both verbal and written, computer skills – Microsoft Office, Outlook, and ability to create spreadsheets in excel, leadership skills, problem-solving and decision making skills, the ability to plan and organize well, ability to meet goals, time management skills, perform well under pressure, and able to maintain a good office environmentPreferred: Understanding of the standard real estate and foreclosure documents, versatility in CaseWare and the various lender systems (LPS) and payroll systems.
EXEMPT/NON-EXEMPT
Non-Exempt
FULL-TIME/PART-TIME
Full-Time
LOCATION
Brock & Scott, PLLC – Winston-Salem
SHIFT
-not applicable-
THIS POSITION IS CURRENTLY ACCEPTING APPLICATIONS.
Schedule will vary with multiple shifts available. Part time & full-time applicants encouraged to apply.
The pay for this position is $24.00 per hour with a $3.00 overnight differential.
About Didi Hirsch
Didi Hirsch Mental Health Services has been a national leader in whole-person mental health, crisis care, and substance use services since 1942 and is home to the nation’s first Suicide Prevention Center. We are a nonprofit organization providing care to nearly 200,000 people annually across our programs. Didi Hirsch has deep roots in community-based mental health and a commitment to providing culturally responsive services that are just and equitable.
As an organization, we value equity, diversity, and inclusion. More than 1,000 dedicated employees and volunteers make Didi Hirsch’s work possible. We intentionally recruit and retain a workforce that is reflective of the communities we serve and strive to cultivate a sense of belonging for them. We embrace employees and candidates from all backgrounds who want to help make this vision a reality.
Summary
Chat/Text Counselors will be responsible for utilizing Crisis Chat and Text services to provide crisis intervention, emotional support, and resources to all help-seekers. The position will be fully remote, with the option to work on-site. A high emphasis is placed on quality assurance for this role.
Primary Duties
Offers crisis-counseling services via chat and text Completes risk assessment, safety planning, de-escalation, and follow-up with Chat/Text visitors. Serves as a mandated reporter in cases of suspected abuse or neglect. Is familiar with resources and providing information and referrals to visitors as appropriate. Maintains accurate and detailed chat/text reports. Documentation must be completed in real time. Completes 1.5 chats/texts per hour (on average). Fulfills continuing education requirements as requested or required for the agency and the Suicide Prevention Center program. Assists in the training process of new counselors. Participates in community outreach events such as resources tables and presentation about suicide prevention as needed. Attends routinely scheduled meetings for the Suicide Prevention Center.
Position Requirements
Possess a high school Diploma or equivalent. Be 18 years of age or older. Have high speed internet with an active Ethernet connection, and a quiet/confidential workspace. Be empathetic, flexible, and adaptable to varying situations. Have open availability and flexibility to work within the Chat/Text program’s operating hours, including weekends and holidays. Be reliable and able to adhere to schedules based upon Chat/Text program needs. Complete yearly trainings as required by Lifeline. Have knowledge of all job specific skills including risk assessment, data collection, and chat/text triage. Possess strong interpersonal skills and can positively interact with others. Have outstanding communication skills with the ability to engage any individual regardless of background. Exceptional at multi-tasking and time management, able to drive multiple pieces of work forward simultaneously while meeting all deadlines. Goal-oriented team player with strong experience working in large and complex systems. Current California driver’s license and a driving record acceptable to the Agency’s insurance carrier. A commitment to team objectives and Didi Hirsch philosophies. Successfully pass our pre-employment screening, including a background check and live scan fingerprinting.
Join our growing team at Vetcove, and help us transform how veterinarians buy the supplies they need to keep America’s pets healthy. Vetcove’s eCommerce and mobile platforms enable veterinary practices to compare and buy from all of their vendors in one place. Our community of more than 17,000 veterinary hospitals employs tens of thousands of veterinarians, and delivers care to many millions of animals every year across all 50 states. We’re a growing team on a mission to modernize the $50B+ animal health industry. Simply put, Vetcove helps veterinary organizations spend more time giving care, and less time shopping and comparing across vendors to supply their practices. Vetcove is a Y Combinator and venture-backed growth stage company with notable investors in Silicon Valley and NYC. We’re looking for exceptionally talented and passionate people to join our growing team.
About the Position
The Support Associate is responsible for engaging with our vibrant community of veterinary professionals to support them in their critical purchasing decisions and processes through the use of the Vetcove platform.
Members of the support team work collaboratively to help provide our users an excellent experience on our platform through live chats, phone calls, emails, internal discussion boards, and platform demos This role plays a pivotal part in ensuring a positive and delightful day-to-day experience for every user leveraging the platform for their supply ordering needs.
The ideal candidate is a proactive self-starter who thrives in a fast-paced, team environment. This person will be excited by the challenge of supporting and growing a large community of thousands of passionate veterinary professionals through answering intercoms via our platform, troubleshooting, and working cross-functionally to help evolve our platform.
Experience in a relevant customer-facing role, as well as excellent written and verbal communication skills, are required. Knowledge of intercom and/or experience with other chat platforms is strongly preferred.
What you’ll do
Support existing Vetcove users by responding to user inquiries via live chat, email, and phone in a timely manner
Troubleshoot issues quickly and explain scenarios/solutions in an easily digestible and effective manner
Handle various daily and weekly admin responsibilities, such as proactive account management, item issue reports, item reviews, credit approvals, and more
Work cross-functionally to provide our engineering, partner, and corporate teams with information on feature requests and recommendations for enhancements to our tools
Work with vendor and industry partners to streamline communication and alerts between systems
Help to continuously develop and expand processes in order to streamline support workflows
You should have
1 year of relevant, customer facing work experience
2 Year Associates Degree or 4 Year College Degree
Excellent written and verbal communication skills
Experience in chat support preferred
Patience and compassion when handling difficult situations
Ability to adapt quickly and manage many concurrent responsibilities
A strong desire to learn and help our customers succeed
A positive attitude and one-for-all team mentality and excellent collaboration skills
Tech/start-up work experience is a plus but not required
Benefits
100% remote within the USA
Medical, Dental, and Vision Insurance
Automatic 401k contribution
Employee referral program
At home office set up
Bi-annual company retreats
Open vacation policy
Equity
Monthly team events
Please note we are unable to sponsor work visas at this time.
Attention all job seekers! We want to ensure that you’re well-informed about a serious matter affecting the job market. It has come to our attention that scammers are operating in the industry, impersonating employees and attempting to deceive savvy applicants like you. Here’s what you need to know:
Our job listings are exclusively available on official sites (our careers page, LinkedIn, BuiltIn, and Indeed). Be cautious of other sources claiming to represent us or any organization that you’re interested in. Stay on the lookout!
Authentic communications from our company will only come through verified email addresses and phone numbers. If you receive unexpected messages or calls, exercise caution and verify their authenticity. Don’t let scammers catch you off guard!
It’s essential to independently verify the legitimacy of any job postings you come across. Visit our official careers page to confirm the validity of any openings. Stay proactive and protect yourself!
Remember that during the application process, we will never request sensitive personal or financial information from you. Be wary of anyone asking for such information. Keep your personal data secure!
If you suspect any fraudulent activity or encounter suspicious individuals, please report it immediately to our recruiting department. By working together, we can combat these scams and keep the job market safer for everyone.
We understand the importance of your job search and want to ensure your experience is positive and secure. Always exercise caution and stay scam-smart!
Vetcove is an equal opportunity employer and is committed to creating a diverse and inclusive workplace. We welcome applicants from all backgrounds, regardless of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other protected status. We are dedicated to providing a work environment free from discrimination, harassment, and retaliation. It is our policy to provide equal employment opportunity to all applicants in accordance with all applicable laws and regulations. If you require accommodations during the application or interview process, please let us know and we will make every effort to accommodate your needs.
Pie’s mission is to empower small businesses to thrive by making commercial insurance affordable and as easy as pie. We leverage technology to transform how small businesses buy and experience commercial insurance.
Like our small business customers, we are a diverse team of builders, dreamers, and entrepreneurs who are driven by core values and operating principles that guide every decision we make.
The Premium Audit Specialist performs a key role in working directly with Pie’s customers and partners to review and process vendor audits and effectively resolve any audit disputes. The Premium Audit Specialist will utilize their commercial insurance expertise to create a best-in-class experience for our clients and generously share their knowledge and application of skills with fellow members of the audit team. As a specialist in the space, they will model superior attention to detail and accuracy as they examine the insured’s information and generate final audit reports.
How You’ll Do It
Use all appropriate systems and validation tools in order to effectively accomplish quality audit results, ensuring the policy premium is still right for the policy holder’s business.
Provide Premium Audit technical support as a subject matter expert in areas such as classification use, payroll calculations, internal audit procedures, and manual rules to both internal and external stakeholders.
Ensure that all Bureau Test Audit standards, where applicable, are met or exceeded. Determine actions required of Pie and vendors to ensure standards are met.
Knowledgeably and clearly communicate final audit results to customers and partners in order to provide an excellent experience.
Oversee the audit dispute process and ensure disputes are handled timely and accurately.
Develop and/or recommend training programs to address error trends and assist with completion of process improvement projects.
Other tasks, responsibilities, and projects as assigned.
The Right Stuff
High school diploma or GED required.
3+ years of professional work experience required.
Minimum of 1 year of insurance audit experience required, Workers Comp strongly preferred
Excellent verbal and written skills in order to effectively and confidently deliver complex information
Ability to build strong cross-functional relationships. Adjusts communication and work style in order to work well with others
Ability to review copious amounts of information and accurately record, sort and identify data relevant to audit
Ability to strengthen customer relationships and deliver customer-centric solutions. Ability to multi-task and work with speed, accuracy, and efficiency. The willingness to do what it takes to get the job done.
Actively seeks to understand “the why”, asks questions, desire to understand the perspective of others, ability to learn from everything.
Approaches work with a sense of ownership, takes accountability for output, decisions, and mistakes.
#LI-MW1
Base Compensation Range
$26—$34 USD
Compensation & Benefits
Competitive cash compensation
A piece of the pie (in the form of equity)
Comprehensive health plans
Generous PTO
Future focused 401k match
Generous parental and caregiver leave
Our core values are more than just a poster on the wall; they’re tangibly reflected in our work
Our goal is to make all aspects of working with us as easy as pie. That includes our offer process. When we’ve identified a talented individual who we’d like to be a Pie-oneer , we work hard to present an equitable and fair offer. We look at the candidate’s knowledge, skills, and experience, along with their compensation expectations and align that with our company equity processes to determine our offer ranges.
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