by twochickswithasidehustle | Oct 13, 2023 | Uncategorized
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work.SM
The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims.
This position is full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:30am-9pm CST. It may be necessary, given the business need, to work occasional overtime.
We offer 6-8 weeks of on-the-job / shadow based training. The hours during training will be 8:00am to 4:30pm CST, Monday – Friday. Duration for training is based on the individual candidate and their needs. More details on the training will be discussed further during the interview process by the hiring manager.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
Authorize the appropriate payment or refers claims to investigators for further review.
Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary.
Analyze and identify trends and provide reports as necessary
Consistently meet established productivity, schedule adherence, and quality standards
Recognize claims by determining claim type – HCFA, Hospital, UB, and/or RX
Identify more complicated claims and refer them to Senior Claim Processor or Supervisor
Calculate other insurance and re-pricing benefits
Work claims files to ensure the appropriate eligibility and provider records are matched to the claim
Updates and maintains claims tracking database
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
High School Diploma / GED (or higher)
2+ years of data entry experience
2+ years experience with Microsoft Excel and Microsoft Outlook, including the ability to create, edit, save and send documents, spreadsheets and correspondence
1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
Basic proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
Ability to work 6:30am – 9:00pm CST. It may be necessary, given the business need, to work occasional overtime.
Preferred Qualifications:
1+ years of experience working with medical claims
1+ years of working in production based environment
Ability to type 60+ WPM
Prior experience working with IDX software
Basic understanding of healthcare claims including ICD-10 and CPT codes
Telecommuting Requirements:
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.
California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The hourly range for California / Colorado / Connecticut / Nevada / New York / New Jersey / Washington / Rhode Island residents is $16.00 – $23.13 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
by twochickswithasidehustle | Oct 13, 2023 | Uncategorized
What are important things that YOU need to know about this role?
This position is eligible to be full-time remote
What will YOU be doing for us? Build data integration solutions to meet the requirements of the business. Manage data analysis and data integration across various systems. Provide process support for all internal departments and external clients including implementing new or changing processes, procedures, reports, etc.
What will YOU be working on every day?
Build data integration solutions to meet the functional and non-functional requirements of the business
Develop or modify data integration solutions to provide optimal performance under increasing data volumes
Provide accurate and timely data to internal and external clients.
Analyze requests from internal and external clients to determine scope of request and determine requirements to successfully complete the request.
Prepare ad hoc data extracts, reports, and analysis.
Perform routine and ad hoc data maintenance.
Provide technical assistance to support new and existing client implementation and maintenance.
Provide technical assistance to support departmental projects.
Evaluate and confirm incoming/outgoing data sets meet defined requirements.
Monitor and assess the quality of data contained within system databases.
Research and resolve issues as requested by internal and external clients.
Properly communicate technical information to internal and external clients to ensure shared understanding.
Identify opportunities to use data to develop new strategies and improve business processes and performance.
Additional Responsibilities:
Research, define, and implement new methods to modify the system to improve workflows.
What qualifications do YOU need to have to be GOOD candidate?
Required Level of Education, Licenses, and/or Certificates
Requires a Bachelor’s degree in Management Information Systems, Computer Science, Engineering, or a related degree or equivalent years of experience.
Required Level of Experience
Typically requires 5 years of experience in a data analyst or similar role
Required Knowledge, Skills, and Abilities
Strong knowledge of SSIS/SSRS or similar tools
Strong knowledge of database application and data query protocol (MS SQL Server, Transact-SQL).
Strong knowledge of the Systems Development Life Cycle (SDLC).
Competencies
Time Management: The ability to manage several competing tasks at once effectively while still meeting deadlines.
Detail Oriented: Ensuring that one’s own and/or others’ work and information are complete and accurate; carefully preparing for meetings and presentations; following up with others to ensure that agreements and commitments have been fulfilled.
Results Oriented: The ability to focus on the desired result of one’s own or one’s unit’s work, setting challenging goals, focusing effort on the goals, and meeting or exceeding them.
Initiative: Identifying what needs to be done and doing it before being asked or before the situation requires it.
Diagnostic Information Gathering: The ability to identify the information needed to clarify a situation, seek that information from appropriate sources, and use skillful questioning to draw out the information, when others are reluctant to disclose it.
Critical Thinking: The ability to analyze/evaluate information as presented, utilize past experience to make decisions that are logical and reasonable and demonstrate sound judgment.
Analytical Thinking: The ability to tackle a problem by using a logical, systematic, sequential approach.
What qualifications do YOU need to have to be GREAT candidate?
Preferred Level of Education, License, and/or Certificates
None
Preferred Level of Experience
Previous healthcare management experience.
Preferred Knowledge, Skills, and Abilities
None.
Primary Technology Used:
DBMS – MS SQL Server 2014
SSIS
SSRS
SQL Management Studio
Source Control / Workflow – GitHub
Managed File Transfer – GoAnywhere
The salary range and midpoint is listed below for your reference. Please keep in mind that your education and experience along with your knowledge, skills and abilities are taken into consideration when determining placement within the range.
Compensation Range:
$69,785.00 – $104,678.00
Compensation Midpoint:
$87,231.00
by twochickswithasidehustle | Oct 12, 2023 | Uncategorized
Become a Part of the NIKE, Inc. Team
NIKE, Inc. does more than outfit the world’s best athletes. It is a place to explore potential, obliterate boundaries and push out the edges of what can be. The company looks for people who can grow, think, dream and create. Its culture thrives by embracing diversity and rewarding imagination. The brand seeks achievers, leaders and visionaries. At NIKE, Inc. it’s about each person bringing skills and passion to a challenging and constantly evolving game.
Open to remote work except in South Dakota, Vermont and West Virginia.
The hourly rate for this position ranges from $24.71 in our lowest geographic market to $55.53 in our highest geographic market. Actual pay rate will vary based on a candidate’s location, qualifications, skills and experience.
Information about benefits can be found here.
Nike’s North America Consumer Services team is passionate about creating opportunities to deliver outstanding consumer experiences! CS members are on the front-line, working as part of a dynamic team focused on building unbreakable bonds with Athletes*. With a continuous focus on “getting the win” for all consumers, the CS Team is organized, nimble, able to effectively prioritize, and passionate about using their understanding of the consumer journey to create and preserve lasting brand loyalty.
WHO WE ARE LOOKING FOR
We are looking for a Specialist who will provide a premium service experience! We communicate via 1:1 messaging within the Nike App. This person’s goal will be to drive consumer retention and reengagement of our Members while simultaneously delivering by the measurable expectations of this business. We will maintain product expertise across all categories and proficiency in both pre and post purchase process. You will engage with Members directly and strengthen their relationship with the Nike Brand. This individual must also communicate effectively with teammates, leaders, and cross-functional partners. You will work with a variety of systems and tools to facilitate a seamless consumer journey in-app.
WHAT YOU WILL WORK ON
As part of our Nike Expert on Demand Team within North America Consumer Services, you’ll help our team support all aspects of our Member experience within our Nike App. Along with serving consumers, we will also provide the management team with insights gained from consumers, offering feedback related to key contact drivers, friction points, products, athletes, and trends. You’ll participate in the development of new strategies targeting growing engagement and encouraging community while maintaining a positive representation Nike Brand. You’ll quickly identify sensitive issues and potential customer concerns appropriate for the Nike category, PR and/or legal assistance. We are able to communicate effectively applying good judgment and business decisions in servicing the consumer. Maintaining an up-to-date understanding of the entire Nike product line, marketing initiatives, and greater digital footprint, including the website, NRC, NTC, and SNKRS is crucial in this role. In addition, you’ll use internal tools and systems to ensure accurate responses to consumer inquiries and to capitalize on potential sales opportunities.
A typical day consists of fielding inbound contacts and maintaining a live messaging channel. Contact types may be either pre or post purchase. You will be engaging with each Member in conversation to provide the best possible service. You will observe trends and communicate across your peers to ensure alignment. You will also attend weekly team meetings to stay up to date on policies and processes.
WHO YOU WILL WORK WITH
This person will be working within a team environment reporting to one of the NEOD Support Managers. You’ll partner with our territory teams to build outstanding and exciting experiences for select Members. You’ll also work cross-functionally to provide relevant consumer insight and feedback.
WHAT YOU BRING
Bachelors degree preferably in Communications or Marketing, or equivalent combination of relevant education, experience and training
Excellent written and verbal communication skills
Strong computer skills, including experience navigating the internet and using PC and Windows-based software (Microsoft Office)
Ability to read, speak and understand English
Demonstrated initiative and ability to work independently and/or in a diverse team environment
Demonstrated strong problem-solving skills, analytical skills and attention to detail
Excellent team and customer service orientation
by twochickswithasidehustle | Oct 12, 2023 | Uncategorized
100% remote opportunity, must be able to work PST hours.
Aston Carter is hiring for an experience call center quality assurance analyst for a long-term (2 year contract)!
Responsibilities:
• Monitors, evaluates and scores a specified number of calls each month for all clients in order to provide an overall assessment of call center and collections quality
• Enters quality scores into a database for tracking and reporting purposes
• Quality issues and performance measures are used to ensure the highest level of customer service to cardholders while maintaining the integrity of the client
• The Call Center QA Analyst will responsible for auditing, analyzing, and managing call center adherence
• This individual will collaborate with multiple departments and outsourced vendor call centers to ensure that sites are implementing the program with a high degree of accuracy and effectiveness that drives agent performance
• Audit representative samples of QA Evaluations in all call center locations to assess accuracy of scoring and analyze results to uncover areas of opportunity for improvement
• Develop and implement improvement strategies with call center QA teams and center leadership to drive performance improvement to Key Performance Indicators
• Manage communication between internal support departments and call center sites to ensure training and knowledge portal information is accurate and effective
• Maintain awareness of call volume trends and customer needs to make recommendations for process changes / improvements that will promote a superior customer experience
• Lead calibration meetings with key stakeholders to develop excellence in Quality Assurance evaluation assessments across the enterprise
• Analyze call trends through call listening to uncover customer concerns that drive the business and work with internal departments to develop solutions to improve the customer experience
• Attend project status and planning meetings as needed
Qualifications:
• Experience auditing and analyzing calls from a call center environment
• Proficient in MS Office suite, especially Excel
• Proficient in leading meetings, providing feedback, and coaching for improved performance
• Strong analytical skills
• Strong written and verbal communication skills
• Ability to work well in a fast paced collaborative work environment
• Exceptional project management skills and attention to detail
• Ability to manage priorities and set direction for a team
• Experience communicating with team members and key stakeholders and setting expectations
Benefits:
- Medical, Dental, Vision, 401k benefits package
Work Environment:
FULLY REMOTE – ideally candidate will be on the West Coast/work PST hours.
by twochickswithasidehustle | Oct 11, 2023 | Uncategorized
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