by twochickswithasidehustle | Oct 11, 2023 | Uncategorized
Conducts quality audits on medical billing, coding, receipting, and/or early out service functions performed by TruBridge employees or TruBridge contracted or sub-contracted staff. Discusses findings with the auditee and/or his/her supervisor(s). Summarizes findings and reports to appropriate Management at prescribed intervals.
Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:
- Conducts quality assurance audits on TruBridge employees, or sub-contracted staff.
- Present findings to the auditee.
- Summarize findings, and report to Management.
- Develop training materials.
- Conduct presentations to audited staff for further development.
- Assists in developing training plans for clients, TruBridge employees, and sub-contracted employees.
Minimum Requirements:
Education/Experience/Certification Requirements
- Excellent communication (written and oral) and interpersonal skills.
- Strong organizational, multi-tasking, and time-management skills.
- Must be detail oriented and able to follow through on issues to resolution.
- Must be able to act both independently, and as a team member.
- 3 years revenue cycle experience.
- Minimum of Intermediate level of Excel experience
- Comfortable speaking in a group setting
- Able to present audit findings in a confident and constructive manner.
- Able to teach billing compliance concepts to an individual or in a group setting.
Preferred Qualifications:
- Associates degree or higher or the years of experience in a related field.
Why Join Our Team?
If you join us, you will receive:
- Work remotely with a work/life balance approach
- Robust benefits offering, including 401(k)
- Generous time off allotments
- 10 paid holidays annually
- Employer-paid short term disability and life insurance
- Paid Parental Leave
by twochickswithasidehustle | Oct 11, 2023 | Uncategorized
Overview
We are CONNECTING HEALTH AND WEALTH. Come be part of remarkable.
How you can make a difference
With moderate supervision, and a strong knowledge of the company products and services the Service Assurance Specialist is responsible for performing quality reviews, identifying possible trends, and providing feedback and suggestions to improve performance to our Operations and Service Experience teams.
What you’ll be doing
- Complete Service Assurance Reviews for specific operations
- Provide unbiased summaries to internal and external parties
- Assist with projects related to Service Assurance, specifically doing so to help gain additional perspectives. This can include, but not limited to:
- Assisting with intern programs
- Identify trends through data
- Review procedures/processes to help Operations and Service Experience Teams succeed
- Reporting
- Assist Service Assurance Specialist II with conducting calibration sessions with internal and external partners and leadership
- Facilitate the process to ensure performance feedback is shared, coached, and or celebrated.
- Maintain current awareness of Company products and services
- Effectively monitor, audit and analyze the quality of the Operations and Service Experience teams
- Attend ongoing product and platform training sessions as needed
What you will need to be successful
- 2+ years customers service experience in finance, insurance, and/or benefits administation
- Moderate experience in excel (Vlookups, pivot tables, etc)
- Strong attention to detail
- Ability to work autonomously without constant supervision
- Preference given to candidates with the following experience:
- Classic Member Portal/Console/Salesforce
- Document Processing – Salesforce
- HSA Account Closures – Salesforce/Console
- Terminations- All Platforms
- Classic RA Plan Set-up / Classic RA Card Configuration – Classic Employer Portal/Salesforce
- V5 Reconciliations – V-5 Employer Site/NetSuite
- Excellent verbal and written communication skills
- Demonstrated ability to innovate and drive process improvement
- Quality Assurance experience a plus
- Ability to work well on cross functional teams
#LI-Remote
This is a remote position.
Salary Range
$16.50 To $23.25 / hour
Benefits & Perks
The compensation range describes the typical minimum or maximum base pay range for this position. The actual compensation offer is determined based on job-related knowledge, education, skills, experience, and work location. This position will be eligible for performance-based incentives as part of the total compensation package, in addition to a full range of benefits including:
- Medical, dental, and vision
- HSA contribution and match
- Dependent care FSA match
- Full-time team members receive a minimum of 18 days of annual PTO and 13 paid holidays per year
- Adventure accounts
- Paid parental leave
- 401(k) match
- Personal and healthcare financial literacy programs
- Ongoing education & tuition assistance
- Gym and fitness reimbursement
- Wellness program incentives
by twochickswithasidehustle | Oct 11, 2023 | Uncategorized
Senior Long Term Disability Claims Specialist
Date Posted: Sep 28, 2023
Location(s): Remote, US, 0
Company: MetLife
Job Location: 100% Virtual
Role Value Proposition:
At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The Senior LTD Claims Specialist evaluates long term disability insurance claims in accordance with plan provisions and within prescribed time service standards. In this role, the Senior LTD Claims Specialist is required to exercise independent judgment, critical thinking skills, exemplary customer service skills as well as effective inventory management skills.
Key Responsibilities:
•Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations while independently managing an assigned caseload of moderately complex claims which consists of pending, ongoing/active and appeal reviews
•Interacts and communicates effectively with claimants, customers, health care providers, attorneys, brokers, and family members during claim evaluations while addressing and resolving escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint or litigation support areas
•Compiles file documentation and correspondence requiring extensive policy and factual detail. Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available and collaborates effectively with both external and internal resources, such as physicians, attorneys, clinical and vocational consultants, as needed, to gather data such as medical/occupational information in order to ensure reasonable, thorough decision
•Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as needed and proficiently calculates monthly benefits due after elimination period, to include COLA, Social Security Offsets, and Rehab Return to Work benefits, and other non-routine payments
Essential Business Experience and Technical Skills:
Required:
•3+ years of LTD Insurance Claims experience
•Creative problem-solving abilities and the ability to think outside the box with independent judgement and decision making while relying on the available facts with the use of critical thinking and analysis when reviewing the information. Excellent interpersonal and communication skills in both verbal/written form and excellent customer service skills proven through internal/external customer interactionswith demonstrated conceptual thinking, risk management, ability to handle complex situations effectively with organizational and time management skills
Preferred:
•Bachelor’s degree and knowledge of STD/FML, state leave laws, worker’s compensation, ERISA, and Social Security
Business Category
GCSO
Number of Openings
3
At MetLife, we’re leading the global transformation of an industry we’ve long defined. United in purpose, diverse in perspective, we’re dedicated to making a difference in the lives of our customers.
MetLife:
MetLife, through its subsidiaries and affiliates, is one of the world’s leading financial services companies, providing insurance, annuities, employee benefits and asset management to help its individual and institutional customers navigate their changing world. Founded in 1868, MetLife has operations in more than 40 countries and holds leading market positions in the United States, Japan, Latin America, Asia, Europe and the Middle East.
We are one of the largest institutional investors in the U.S. with $642.4 billion of total assets under management as of March 31, 2021. We are ranked #46 on the Fortune 500 list for 2021. In 2020, we were named to the Dow Jones Sustainability Index (DJSI) for the fifth year in a row. DJSI is a global index to track the leading sustainability-driven companies. We are proud to have been named to Fortune magazine’s 2021 list of the “World’s Most Admired Companies.”
MetLife is committed to building a purpose-driven and inclusive culture that energizes our people. Our employees work every day to help build a more confident future for people around the world.
The wage range for applicants for this position is $44,300.00 to $59,100.00 per year. This role is also eligible for annual short-term incentive compensation. MetLife offers a comprehensive benefits program, including healthcare benefits, life insurance, retirement benefits, parental leave, legal plan services and paid time off. All incentives and benefits are subject to the applicable plan terms.
by twochickswithasidehustle | Oct 11, 2023 | Uncategorized
As a Data Entry Agent, you will be joining our Data Enrichment team to support the execution of licensing in the healthcare field for our clients. You’ll be held to a high quality of work standard and will be a contributor to the quality control process.
What will you really do?
Responsible for reviewing and completing Enrichment Tasks as defined and trained by the client
Primary work will be application data entry, vendor resource verifications, board certifications, and following up with various state boards for statuses
Responsible for timely and quality execution of tasks
Why we think this job is great:
It’s a full-time, 100% remote position where you’ll work from home.
You’ll have clear goals and the training resources you need to deliver. How you execute and deliver is up to you.
by twochickswithasidehustle | Oct 11, 2023 | Uncategorized
WW is looking for candidates to help change people’s lives. We are a global wellness technology company inspiring millions of people to adopt healthy habits for real life. We do this through engaging digital experiences, face-to-face workshops and sustainable programs that encourage people to move more, shift their mindset and eat healthier while enjoying the foods they love. By drawing on over five decades of experience and expertise in behavioral science, we build communities in order to deliver wellness for all.
Who we are
The role of the Senior Member Support Specialist is to directly engage with current and potential members to provide guidance, support, and motivation through Social Media channels and internal community message boards. Assisting members with program, membership, and technical inquiries.
What you will do
Customer Service:
- Serve as a company ambassador, taking ownership of member issues and/or questions. Escalating issues to the appropriate team and ensures prompt follow up accordingly to provide full member resolution.
- Deliver a “best-in-class” member support experience to drive satisfaction and brand loyalty
- Establish rapport with members by creating a personalized experience through active listening to understand members’ personal wellness and weight health goals to provide tailored recommendations and encouragement.
- Demonstrate an ability to display patience, empathy, and strong listening skills while ensuring member needs are fulfilled in a timely and satisfactory fashion.
- Handle high stress interactions and situations and is able to de-escalate appropriately using empathy and ownership.
- Have expert knowledge and understanding of WeightWatchers, including program, in-app experience, and studio offerings..
- Troubleshoot and problem solve technical issues or concerns for members by providing solutions, recommendations, gathering of sensitive information, and/or detailed app information with a sense of urgency while using a positive and empathic approach at all times.
- Be adaptable and willing to learn new tools, technologies, and program innovations.
Social Media/Community:
- Follow brand voice guidelines when responding quickly and professionally to social channel engagements through our aggregated platform and organically (as needed) on Facebook, X, Instagram, YouTube, Tik Tok, and other platforms.
- Fuel engagement on social media platforms by interacting with our community through positive and informative comments
- Assist on all social media campaigns and initiatives, providing insight to member response through tagging and organic channel monitoring
- Proactively identify social trends and/or sentiment shifts, escalating to proper stakeholders when needed
- Complete thorough review of social media posts to ensure that all inappropriate content is removed in a timely manner
- Serve as a brand expert, providing accurate and effective responses for paid ads to support new member enrollment
- Moderate internal member community, Connect
- Review and respond, when appropriate, to member posts and comments
- Review all flagged content to ensure adherence of community guidelines, remove content as needed.
- Alert stakeholders in situations where significant harm or distress is disclosed on social media or Connect community
Who you are
- 5+ years of experience in a high-volume customer service position, or equivalent
- 1+ years of professional experience within Social Media channels (Facebook, Instagram, X, TikTok)
- Exceptional interpersonal, verbal and written communication skills
- Thrive in a collaborative team environment, while also able to work independently
- Possess a growth mentality, eager to adapt and be flexible in an ever-changing environment
- Strong comprehension skills with the ability to recognize and resolve issues, while maintaining a consistent brand voice
- Superior organizational, communication, and time management skills
- Strong emotional intelligence and resilience
- Proficiency in G-suite and/or Microsoft Office and other web-based applications
- Ability to work a flexible schedule including evening, weekends and holidays
- HS Diploma/GED equivalent
Preferred Qualifications
- Proficient German and/or French language skills, both written and verbal
- Proficiency in CXM platforms (Sprinklr, Conversocial, Hootsuite..)
This job description is not intended to be an exhaustive list of all duties or responsibilities associated with the job. Other job-related duties may be assigned.
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