by twochickswithasidehustle | Oct 15, 2023 | Uncategorized
WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide plans and services that work for our members, no matter their circumstances.
It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.
The Provider Appeals Coordinator is responsible for managing the overall coordination, investigation, documentation and the resolution process of medical claims appeals and ensuring compliance with policies and procedures under company, MassHealth, Commonwealth Care contracts and NCQA standard guidelines.
Our Investment in You:
Full-time remote work
Competitive salaries
Excellent benefits
Key Functions/Responsibilities:
The Appeals Coordinator is competent in the following related responsibilities but may not be expected to be responsible for all of the functions simultaneously. The Appeals Coordinator may have a major focus on administrative appeals; while also providing clinical edit claims review support to the dept. Nurse Coordinator.
Maintains the Provider Appeals process and workflow toward process improvement; provider satisfaction and claims payment accuracy under MassHealth, Commonwealth Care contract requirements and NCQA accreditation guidelines where applicable
Establishes and ensures workflow continuity with the Plan in the areas of Claims Processing; Provider Servicing and Health Services
Responsible for the preparation and research of data and records required to assure timely processing of administrative appeals in compliance with company guidelines
Produces administrative appeals reports for management and nurse review, as well as ad hoc reports
Ensures the quality and organization of administrative appeal documentation
Provides claims review and interpretation of appropriateness of administrative appeal
Coordinates management of provider appeals with other departments and tracks through resolution
Ensures continuous improvement of the administrative appeals process and establishment of related workflows as needed in response to Plan policy and procedure or claims processing changes
Responds to, documents, investigates and facilitates the resolution of provider administrative appeals, including the writing, review, and approval of resolution letters
Identifies and communicates trends
Works with other departments to create and implement improvement plans
Qualifications:
Education:
Bachelor’s degree in Health Care Administration, related field or, an equivalent combination of education, training and experience is required
Certification in Medical Coding (CPC Certification) preferred
Experience:
2 or more years’ experience working in a managed care organization required
Experience with claims processing and appeals required
Knowledge of Medical Coding, Medical terminology, CPT‚ ICD9‚ and HCPCS codes required
Project Management experience highly desirable
Competencies, Skills, and Attributes:
Demonstrated ability to successfully plan, organize and manage projects within a managed care organization
Strong working knowledge of Microsoft Office products required
Detail oriented, excellent verbal and written communication skills essential
Ability to work in both team and independent settings at all levels of the organization
Good customer service skills essential
Experience working with diverse populations preferred
Knowledge of health care terminology helpful
Effective collaborative and proven process improvement skills
Strong oral and written communication skills; ability to interact within all levels of the organization
A strong working knowledge of Microsoft Office products
Demonstrated ability to successfully plan, organize and manage projects
Detail oriented, excellent proof reading and editing skills
About WellSense
WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances.
by twochickswithasidehustle | Oct 15, 2023 | Uncategorized
About iRhythm:
iRhythm is a leading digital healthcare company focused on the way cardiac arrhythmias are clinically diagnosed by combining our wearable bio sensing technology with powerful cloud-based data analytics and Artificial Intelligence capabilities. Our goal is to be the leading provider of ambulatory ECG monitoring for patients at risk for arrhythmias. iRhythm’s continuous ambulatory monitoring has already put over 4 million patients and their doctors on a shorter path to what they both need – answers.
About this role:
iRhythm is seeking a Data Privacy Specialist to join our growing Global Privacy Compliance Team. The Data Privacy Specialist will be responsible for supporting the implementation of operational aspects of the global privacy compliance strategy and managing some day-to-day privacy operations activities, including data subject rights requests, incident process and review, and training. Our ideal teammate has a desire to grow professionally and a commitment to being a compliance business partner. This role will be a part of a fast-paced, results-driven environment that fosters diversity and engagement, employee growth and career development.
Key Responsibilities
Assist with the implementation of One Trust Data Privacy compliance platform, and manage the ongoing daily business needs;
Manage personal data requests (including medical records and billing reports) & associated documentation, including collaboration with relevant business function team members;
Undertake Data Privacy Incident triage and management, investigations & documentation; escalate as per policy;
Assist with the completion and ongoing maintenance of organizational Records of Processing Activity (RoPAs);
Provide Data Privacy guidance and support to routine customer, patient and colleague questions, and escalate where appropriate;
Assist in the development and maintenance of Data Privacy training materials and business unit specific training, including Data Privacy training plans. Monitor employee compliance with required training;
Conduct ad hoc training sessions for employees on the importance of data privacy and how to maintain compliance with data privacy policies and procedures;
Provide support with audits, both internal and external;
Provide vendor contracting support to internal Procurement team;
Manage and update Data Privacy documentation as required, including policies, SOPs and DOPs;
Support audit teams, as requested, to conduct privacy related audit projects;
Assist in conducting data privacy risk and impact assessments (e.g. DPIAs);
Assist with conducting monitoring plans for Data Privacy risks, in line with iRhythm’s privacy compliance program; and
Assist with Data Protection Officer (DPO) reports and ensure accountability is managed appropriately.
Other related duties as may be assigned.
About you:
Bachelor’s degree is required.
At least 2 years professional experience is required; Experience in compliance function, healthcare, medical device or legal environment is preferred.
Experience with data privacy management platforms, such as OneTrust is desirable.
Experience with data privacy operations and documentation, including RoPAs. DPIAs, data subject requests, etc is desirable.
Strong analytical skills to identify patterns and trends, as well as potential threats and mitigation measures, are essential.
Excellent communication skills to work effectively with other members of the Privacy, IT and Legal teams are essential.
What’s in it for you:
This is a full-time position with competitive compensation package, excellent benefits including medical, dental, and vision insurance (all of which start on your first day), paid holidays, and PTO!
iRhythm also provides additional benefits including 401K (with company match), an Employee Stock Purchase Plan, paid parental leave, pet insurance discount, Cultural Committee/Charity events, and so much more!
FLSA Status: Exempt
As a part of our core values, we ensure a diverse and inclusive workforce. We welcome and celebrate people of all backgrounds, experiences, skills, and perspectives. iRhythm Technologies, Inc. is an Equal Opportunity Employer (M/F/V/D). We will consider for employment all qualified applicants with arrest and conviction records in accordance with all applicable laws.
Make iRhythm your path forward.
LI-SB1
LI-Remote
Actual compensation may vary depending on job-related factors including knowledge, skills, experience, and work location.
Estimated Pay Range
$71,600—$104,100 USD
by twochickswithasidehustle | Oct 15, 2023 | Uncategorized
Train AI Chatbots, earn money. It’s that simple.
Are you interested in helping to train AI models to become better writers?
Help train cutting-edge AI chatbots on Remotasks! Earn up to an equivalent of $15 per hour while working remotely and choosing your own hours.
Click “Start earning today!” to join thousands of others building the future of AI!
Details
– You can start right away on our website – onboard in less than an hour!
– Earn money for short writing and evaluation assignments, up to an equivalent of $15 or even $20 per hour based on your skill and consistency.
Hours are flexible – work whenever you’d like!
NOTE: This opportunity is only available to proficient English speakers in the following states and territories in the United States: Alabama, Delaware, Florida, Georgia, Guam, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Montana, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.
by twochickswithasidehustle | Oct 15, 2023 | Uncategorized
Compensation: Competitive hourly rate
Location: Anywhere, remote
Employment Type: Part time or full time
Do you want to reach and make a positive impact on millions of people?
Do you love crafting email campaigns and push notifications that convert?
Are you excited about the idea of taking on a 200,000+ person email list?
Hiring deadline: Ongoing
This job might be for you if you:
- like being able to set your own hours and work from home
- don’t like drumming up new business or chasing down clients
- like exercising your creativity and experimentation
- like having responsibility
- like working collaboratively
- like having a dependable, reliable stream of work
- want to make the world a better place
- are comfortable with a fast-changing environment.
You should NOT take this job if you:
- are looking for another client to add to your list of clients
- have a strong need/desire for in-person social interaction at work
- like following instructions and being told what to do
- don’t like needing to come up with ideas
- are not comfortable in a fast-changing environment
- don’t have a real interest or experience in online education.
- don’t have experience with email marketing.
ABOUT US
FluentU is an online education company that helps people learn languages with real-world videos, including movie trailers, music videos, news and inspiring talks. We have a popular website, iOS app, and Android app. Founded in 2011, we’re a profitable, stable company with long-term focus, and we’re proudly self-funded.
We get millions of visitors per month on our website and have hundreds of thousands of people on our email list.
This is a unique opportunity to be the primary person behind our email list and mobile push strategy.
JOB DESCRIPTION
As our email marketer, you would be responsible for:
- Writing emails and mobile push notifications
- Setting up funnels
- Conceiving of landing pages and offers that convert
- Managing holiday/seasonal promotions
- Increasing email opt-ins
- Conversion rate optimization
- Setting up marketing automation
- Analyzing campaign performance
You do NOT need to be able to design or code (other team members will handle that).
You would work closely with the founder of FluentU (https://www.linkedin.com/in/alancpark/).
HOW WE WORK
We’re a 100% distributed/remote team. Here’s a little bit more about how we work:
QUALIFICATIONS
Our ideal candidate:
- has several years of email marketing experience
- has a quantitative and analytical bent
- loves experimenting and is results oriented
- has a bias for action
- is a fast learner who is willing to put in the work to figure it out
- writes and speaks English like a native speaker
- is terrific at written communication
- has a deep interest in language learning or online education
- is able to work a minimum of 20 hours per week
by twochickswithasidehustle | Oct 15, 2023 | Uncategorized
About Gusto
Gusto is a modern, online people platform that helps small businesses take care of their teams. On top of full-service payroll, Gusto offers health insurance, 401(k)s, expert HR, and team management tools. Today, Gusto offices in Denver, San Francisco, and New York serve more than 300,000 businesses nationwide.
Our mission is to create a world where work empowers a better life, and it starts right here at Gusto. That’s why we’re committed to building a collaborative and inclusive workplace, both physically and virtually. Learn more about our Total Rewards philosophy.
Gusto is looking for a team oriented, experienced Workforce Administrator who loves strategically thinking outside the box to solve complex contact center quandaries. You will report into the Workforce Management (WFM) team and be an integral part of scaling the team to propel Gusto to the next level of success.
The Workforce Management Administrator helps deliver exceptional customer experiences and achieve overall business objectives by maintaining/improving Gusto’s agent-facing solutions, and the productivity/performance reporting workstream. The Administrator will lead the program management for the WFM optimization, telephony, and CRM tools, implementations and upgrades as well as all training needs within the department. Other responsibilities include fulfilling management, operational, procedural, and ad-hoc analysis duties.
Here’s what you’ll do day-to-day:
Coordination of technology issues and reporting improvements
Primary ownership of strategy/program management for IVR/Bliss as it ties into WFM tools/Scheduling Tool and collaborator for development and usage of workload delivering tools
Monitoring IVR use and making recommendations to improve customer and agent experience
Handle reporting requests from the management team including requirements gathering, resolving expected impact, prioritization, process/report development and ensures consistency and relevancy
Prioritization of new functionality and enhancements and deprecating old or unused product functionality
Improving and maintaining routing strategies/in-queue messaging and new media channels [incl. new modalities]
Training on Scheduling tool as well as quality audits
Off hours support for high-severity issues as needed
Other duties and responsibilities as assigned
Stay current on internal policies and procedures
Effectively communicate with peers and those we support in the business to ensure high quality and timely completion of work requests
Respond to management requests to produce “what if” scenarios
Here’s what we’re looking for:
5 years relevant Workforce Management experience working in a contact center environment
Prior experience with workforce optimization software
Experience working in a global environment
Experience leading remote team
Experience working with third party vendors
Strong data analysis experience capturing, storing and reporting historical statistics
Shown NICE IEX, NICE CXOne, and Salesforce knowledge
Strong analytical skills and prioritization skills, as well as a well-developed sense of urgency and follow-through; ability to handle multiple projects under pressure
Excellent written and oral communication skills that can be demonstrated through the use of email, chat and all other forms of media channels
High-caliber interpersonal skills, presentation/facilitation skills and ability to work productively with all levels in an organization while maintaining a positive demeanor
Optimistic leadership: you are passionate about making magic for our community. You realize the vital role that staffing plays in appropriately cultivating positive experiences with our customers, allowing for positive support experiences every time, all the time
Our cash compensation range for this role is $107,000/yr to $141,000/yr in Denver & most major metros. Final offer amounts are determined by multiple factors, including candidate location, experience and expertise, and may vary from the amounts listed above.
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