by twochickswithasidehustle | Sep 11, 2023 | Uncategorized
Job Requisition ID:5158
Position Summary/Position
Under the general supervision of the Claims Oversight Supervisor, the Claims Oversight Auditor – FWA is responsible for auditing IEHP providers, giving feedback for billing process improvement and providing trending information to IEHP internal departments: Provider Services and Contracting. The Auditors will support the Compliance department by auditing providers to ensure the Plan meets Federal and State regulatory and contractual requirements for Fraud, Waste and Abuse.
Major Functions (Duties and Responsibilities)
- Audit claims to ensure providers are billing correctly.
- Provide feedback to Providers for billing process improvement through provider report cards.
- Validate the effective implementation of Corrective Action Plans (CAPs) through future audits to ensure compliance.
- Provide trending information to Provider Services and Contracting through reports and meetings to review data.
- Report any possible FWA to the Compliance department.
- Initiate and expand recovery opportunities by working with the Provider Resolution and Recovery department and the Reconciliation and Reporting department to develop standard audits.
- Promote teamwork and maintain effective working relationships with others throughout the organization.
Supervisory Responsibilities
Leading: Self
Experience Qualifications
Four (4) years auditing claims in a managed care environment including contract and financial DOFR interpretation. Two years (2) claims processing including Medi-Cal and Medicare.
Preferred Experience
Education Qualifications
High school diploma or GED required.
Preferred Education
Bachelor’s degree from an accredited institution preferred.
Professional Certification
Professional Licenses
Drivers License Required
Yes, must have a valid California Driver’s License.
Knowledge Requirement
Knowledge of Medi-Cal and CMS guidelines for claim payments.
Skills Requirement
Strong analytical and problem-solving skills. Must be able to review cause and impact of problems and recommend realistic solutions both in writing and in meetings. Microsoft Office including being able to manipulate large data sets in Excel files. Excellent oral and written communication skills.
Abilities Requirement
Ability to build successful relationships across the organization.
Commitment to Team Culture
The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.
Working Conditions
Office environment.
Physical Requirements
Keyboarding: Traditional – FREQUENTLY
Keyboarding: Other – FREQUENTLY
Use of computer mouse – FREQUENTLY
Hearing: One-on-One – FREQUENTLY
Hearing: In a group – FREQUENTLY
Hearing: Over the Telephone/Cell Phone – FREQUENTLY
Hearing: Conference Speakers/Video Calls/Radio Calls – FREQUENTLY
Turning/rotation of wrist or hand – FREQUENTLY
Communicate: Information/ideas verbally – FREQUENTLY
Alternate Sit/Stand or Walk at Will – FREQUENTLY
Near Visual Acuity – FREQUENTLY
Sitting – FREQUENTLY
Lighting – CONSTANTLY
Indoors – CONSTANTLY
Perform complex and varied tasks – FREQUENTLY
Develop and maintain positive work relationships – CONSTANTLY
Regular contacts: co-workers, supervisor – FREQUENTLY
Decision-making – FREQUENTLY
Lead/Influence Others – FREQUENTLY
Work review – FREQUENTLY
Rapid Pace of work – FREQUENTLY
Control of work pace – FREQUENTLY
Problem Solving – FREQUENTLY
Memory – FREQUENTLY
Understand and follow direction – FREQUENTLY
Regular and reliable attendance – CONSTANTLY
A reasonable salary expectation is between $57,948.80 – $73,860.80, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 6,000 and a team of more than 2,000 employees, IEHP provides quality, accessible healthcare services to more than 1.2 million members. And our mission and core values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and Make a Difference with us! IEHP offers a Competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and retirement plan.
by twochickswithasidehustle | Sep 11, 2023 | Uncategorized
- Job Information:
- Job Description:
- The “Chat Moderator” position is a part-time, remote, and flexible position that entails moderating the chat of the official Discord of The Mayeaux Foundation. This can include but is not limited to: 1) Deleting messages made by users that violate the rules of the Discord server. 2) Banning users that have multiple and repeat violations of the rules of the Discord server. 3) Muting users that have violated the rules of the Discord server. 4) Investigating reports made by users about violations of the rules of the Discord server.
- Pay Rate:
- The Pay Rate for this position is $12.50 per hour.
- The Pay Cycle is Weekly starting from Monday and ending on Sunday.
- Qualifications:
- Must be 18 years of age or older.
- Must have a High School Diploma or GED.
- Company Information:
- Equal Opportunity Employer Disclosure:
- No matter how you identify in this crazy world, The Mayeaux Foundation, will forever stand for fair and equal hiring practices and opportunities. The Mayeaux Foundation does not (will not) discriminate race, religion, ethnicity, sexual orientation, gender and sex identity. Come join us and help build a community that is worth lasting.
- About the Company:
- We, The Mayeaux Foundation, are a company based in Castle Rock, Colorado and we strive and stand for equality while managing our company. Our company offers services such as computer programming courses on a variety of programming languages. We plan on launching our own social media app and bank account.
by twochickswithasidehustle | Sep 11, 2023 | Uncategorized
JOB DESCRIPTION
Come join our amazing team and work remote from home!
The Vendor Management Specialist will be responsible for maintaining an existing network of third-party legal vendors, their company portfolios, building the relationship with such vendors and monitoring their continued compliance. Perform all duties in accordance with the company’s policies and procedures, all US state and federal laws and regulations, wherein the company operates. The target pay range for this position is $24.00 – $26.00 per hour.
What you’ll do:
Review and assess large volume of documentation to complete vendor review in accordance with regulatory compliance and internal policy.
Setup new legal vendors in accordance with the company’s rules and guidelines through a formalized process, ensure ongoing compliance through evaluating and reviewing vendor’s policies and procedures and other required documentations.
Be the first point of contact for vendors and provide updates and on-going communication by running status reports and communicating with vendors through various means to follow up on required compliance items.
Update internal system of record with most up to date records upon receipt.
Manage the vendor ongoing reviews and annual contract obligations.
Gather data for potential new service providers for onboarding consideration.
Monitor and track documents needed from third-party vendors to ensure compliance.
Contact third-party vendors by various means for required documents as needed.
Escalate matters to leadership team timely if unable to resolve issues.
Responsible for all tasks related to the ongoing oversight of an assigned pool of legal vendors and escalating any identified risks, material change in business operations, or privacy issues.
Process marketing and mortgage lending vendor invoices as needed.
Perform other duties and special projects as assigned.
What you’ll need:
High School Diploma or equivalent work experience; and/or some college preferred.
One or more years of mortgage servicing, auditing, finance, compliance or vendor management work experience.
Experience with Loan Origination and Loan Servicing Systems is a plus.
Proficient in MS office, in particular Word, Outlook, Excel and Visio.
Our Company:
Carrington Mortgage Services is part of The Carrington Companies, which provide integrated, full-lifecycle mortgage loan servicing assistance to borrowers and investors, delivering exceptional customer care and programs that support borrowers and their homeownership experience. We hope you’ll consider joining our growing team of uniquely talented professionals as we transform residential real estate. To read more visit: www.carringtonmortgage.com.
What We Offer:
Comprehensive healthcare plans for you and your family. Plus, a discretionary 401(k) match of 50% of the first 4% of pay contributed.
Access to several fitness, restaurant, retail (and more!) discounts through our employee portal.
Customized training programs to help you advance your career.
Employee referral bonuses so you’ll get paid to help Carrington and Vylla grow.
Educational Reimbursement.
Carrington Charitable Foundation contributes to the community through causes that reflect the interests of Carrington Associates. For more information about Carrington Charitable Foundation, and the organizations and programs, it supports through specific fundraising efforts, please visit: carringtoncf.org.
EEO/AAP Employer
by twochickswithasidehustle | Sep 11, 2023 | Uncategorized
JOB DESCRIPTION
Come join our amazing team and work remote from home!
The Property Preservation Specialist will coordinate and facilitate all activities related to the preservation of abandoned properties serviced by CMS, making certain they are quickly secured and remain protected during the default and foreclosure process. Partner with teammates and Vendor(s) to ensure needs are fulfilled timely and in accordance to department protocol. Perform all duties in accordance with the company’s policies and procedures, all US state and federal laws and regulations, wherein the company operates. The target pay for this position is $21.00 – $22.00 per hour.
What you’ll do:
Swift processing of incoming email and phone calls from Vendor(s) and business partners.
Loan reviews to identify Vendor or Mortgagee neglect.
Repair authorizations within authority limits.
Escalations and ad hoc requests.
Intake processing of City Citations and resolution follow up.
Review and reconciliation of control reports to ensure data integrity and servicing tolerance.
Assist with the development and implementation of departmental policies and procedures.
Bid processing. Validate that bids are reasonable, justified and necessary for conveyance.
Assist in processing excessive work flow and special projects.
Maintain consistent attendance to ensure fulfillment of essential duties and responsibilities.
Perform other duties as assigned.
What you’ll need:
High school diploma or equivalent required; Bachelor’s degree in related field preferred..
One (1) to two (2) years of related experience in default required.
Knowledge of Microsoft Suite required.
Knowledge of investor/insurer guidelines.
Knowledge of relevant and industry-specific computer software packages preferred.
Our Company:
Carrington Mortgage Services is part of The Carrington Companies, which provide integrated, full-lifecycle mortgage loan servicing assistance to borrowers and investors, delivering exceptional customer care and programs that support borrowers and their homeownership experience. We hope you’ll consider joining our growing team of uniquely talented professionals as we transform residential real estate. To read more visit: www.carringtonmortgage.com.
What We Offer:
Comprehensive healthcare plans for you and your family. Plus, a discretionary 401(k) match of 50% of the first 4% of pay contributed.
Access to several fitness, restaurant, retail (and more!) discounts through our employee portal.
Customized training programs to help you advance your career.
Employee referral bonuses so you’ll get paid to help Carrington and Vylla grow.
Educational Reimbursement.
Carrington Charitable Foundation contributes to the community through causes that reflect the interests of Carrington Associates. For more information about Carrington Charitable Foundation, and the organizations and programs, it supports through specific fundraising efforts, please visit: carringtoncf.org.
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