by twochickswithasidehustle | Jun 24, 2023 | Uncategorized
Description
American Specialty Health Incorporated is seeking a Data Entry Supervisor to join our Medical Necessity/ Benefits Administrations Team. This position will oversee MNA Examiners Level I, II, and III, Administrative Support Reps and Fax Administrators.
Salary Range
American Specialty Health complies with state and federal wage and hour laws and compensation depends upon candidate’s qualifications, education, skill set, years of experience, and internal equity. $48,000.00 to $55,000.00 Full Time Annual Salary Range.
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).
Responsibilities
- Supervises and is responsible for all Examiners, Senior Examiners and Administrative Support Reps.
- Monitors data entry staff production ensuring all Medical Necessity Review (MNR) Forms and ReOpen/Modification forms are processed within 48 hours.
- Assists staff in resolving problematic MNR Forms and ReOpen/Modifications within 24 hours of receipt.
- Trains new Examiners.
- Interacts with other Managers and Supervisors to ensure proper MNR Form processing.
- Researches MNR Forms that do not meet performance standards and identifies ways to improve the approval process.
- Monitors Administrative Support staff to ensure all queries are run on an hourly basis and files are delivered in a timely manner.
- Ensures Senior Examiners process ReOpen/Modification Forms, Referrals, Pink Sheets and complex MNR Forms within standards.
- Monitors performance of subordinates.
- Prepares a variety of employee production reports for Manager and Human Resources.
- Participates in the hiring and termination processes.
- Documents subordinates’ performance and provides feedback
- Coaches, counsels, and disciplines as necessary.
- Prepares and delivers performance evaluations.
Qualifications
- High school diploma required.
- Minimum two years’ experience in Specialty Health Care or related field; with at least one year in a supervisory capacity.
- Proficient in MS Office with experience in word processing and spreadsheets required.
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.
- Demonstrated accuracy and productivity in a changing environment with constant interruptions.
- Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
- 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.
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by twochickswithasidehustle | Jun 24, 2023 | Uncategorized
Description
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).
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) office setting.
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.
#LI-Remote
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by twochickswithasidehustle | Jun 24, 2023 | Uncategorized
Opal Group organizes live conferences catered to top executives and decision-markers. We provide high-quality events and information through unparalleled speaking sessions, workshops, and unique face-to-face networking opportunities.
We are looking for a detail-oriented, organized Data Entry Specialist with coding and analytics skills to join our team. The selected candidate will be responsible for entering and verifying huge amounts of data into our databases and systems, as well as applying their coding and analytics talents to enhance procedures and facilitate data-driven decision making.
Location: Remote 100%
Type of Employment: FT International consultant
Salary: (15-25k) subject to review
**Resume and Cover Letters only in English will be accepted**
Responsibilities:
- Enter and validate massive volumes of data in our databases and systems with precision.
- Utilize coding abilities to automate and optimize data entry processes
- Analyze and interpret data to enable data-driven decision making
- Work with cross-functional teams to identify and resolve data-related problems.
- Perform quality control procedures to guarantee data accuracy and completeness.
- Data management and analysis best practices and technology should be kept current.
Qualifications:
- Proven experience as a data entry specialist
- Extensive familiarity with at least one programming language, such as Python, R, or SQL.
- Knowledge of data analysis methods and instruments
- Outstanding attention to detail and ability to maintain a high level of precision.
- Solid organizational and time management competencies
- Excellent interpersonal and communication abilities
- Capability to operate in a fast-paced and dynamic workplace High school graduation or GED; a bachelor’s degree in a relevant discipline is preferred.
We encourage you to apply for this interesting position if you are a meticulous and organized individual with a passion for coding and statistics.
Disclaimer: Opal Group does not ask for any personal information or payments during the recruitment process.
Equal pay for equal work. EEO-ACA Compliance.
APPLY HERE
by twochickswithasidehustle | Jun 24, 2023 | Uncategorized
Job Description
This position can be work from home anywhere in the United States.
This exciting role is a fast-paced healthcare provider support role, intended to foster a positive provider experience by responding to provider inquiries, performing provider demographic updates and data audits, as well as
other provider initiatives.
– Manage the provider application / onboarding process and workflow within internal systems, ensuring information is collected and documented against workflow standards.
– Role is responsible for achieving production volume standards as defined by department management, and may only focus on specific aspects of the provider application / inquiry / data integrity processes (as defined by management)
– Role will be oriented to specific workflow supporting these tasks, and will generally follow these workflow expectations towards production expectations
– Respond to provider inquiries (Network Assistance Form tickets) spanning several types of inquiries (ex: status of their application)
– Role will conduct necessary independent research/outreach/steps to resolve provider situations within specified turnaround times
– Research provider requests for demographic data maintenance to validate accuracy of change request and/or if more information may be needed. Interact with provider to close information gaps where necessary.
– Work with internal cross-functional partners to submit information updates into various provider data systems
– Ensure accuracy of our provider applications, inquiry responses, and all corresponding data by engaging in related review and audit processes
– Role will interact with external providers and must demonstrate appropriate professionalism and communication standards
Pay Range
The typical pay range for this role is:
Minimum: 18.50
Maximum: 34.60
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit
jobs.CVSHealth.com/benefits
Required Qualifications
– 2-5 years data entry experience
– 1-2 years of working with provider data
– Strong Excel experience
Preferred Qualifications
– 1-2 years of PRMS (Salesforce)
– Strong communication, attention to detail, critical thinking, problem resolution and interpersonal skills.
– QNXT and ProData knowledge is preferred.
Education
– Associate degree or equivalent combination of education and experience
Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
APPLY HERE
by twochickswithasidehustle | Jun 24, 2023 | Uncategorized
Overview
Preference will be given to those who have experience with medical bills, ICD’s and CPT’s.
Joining ExamWorks as a Data Entry Associate may be the best decision you ever make.
We are seeking a medical billing-savvy professional who is keen to pick up on important details and looking to thrive in a fast-paced, growing environment.
This position is 100% remote. Candidate must be available to work 8:00am-5:00pm PST; Monday through Friday. Office equipment (office phone, screen, keyboard, mouse and virtual desktop) will be provided.
The hourly rate of pay for this role is between $16.00-$16.50.
If you’re ready for a change, let’s hear from you!
Responsibilities
ESSENTIAL DUTIES AND RESPONSIBILITIES TO PERFORM THIS JOB SUCCESSFULLY INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING:
- Gathers, organizes and prepares source documents for data entry into the appropriate system database.
- Reviews data for discrepancies, missing pages or information and resolves discrepancies by using standard procedures or returning incomplete documents to the team leader for resolution.
- Enters both alphabetic and numeric data from source documents into the proper system database.
- Reviews data entered against the original source documents for accuracy and corrects any data entry errors or duplications.
- Follows data program security practices and procedures at all times.
- Routinely secures information by completing database backup daily.
- Performs other varies clerical duties such as sorting, filing, emailing and proofreading as required.
- Maintains confidentiality of all personal and financial information at all times and in accordance with HIPPA regulations.
- Perform other duties as assigned.
Qualifications
EDUCATION AND/OR EXPERIENCE
High school diploma or equivalent required. A minimum of 6 months related experience; or equivalent combination of training and experience. Experience in a medical office preferred.
QUALIFICATIONS
- Must possess complete knowledge of general computer, fax, copier, scanner, and telephone.
- Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
- Must have a full understanding of HIPAA regulations and compliance.
- Must be a qualified typist with a minimum of 40 W.P.M.
- Ability to follow instructions and respond to managements’ directions accurately.
- Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.
- Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.
- Must be able to work independently, prioritize work activities and use time efficiently.
- Must be able to maintain confidentiality.
- Must be able to demonstrate and promote a positive team -oriented environment.
- Must be able to stay focused and concentrate under normal or heavy distractions.
- Must be able to work well under pressure and or stressful conditions.
- Must possess the ability to manage change, delays, or unexpected events appropriately.
- Demonstrates reliability and abides by the company attendance policy.
- Must maintain a professional and clean appearance at all times consistent with company standards.
ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers’ compensation insurance coverages.
Examworks offers a fast-paced team atmosphere with competitive benefits, paid time off, and 401k.
Examworks is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws.
Equal Opportunity Employer – Minorities/Females/Disabled/Veterans
APPLY HERE
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