by twochickswithasidehustle | May 8, 2023 | Uncategorized
Job Type
Contract
Industry
Federal Government
Language
English
Work Arrangement
Remote
Date Posted
Friday, May 5, 2023
Salary
16.00 – per Hour
Specialization
Administration and Clerical
Security Clearance
Reliability
Location
Calgary, AB
Opportunity Number
8059
Job Description
Our Federal Government client at Canadian Energy regulator are looking for a Senior Data Entry Operator to join their team. This is a 1 year contract starting May 25th, 2023 to April 30th, 2024. The position is 2 days a week (no set days, but a set, predictable schedule is required), 7.5 hours daily (exclusive of lunch breaks) scheduled between 8:30 am and 5:00pm MST.
This position is based in Calgary, AB but can be remote from anywhere in Canada. (Only local candidates will be asked to come into the office).
Responsibilities:
Entering data from various sources and formats into an electronic computer according to pre-described format
Verifying data entered by checking printouts for errors and correcting as required
Communicate promptly with department Coordinators regarding any issues or obstacle beyond the Data Entry Operator’s control that may hinder the Data Entry Operator or its resources ability to complete a task and /or deliverables as outlined in this statement of work
Assist department Coordinator and resources in resolving issues that may arise during the performance of the work
Qualifications Required:
3 years of Data Entry experience
Must have a valid Reliability Security Clearance
Experience working with MS Office (Word, Excel, Outlook)
Secondary High School Diploma or Equivalence
APPLY HERE
by twochickswithasidehustle | May 8, 2023 | Uncategorized
Job Summary:
Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and care coordination for members enrolled with a CareSource Management Group line of business, as well as monitoring the delivery of healthcare services in a cost effective manner.
Essential Functions:
Complete prospective, concurrent and retrospective review of acute inpatient admissions, post acute admissions, elective inpatient admissions, outpatient procedures, homecare services and durable medical equipment
Coordinate care and facilitate discharge to an appropriate level of care in a timely and cost-effective manner
Refer cases to CareSource Medical Directors when clinical criterial is not met or case conference is needed/appropriate
Maintain knowledge of state and federal regulations governing CareSource, State Contracts and Provider Agreements, benefits, and accreditation standards
Identify and refer quality issues to Quality Improvement
Identify and refer appropriate members for Care Management
Document, identify and communicate with Health Partners, Care Managers and Discharge Planners to establish safe discharge planning needs and coordination of care
Provide guidance to non-clinical medical management staff
Provide guidance to and assist with oversight of LPN and LISW medical management staff
Attend medical advisement and State Hearing meetings, as requested
Assist Team Leader with special projects or research, as requested
Perform any other job-related instructions, as requested
Education and Experience:
Completion of an accredited registered nursing (RN) degree program is required
Minimum of three (3) years clinical experience is required
Med/surgical, emergency acute clinical care or home health experience is preferred
Medical management experience is preferred
Medicaid/Medicare/Commercial experience is preferred
Competencies, Knowledge and Skills:
Basic data entry skills and internet utilization skills
Working knowledge of Microsoft Outlook, Word, and Excel
Effective oral and written communication skills
Ability to work independently and within a team environment
Attention to detail
Familiarity of the healthcare field
Proper grammar usage and phone etiquette
Time management and prioritization skills
Customer service oriented
Decision making/problem solving skills
Strong organizational skills
Change resiliency
Licensure and Certification:
Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice is required
MCG Certification is required or must be obtained within six (6) months of hire
Working Conditions:
General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$58,000.00 – $92,800.00
Compensation Type (hourly/salary):
Hourly
Organization Level Competencies
Create an Inclusive Environment
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
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by twochickswithasidehustle | May 8, 2023 | Uncategorized
Remote
Position Summary:
The Revenue Cycle Claims Specialist will be responsible for building and maintaining collaborative and productive relationships within the organization relating to Revenue Cycle Management, managing revenue cycle projects, driving performance in operations related to reimbursement and providing direction and oversight of processes impacting cash collections.
Job Responsibilities:
Serves as a source of knowledge for the designated revenue cycle function
Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement for the designated revenue cycle function.
Responsible for developing appropriate workflows and tracking for the designated revenue cycle function.
Establishes an ongoing working relationship with other departments impacting revenue cycle performance.
Works closely with various vendor operations teams (Prior authorization, Claims and Appeals) to oversee operations activity that directly impacts the revenue cycle to accurately process actions in a timely manner for optimal reimbursement.
Tracks outcomes of payment resolution, appeals, and negotiated claims to ensure goals are met.
Leads weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities.
By continually reviewing and monitoring billing and coding changes, researches, evaluates, and interprets guidance from a variety of sources to determine departmental actions.
Coordinates with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance.
Develops goals and metrics to link department and revenue cycle initiatives with the organization’s strategy.
Develops, manages and monitors successful completion of implementation and project plans.
Acts as an educator on performance improvement requirements in operations and methodologies to related teams and departments.
Continuously seeks new and creative technologies that help identify and guide improvement opportunities that align with overall company success.
Qualifications:
At least 3 years of experience in medical billing and Insurance collections
At least 3 years of experience with Prior Authorization requirements, payer utilization management policies and Appeals
Knowledge of CPT/HCPCS. ICD-10, modifier selection and UB revenue codes
Bachelor’s Degree
Healthcare related field of study or equivalent experience.
Required Knowledge, Skills and Abilities:
Proficiency with medical billing systems, Microsoft Excel, medical terminology and basic procedure coding knowledge.
Knowledge of medical terminology and abbreviations, and health care nomenclature and systems.
Strong communication (verbal and written), organizational, problem solving and team player skills.
Ability to navigate across multiple customer demands and balance competing priorities successfully.
Ability to analyze, identify and articulate identified trends and report trends succinctly in a clear and concise manner.
Ability to solve problems using critical thinking skills.
Maintains confidentiality of sensitive information.
Analytical skills required.
Ability to think critically and identify the impact across the revenue cycle with a solution oriented approach.
Ability to develop, implement and produce analysis and reports
Pay Range: The pay range for this role is $25-$30/hr. Actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.
LI-REMOTE
The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.
Colorado
$76,000—$114,000 USD
APPLY HERE
by twochickswithasidehustle | May 8, 2023 | Uncategorized
Remote
Position Summary:
The Clinical Data Specialist/Coder – Pre Claims is responsible for the accurate and timely work to effect filing of Insurance claims. Qualified individual will demonstrate clinical claims detailed knowledge, coding and delivering resolutions to missing/ incomplete order data. This person will identify invalid clinical values to help drive clean claims and revenue pull through on all products and services.
This position will support the Revenue Cycle function and report to the Front End Manager of Revenue Cycle.
Essential Duties and Responsibilities:
- Identify order and reimbursement deficiencies – both clinical and code related
- Investigate and correct, where appropriate, deficient clinical claim information
-Identify and escalate missing, and sometimes invalid, clinical order data for timely contact resolution with supporting cross functional teams
- Partner with multiple internal cross-functional teams and successfully manage multiple product projects simultaneously.
-Research claim and account information using various systems and portals internal and external
-Stay current with relevant medical billing regulations, rules and guidelines
-Complete position responsibilities within the appropriate time frame while adhering to quality standards
-Ability to interact with various insurances/ third party payors accurately and timely to ensure that authorizations are obtained and necessary documents are available for claim support based on internal and external policies and regulations
- Participate in clinical data management activities including leading clinical data initiatives, analysis and optimization of our clinical data capture workflows
- Translate data into meaningful information and knowledge that supports decision making or determining action that drives performance improvement and quality
- Identifies and uses internal and external sources of information for benchmarking and comparative performance, which includes networking with clinical communities, researching literature and agencies, and staying current on new indicators and other requirements
-Act as SME for multiple purposes where coding and clinical operations data is relevant
- Support and comply with the company’s policies and procedures.
-Maintains strictest confidentiality, and adheres to all HIPAA guidelines/regulations
- Regular and reliable attendance.
- Ability to work on a mobile device, tablet, or in front of a computer screen and/or perform typing for approximately 90% of a typical working day.
-Perform analytical and special projects, prepare ad hoc reports/data queries as may be assigned/requested, working with leadership
Qualifications:
Minimum Qualifications:
- Bachelor degree in relevant field is preferred
- 3+ years professional coding experience with current certification including International Classification of Diseases (ICD-10) and Coding Procedure Terminology (CPT) and HCPCS coding.
- Authorization to work in the United States without sponsorship.
- Certified coder designation/ certification by NHA, AHIMA or AAPC
- Superior organization skills, detail oriented, and ability to be persistent and follow through
- Problem-solving, ability to adapt, flexibility in approaches to accomplishing tasks, and ability to independently arrive at creative solutions to problems
- Excellent communication skills, both verbal and written, particularly the ability to convey technical information in an accessible and understandable manner
- Ability to work both independently and in collaboration with individuals from various disciplines
Preferred Qualifications:
- 5+ years of experience coding in the medical/healthcare billing area- Lab a plus
- Any years of experience in the revenue cycle function to include third party payer experience.
- Thorough understanding of professional coding, documentation, medical billing processes.
- Deep familiarity with payer/insurance Medical policy, Prior Auth, claims, appeals and reimbursement processes.
- Knowledge and familiarization with Medicare billing regulations and reimbursement methodologies for Laboratory
Pay Range: The pay range for this role is $30.00-$38.00. Actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.
LI-REMOTE
The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.
Colorado
$64,800—$97,200 USD
APPLY HERE
by twochickswithasidehustle | May 8, 2023 | Uncategorized
REMOTE, UNITED STATES /
OPERATIONS – SHARED SERVICES /
CONTRACT
/ REMOTE
APPLY FOR THIS JOB
At Zotec Partners, our People make it happen.
Transforming the healthcare industry isn’t easy. But when you build a team like the one we have, that goal can become a reality. Our accomplishments can’t happen without our extraordinary people – those across the country who make up our diverse Zotec family and help make this company a best place to work.
Over 20 years ago, we started Zotec with a clear vision, to partner with physicians to simplify the business of healthcare. Today we are more than 1,000 employees strong and we continue to use our incredible talent and energy to bring that vision to life. We are a team of Innovators, Collaborators and Doers.
Zotec Partners, a leading high-tech healthcare company providing complete physician revenue cycle management through innovative solutions, is looking for a Central Ops Processor who embodies our core culture of: passion, persistence, people, predictability and perspective.
As a Central Ops Processor, you will be responsible for matching paper insurance claim forms and appeals with necessary documentation, generating Collection files, as well as special projects as assigned.
What will you bring to Zotec:
- 1+ years’ experience in an office environment, preferably a medical billing environment
- Familiarity with medical billing processes
- Proficient in Microsoft Windows and email
- Able to communicate effectively through emails and correspondence
- High school diploma or equivalent
At Zotec, you will enjoy a network of highly experienced professionals in an environment where you can operate with autonomy yet have the resources and backing of other professionals in a similar role. Entrepreneurial and enterprising is the spirit of our team. If you are an original thinker and opportunity seeker, if you’d like to use your strong business savvy in a new way, we’d like to talk to you! Apply Now!
APPLY HERE
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