by twochickswithasidehustle | May 2, 2023 | Uncategorized
About this job
Description
The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims, submitted either via paper or electronically. The Claims Processing Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
Responsibilities
Claims Processing Representative 2:
Determines whether to return, deny, or pay claims following organizational policies and procedures
Decisions are typically focus on interpretation of area/department policy and methods for completing assignments
Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction
Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion
Required Qualifications
Medical Claims Processing and/or Medical Coding/Billing
Provider Customer Service experience
Proficiency in all Microsoft Office -Basic understanding using Word, Excel, and Outlook
Preferred Qualifications
Medical Coding certification
Quality background
Additional Information
Hours: Monday – Friday 8:00 AM to 4:30 PM with ability to support business as needed for overtime.
Additional Information
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Work at Home Guidance
To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
APPLY HERE
by twochickswithasidehustle | May 2, 2023 | Uncategorized
NO EXPERIENCE NECESSARY- WE WILL TRAIN
Do you want a career where you can make a difference? Allegiance is a growing company with hometown values that is looking for dynamic candidates to join the team! A positive, team-oriented environment is provided with opportunities for advancement.
Allegiance offers full-time positions with evenings, weekends, and holidays off and a multi-faceted benefits package.
We pride ourselves in having a reputation for top-notch customer service. Make a difference. Start your career with Allegiance today!!
POSITION RESPONSIBILITIES:
The UM-IP Review Tech is responsible for the coordination and collaboration of the Inpatient Authorization process. The incumbent is expected to provide courteous and prompt preparation and responses for all referrals.
The incumbent is expected to communicate professionally with peers, supervisors, subordinates, vendors, customers, and the public, and to be respectful and courteous in the conduct of this position.
ESSENTIAL JOB FUNCTIONS:
Essential job functions include the following. Other functions may be assigned as business conditions change.
Reviews Inpatient Authorization requests received
Determine if additional information is necessary. Contact provider and obtain additional information.
If medical necessity not met
Prepare package for clinical review
Initiate and continue direct communication with health care providers involved with the care of the member to obtain complete and accurate information.
Review IMR responses for accuracy and completeness and correspond with clinical staff as necessary.
Coordinate with UM-IP Nurses to determined accurate documentation and clinical oversight on required reviews.
Coordinate peer to peer appointments.
Prepare & distribute Inpatient Authorization response letters in required timeframes.
Meets service standards for decision turn-around times and written correspondence
Initiate referrals for Case Management when appropriate
Contributes the daily workflow with regular and punctual attendance.
Maintain general clinical knowledge and skills through the attendance of available Internet education or conference calls, written works, or other similar resources and share knowledge with others
Ensure accurate coding using current CPT and ICD codes and document all information accurately.
Assist in managing incoming fax queue
Initiate and receive phone calls related to Inpatient admissions and continued stay reviews.
NON-ESSENTIAL JOB FUNCTIONS:
Performs related or other assigned duties as required or directed.
SUPERVISION EXERCISED:
None
PHYSICAL WORKING CONDITIONS:
Physical requirements are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
APPLY HERE
by twochickswithasidehustle | May 2, 2023 | Uncategorized
Position Overview:
At Zelis, the Itemized Bill Review Facility Reviewer is responsible for analyzing facility inpatient and outpatient claims for Health Plans and TPA’s to ensure adherence to proper coding and billing guidelines. They will work closely with Hospital Bill Review and Concept Development staff to efficiently identify billing errors and adhere to policies and procedures for claims processing. This is a production-based role with production and quality metric goals.
Key Responsibilities:
Conduct detailed review of hospital itemized bills for identification of billing and coding errors for all payor’s claims
Contribute process improvement and efficiency ideas to team leaders and in team meetings
Translate client reimbursement policies into Zelis coding and clinical concepts
Understand payor policies and their application to claims processing
Prepare and upload documentation clearly and precisely identifying findings
Accurately calculate/verify the value of review and documentation for claim processing
Monitor multiple reports to track client specific requirements, turnaround time and overall claims progression
Maintain individual average productivity standard of 10 processed claims per day
Consistently meet or exceed individual average quality standard of 85%
Ability to manage a variety of claim types with charges up to $500,000
Collaborate between multiple areas within the department as necessary
Follow standard procedures and suggest areas of improvement
Remain current in all national coding guidelines including Official Coding Guidelines and AHA Coding Clinic and share with review team
Maintain awareness of and ensure adherence to Zelis standards regarding privacy
Skills, Knowledge, and Experience:
CPC credential preferred
Working knowledge of health/medical insurance and handling of claims
General knowledge of provider claims/billing, with medical coding and billing experience
Knowledge of ICD-10 and CPT coding
Ability to manage and prioritize multiple tasks
Attention to detail is essential
Accountable for day-to-day tasks
Excellent verbal and written communication skills
Proficient in Microsoft Office Suite
LI-Remote
As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.
Zelis provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.
APPLY HERE
by twochickswithasidehustle | May 2, 2023 | Uncategorized
Audio Transcription Center
Transcriptionists (Independent Contractors)
Nationwide, United States
What you will do:
As an independent contractor, you will be working from home as a freelance transcriptionist, making an accurate text document of the contents of audio, video, typed or handwritten material.
We transcribe oral history interviews (with WWII veterans, women in academia, farmers, midwives), focus groups, financial forecasts or quarterly reports, tech webinars, commencement addresses, interviews about NGO work, educational reform or health care access, or anything else you could think of, and even occasionally TV shows. We don’t do medical transcription.
Who we’re looking for:
- Fast and accurate typists (minimum of 80 wpm), who can deliver files within 24 hours or less for an hour-long file.
- People with a wide range of interests or educational experiences. As the subject matter varies broadly, it’s easier to understand the flow of conversation when you have some context for what is being discussed.
- Transcriptionists who are fluently bilingual or multilingual are always welcome.
Requirements
- Strong language, style, and punctuation skills, and the capability and willingness to follow our in-house style manual as well as project-specific instructions.
- Ability to verify names and terms via brief internet research. Much of the work we do is for archives, so these transcripts will become part of a historical record and need to be of high quality to reflect that permanence.
What you will need
- A reliable internet connection is a must. ATC sends project files via Dropbox links, so no special FTP setup is necessary.
- For confidentiality reasons, we require that you use an email address that no one else has access to.
- Transcripts should be returned to ATC as .doc files. You are not strictly required to use Microsoft Word; you can also use Open Office or some other program that has the capability to save as a .doc file as long as the formatting requirements are met and the functionality of the end product is indistinguishable from a document completed in Word.
- ATC highly recommends the use of transcription software controlled via hotkeys or a foot pedal, and the use of good-quality headphones to cut down on ambient noise while you are transcribing.
APPLY HERE
by twochickswithasidehustle | May 2, 2023 | Uncategorized
Deque Systems
People come to work for Deque because of what we do: enable businesses and organizations to make their sites and apps accessible to everyone, including people with disabilities. The personal fulfillment employees feel here is unparalleled. In addition to the altruistic nature of our jobs, the organizational structure is extremely flat and welcoming. Women-owned and operated, Deque CEO Preety Kumar is internationally revered for her down-to-earth personality and work ethic. Deque’s core values are central to our culture of customer satisfaction. Do you share them?
- Innovation with results that matter
- Deliver what you promise
- Can-do attitude
- Open, direct & respectful communications
- We care deeply
- We practice humility
At Deque, you’ll work with the best and brightest minds in the industry, sharing best practices, tackling new issues and uncovering new approaches. Accessibility Consultants at Deque also love their jobs because of the support systems in place.
Deque experts regularly contribute to W3C Accessibility Working Groups and collectively hold more CPACC, WAS, & CPWA certifications issued by the IAAP than any accessibility testing company in the world.
Position Description
Deque is seeking a Payroll Specialist to join our Accounting Team. This individual will be responsible for ensuring accurate and timely payroll submission, reporting, and reconciliation. This individual will also ensure Federal, State and Local compliance. The ideal candidate is detail oriented, a multi-tasker, and able to work independently.
Primary Responsibilities
- Process Company Payroll Bi-Weekly through ADP, including reviewing payroll changes for accuracy, ensuring all Special payments due are made; Commissions, Bonus, Severance Pay, etc.
- Register and set up any new State and Local tax jurisdictions as necessary (Out of State New Hires) and set up in ADP.
- Reconciling and booking necessary payroll journal entries into the General Ledger.
- Respond to requests from regulatory agencies as needed
- Provide assistance to employees and HR with payroll inquiries.
- Serve as point of contact and trainer for ADP
- Reconcile ADP Monthly, Quarterly, and Annual Payroll Tax Returns with General Ledger.
- Assist in timely month-end closing procedures related to Payroll Accrual and Vacation Accrual calculations and assist with other reconciliations and projects as deemed necessary by the Controller.
- Maintain files and documentation thoroughly and accurately, keep payroll data confidential, and by company policy and Generally Accepted Accounting Principles (GAAP).
- Serve in a fiduciary capacity for Deque, safeguarding the company property, equipment, money, and assets against unauthorized use or removal, as well as from loss due to a criminal act or breach of trust.
- Assist in special HR/Payroll projects as needed.
- Perform other accounting duties as assigned.
- Develop and maintain a broad knowledge of the company’s products and services; Keeps up to date with accounting and payroll legislation changes, practices, and procedure; Cross-train with AR / AP Specialists to build skills.
- Serve as a backup to AP specialist as needed.
Requirements
- High School diploma or GED with 4 years’ experience in an accounting environment specializing in Payroll OR an Associate degree in accounting/finance and 2 years of accounting experience
- MS Office/PC skills required.
- Experience with multi-state payroll of up to 100 or more employees, working with payroll and HRMS systems; ADP experience highly preferred. Fundamental Payroll Certification (FPC) considered.
- Must possess excellent communications skills and the ability to build trust, rapport, and credibility.
- Capable of exercising extreme discretion.
- ADP: 2 years (Preferred)
- Multi-State Payroll: 3-5 years (Preferred)
- Payroll: 2 years
About Deque
Deque (pronounced dee-cue) is a web accessibility software and services company, and our mission is Digital Equality. We believe everyone, regardless of their ability, should have equal access to the information, services, applications, and everything else on the web.
We work with enterprise-level businesses and organizations to ensure that their sites and mobile apps are accessible. With over 475,000 extensions installed and over 5,000 audit projects completed, Deque is the industry standard. Join our growing family as we work to make the web a better place for everyone.
Job Location
How to Apply
- Apply by submitting your resume and a cover letter. Applications without a cover letter will not be considered.
In your cover letter
- Explain your interest in joining Deque and how you align with our Core Values
- Depict key attributes that differentiate you as a candidate
Deque is committed to providing Equal Employment Opportunities. Reference and background checks will be required. The expected salary range is 60K-70K but is subject to change based on the skills, abilities, and experience of each candidate. The values listed are not intended to guarantee a salary for candidates or current employees.
Thank you for your interest in joining our exciting company!
APPLY HERE
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