by twochickswithasidehustle | Oct 10, 2022 | Uncategorized
Moda Health
Medical Claims Processor I – Remote (AK, AZ, FL, ID, OR, TX, WA)
Duration
Open Until Filled
Work Remote
Yes
Location
Bend-Remote, OR
Other Location
Description
Let’s do great things, together
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.
Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.
We are currently seeking a Medical Claims Processor. This role is responsible for utilizing resources efficiently for the accurate and timely entry, review, and resolution of simple to moderate complexity medical claims in accordance with policies, procedures, and guidelines as outlined by the company.
This position is currently full time work from home and is accepting candidates from AK, AZ, ID, FL, OR, TX, and WA.
Required Skills & Credentials:
- High School diploma or equivalent
- 6-12 months data entry or medical office experience preferred
- 10-key proficiency of 135 spm
- Type a minimum of 35 wpm
- Knowledge of medical terminology, CPT codes and ICD-9/10 codes preferred
- Demonstrates work habits that include punctuality, organization, and flexibility
- Ability to maintain balanced performance in areas of production and quality
- Analytical reasoning and flexibility
Primary Functions:
- Enters claims data into system while interpreting coding and understanding medical terminology in relation to diagnosis and procedures.
- Review, analyze, and resolve claims through the utilization of available resources for moderately complex claims.
- Analyze and apply plan concepts to claims that include; deductible, coinsurance, copay, out of pocket, etc.
- Examines claims to determine if further investigation is needed from other departments and routes claims appropriately through the system.
- Adjudication of claims to achieve quality and production standards applicable to this position.
- Release claims by deadline to meet company, state regulations, contractual agreements and group performance guarantee standards.
- Reviews User Procedure Manuals (UPMs) for process instructions to ensure accurate and efficient claims processing as well as providing suggestions for potential process improvements.
- Performs all job functions with a high degree of discretion and confidentiality in compliance with federal, state and departmental confidentiality guidelines.
Benefits:
- Medical, Dental, Vision & Pharmacy
- 401K and FSA
- PTO and Paid company holidays
Together, we can be more. We can be better.
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.
APPLY HERE
by twochickswithasidehustle | Oct 10, 2022 | Uncategorized
GeBBS Healthcare Solutions
Overview
This position is responsible for providing expert sourcing and staffing services for GeBBS Healthcare Solutions, creating the pipeline, and delivering high quality candidates to address business requirements. As a result of knowledge and skillful tactics, the resourcer will help advance the GeBBS brand across numerous markets and professional communities, while guiding candidates through the selection process. This individual will maintain excellent relations with hiring managers, candidates, and professional groups.
This role will primarily be responsible for sourcing candidates to our medical coding business unit and other positions may be assigned depending on business needs. Experience with HIM, RCM, and Payor role professionals is strongly desired. This position will be virtually based in a home office with a Monday Friday schedule.
Responsibilities
- Research and source qualified candidates in target markets.
- Screen candidate resumes and applications submitted through GeBBS ATS online tool, internal referrals, partner organizations and other sources.
- Assist Talent Acquisition team with scheduling candidate interviews, prescreening candidates as needed.
- Send appropriate required assessments to candidates and utilize ATS to organize qualified candidates for Talent Acquisition team to complete the hiring process.
- Manage relationships with hiring managers and candidates.
Qualifications
- Two years experience in a staffing or high-volume recruiting environment and at least one year experience within the health information management industry is required.
- Proficiency with automated applicant tracking systems; iCIMS experience preferred.
- Project management, excellent oral and written communication skills are required.
- Associate degree or Bachelors preferred.
APPLY HERE
by twochickswithasidehustle | Oct 10, 2022 | Uncategorized
Change Healthcare
Change Healthcare is a leading healthcare technology company with a mission to inspire a better healthcare system. We deliver innovative solutions to patients, hospitals, and insurance companies to improve clinical decision making, simplify financial processes, and enable better patient experiences to improve lives and support healthier communities.
Work Location: Fully Remote – US
Position: As a Data Entry Operator, you will provide analytical and specialized administrative support.
Core Responsibilities:
- Perform administrative task as assigned.
- Analyzes problems, determines approach, compiles, and analyzes data, and prepares reports/recommendations.
- Identify any issues or trends and bring them to the attention of management team
- Work is generally of a critical or confidential nature. Assignments may be found in various functional areas
- Work on special projects as assigned
- Other duties as assigned
Requirements:
- High School diploma, vocational training, or equivalent experience
- 1+ years of administrative support experience
- Experience working with clinical hospital systems or medical billing is an asset.
- Ability to meet position performance goals
- Strong written and verbal communication skills
- Knowledge of Adobe Pro & Microsoft Excel spreadsheets
- Working in a virtual environment.
Working Conditions / Physical Requirements:
Unique Benefits:
- Flexible work arrangements
- Paid Time Off (PTO), eight (8) paid holidays and two (2) floating holidays
- Volunteer days, employee giving and matching gifts programs, community awards and dollars for doers, community partnerships
- Ready, Set, Grow Career Development Center & access to Change Healthcare University for continuous professional learning & development with more than 5,000 training assets
- Your choice of four medical plans & My Healthy Changes well-being program
APPLY HERE
by twochickswithasidehustle | Oct 10, 2022 | Uncategorized
Kelly
Overview
The Business Data Processor I is responsible for ongoing maintenance of global business data updates to SAP and Salesforce cloud environments. Position support creation of and edits to batch uploads, data exports and manual data update needs. Position will support data error log maintenance and analysis. This position works directly with the Global Service Business team to support data maintenance request. Adheres to environmental policy, procedures, and supports department environmental objectives.
Responsibilities
- Maintaining databases by creating new records or updating existing.
- Apply data from automated jobs for import and export of data between data systems.
- Support data setup request, tickets and template/ form updates for new service product offerings and changes to business data.
- Supervise and support Salesforce data error logs, reviewing and correcting errors in automated data and manual records.
- Crafting reports, spreadsheets or other documents using data from internal or external sources.
Qualifications
- A bachelor’s degree in computer science prefered.
- Proven track record with SAP and Salesforce data administration and maintenance in a similar environment.
- Experience in working with various types of data sources, data reports and extracts.
- Intermediate/advanced MS Excel and MS Office skills.
APPLY HERE
by twochickswithasidehustle | Oct 10, 2022 | Uncategorized
American Specialty Health
Description
American Specialty Health (ASH) 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 ASH’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.
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.
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.
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.
APPLY HERE
Recent Comments