The Data Entry Operator is an entry level position which is production oriented. Individuals are responsible for the introduction of data into the system which is then provided to the client for use in their internal adjudication system.
FOUNDATION KNOWLEDGE, SKILLS, AND/OR ABILITIES REQUIRED
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
ESSENTIAL DUTIES AND RESPONSIBLITIES
• Enter data from scanned and/or processed images into the data capture system.
• Meet expected hourly production volume goals.
• Maintain quality levels above minimums set by management
• Increase speed and difficulty of tasks as expected with training and practice
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ADDITIONAL RESPONSIBILITIES
• Maintain awareness of and actively participate in the Corporate Compliance Program.
• Maintain a neat and orderly workstation.
• Assist with other projects as assigned by management
• Must be prompt and dependable (excellent attendance)
• Must be comfortable working in a production environment
Symbria Rx Services is seeking a team oriented, experienced Data Entry Technician who shares our commitment to ensuring the health and wellness of seniors. As one of the few 100% employee-owned companies in healthcare, our business practices are guided strictly by the values to which our employee owners are committed to. For more than 20 years, Symbria has been providing an outstanding work environment for talented employees to deliver patient-centered care to the geriatric population in senior-living and post-acute settings.
Position Details:
12:00pm-8:30pm Monday-Friday and every other Saturday/Sunday 11:00am-7:30pm
100% Remote
***Must currently live in a state Symbria Rx Services is licensed in***
***AZ, CO, FL, IL, IN, KS, MA, MI, MO, PA, OH, WI***
Responsibilities
Contact physician’s office as needed for refill authorization.
Contact client for verification of orders as needed.
Process all new and refill prescriptions.
Open orders as needed, verify eligibility, proof and input prescriptions while maintaining productivity and quality standards.
Document correspondence and follow up in the system.
Prepare audit sheets and provide feedback to manager.
Forward incomplete or rejected scripts to appropriate department for resolution and track status in the system.
Initiate and document correspondence and follow up in system.
May assist with research of lost or missing orders per internal department requests.
May provide backup support to other pharmacy groups based on business needs or production levels.
Answer incoming calls promptly and provide high standard of customer service to the client.
Qualifications
High School diploma or general education degree (GED).
Pharmacy Technician License and/or Certification (CPhT) as per State requirements.
General computer knowledge including Microsoft Office: Word, Excel and Outlook.
Excellent customer service, interpersonal, verbal and written communication skills.
Work collaboratively with other team members and manager to ensure that best practices are shared.
Must be able to work weekends, holidays and alternate shifts for PTO/staffing coverages as 24/7/365 operational needs dictate.
Qualifications Preferred
Pharmacy data entry experience; minimum one year.
Strong knowledge of Brand/Generic drugs and medical terminology.
Why work at Symbria?
100% employee-owned company through an Employee Stock Ownership Plan, also known as an ESOP. You, along with your co-workers, have an ownership stake in this company!
Competitive compensation
ESOP retirement plan
401(k) & Roth 401(k) plans
Employee Assistance Program
Full-time employees are eligible for medical, dental, vision, life insurance, short/long term disability, flexible spending accounts (FSA), Paid Time Off (PTO) and Yearly Tuition Reimbursement.
All applicants will be afforded equal opportunity without discrimination because of race, color, religion, sex, sexual orientation, marital status, order of protection status, national origin or ancestry, citizenship status, age, physical or mental disability unrelated to ability, military status or an unfavorable discharge from military service.
Pie’s mission is to empower small businesses to thrive by making commercial insurance affordable and as easy as pie. We leverage technology to transform how small businesses buy and experience commercial insurance.
Like our small business customers, we are a diverse team of builders, dreamers, and entrepreneurs who are driven by core values and operating principles that guide every decision we make.
Pie is building a Claims Department where data, analytics, and technology will play a key role in achieving our goal of making small business insurance as easy as Pie. The ideal candidate will have a combination of strong technical skills in data analysis, data visualization, and predictive modeling and a strong understanding of Workers’ Compensation insurance claims. Initially, the successful candidate will focus on working with Claims business team to create repeatable ad hoc reports to measure key performance indicators for high level objectives as well as basic operational metrics. Concurrently, this role will collaborate with our data engineering team to build the data infrastructure necessary for data warehouse reporting and analysis. This is a rare opportunity for an analyst to strongly influence data collection, storage, and organization from the ground up and ensure that data documentation is accurate and complete to facilitate their future analyses. Predictive Modeling, decision management, and claims process automation will become a growing part of this role as more data is accumulated and the claims department matures. The successful candidate must be a quick learner, and be comfortable with ambiguity and working in a “build” environment.
How You’ll Do It
Data Visualization and Reporting
Mines data, performs quantitative analysis and creates clear and actionable narratives about the business.
Turn data into visualizations to create a comprehensive picture of results and trends.
Extract data from Pie’s data warehouse or other sources, such as claims software and enterprise dashboards, for ad hoc reporting requests and larger projects
Create dashboards, ad hoc reports, and data visualizations for high level analysis as well as basic operational reporting needs
Work with Claims leadership to develop reporting for key performance metrics
Data Analysis
Analyze complex business problems and issues using data from internal and external sources to provide insight to decision-makers.
Develop new data analysis processes, including data collection and data governance.
Perform predictive analytics by reviewing large data sets of historical data, including market trends, financial data and operational metrics. This data will then be used in the future to build predictive models that can generate forecasts and risk assessments to reduce exposures.
Create models and tools that produce relevant insights to identify inefficiencies and generate insights to improve workflow processes
Analyze data to identify drivers of claim outcomes, investigate ways to reduce claim severity and improve the operational efficiency of the claims department.
Benchmark claim department results against external data sources
Business Acumen
Understanding of the insurance industry’s key metrics, challenges and what drives success.
Ability to align data and analytics with overall business goals
Proficiency in communicating complex data insights in a clear and actionable manner to stakeholders across the organization.
Collaboration
Offers recommendations for new data analytic techniques and methodologies
Support other strategic projects as assigned to meet business needs
Serve as the subject matter expert on claims data
Collaborate with Claims leadership, as well as Data Science, Data Engineering, and Enterprise Engineering, to create data warehouse reporting capabilities, predictive models, automation, and data mapping for vendor integrations.
The Right Stuff
SQL Programming, preferably in a Cloud environment
Statistical Programming Language- experience with at least one – Python (Pandas and data analysis packages), R, SAS, SPSS, Stata
Extracting and manipulating large data sets using Snowflake, Looker, and Montecarlo platforms.
Understanding of data capture, data mapping, and data cleansing.
Strong understanding of workers’ compensation claims process, terminology, and metrics.
Ability to draw meaningful insights from data. Ability to perform basic statistical analysis.
Experience using Looker, Tableau, or similar data visualization tools
Comfortable using Excel and Google sheets for interim reporting needs
Self-motivated, flexible, organized who is interested in performing exploratory data analysis with complex data sets with minimal direction
Seeking innovative solutions through data and analytics while being adaptable to new tools and technologies
Base Compensation Range
$125,000 – $160,000 USD
Compensation & Benefits
Competitive cash compensation
A piece of the pie (in the form of equity)
Comprehensive health plans
Generous PTO
Future focused 401k match
Generous parental and caregiver leave
Our core values are more than just a poster on the wall; they’re tangibly reflected in our work
Our goal is to make all aspects of working with us as easy as pie. That includes our offer process. When we’ve identified a talented individual who we’d like to be a Pie-oneer , we work hard to present an equitable and fair offer. We look at the candidate’s knowledge, skills, and experience, along with their compensation expectations and align that with our company equity processes to determine our offer ranges.
Each year Pie reviews company performance and may grant discretionary bonuses to eligible team members.
Location Information
Unless otherwise specified, this role has the option to be hybrid or remote. Hybrid work locations provide team members with the flexibility of working partially from our Denver office and from home. Remote team members must live and work in the United States* (*territories excluded), and have access to reliable, high-speed internet.
Posted Wednesday, October 16, 2024 at 11:00 PM | Expires Tuesday, December 17, 2024 at 10:59 PM
Dayforce is a global human capital management (HCM) company headquartered in Toronto, Ontario, and Minneapolis, Minnesota, with operations across North America, Europe, Middle East, Africa (EMEA), and the Asia Pacific Japan (APJ) region. Our award-winning Cloud HCM platform offers a unified solution database and continuous calculation engine, driving efficiency, productivity and compliance for the global workforce. Our brand promise – Makes Work Life Better TM– Reflects our commitment to employees, customers, partners and communities globally.
Location:Work is what you do, not where you go. For this role, we are open to remote work and can hire anywhere in the United States. This candidate will be required to work PST hours.
About the opportunity
Dayforce is currently seeking a Payroll Specialist III to join our Dayforce Managed Team. We service our US Large Enterprise clients (multiple thousands of employees) by supporting the complete employee life cycle including payroll, workforce management, benefits, and contact center; allowing the client to focus on their core business.
The ideal candidate will have significant experience in the area of payroll and a strong working knowledge of benefits, workforce management and tax. They will also have the ability to interface with clients and to use critical thinking skills to resolve complex problems.
What you’ll get to do
Responsible for ensuring all aspects of the payroll cycle, including tax, benefits, garnishments, etc. are processed, reconciled, audited and transmitted accurately and timely
Ensure accurate and timely processing of payroll impacting changes, tax forms, payments and payroll processing for assigned clients
Responsible for quality control and auditing to ensure accuracy and low error or defect percentage
Work with cross-functional internal partners to resolve client payroll matters and employee inquiries
Provide Payroll support services to clients according to Dayforce contract, legislative requirements and business needs
Establish and maintain a deep understanding of customer’s requirements and their changing needs to ensure services delivered are as per contractual obligations and in accordance with customer SLAs.
Create, update and review standard operating procedures and performs quarterly document reviews
Have an “I own it” attitude about deliverables and projects from start to finish
Manage client and consumer related tasks within the case management system ensuring all documentation is complete, accurate, and timely
Proactively manage quarter, and year-end payroll auditing and processing
Think and act ahead, spot opportunities and act accordingly and proactively contribute to process improvements
Skills and experience we value
Must be available to accommodate shifts within operating hours (between 8 a.m. and 9 p.m.)
Must be available to stay later or adjust shift based on client assignment
Hours will usually be 9a-6p PST but require schedule flexibility to work within above listed hours
2+ years of End to End payroll processing experience in a high-volume payroll operation (1,500-6,000+ employees)
Experience in the payroll outsourcing or consulting industry preferred
Experience and a clear understanding of payroll, benefits and taxation and an understanding of applicable legislative requirements
Ability to resolve client’s issues and provide superior customer service to internal and external partners
Excellent verbal and written communication skills with the ability to communicate clearly, technically, and effectively with customers and internal partners
Good analytical, organizational, and problem-solving skills
Proficiency in Microsoft Word, intermediate Excel, and PowerPoint
What would make you really stand out
Experience with Dayforce HCM or similar cloud payroll technology
Multi-client payroll processing experience
2k+ employee payroll processing experience (working with Enterprise sized customers)
Industry related certifications or desire to obtain within two years of employment
Strong working knowledge of quality control and auditing standards
From Intake to Outcomes, CareMetx is dedicated to supporting the patient journey by providing hub services, innovative technology, and decision-making data to pharmaceutical, biotechnology, and medical device innovators.
Job Title: Reimbursement Specialist
POSITION SUMMARY:
Under the general supervision of the operational program leadership, the Reimbursement Specialist is responsible for various reimbursement functions, including but not limited to benefit investigations, prior authorization support, and call triage. The Reimbursement Specialist responds to all provider account inquiries, appropriately documents all provider, payer and client interactions into the CareMetx Connect system and ensures that the necessary data for prior authorization request are obtained.
PRIMARY DUTIES AND RESPONSIBILITIES:
Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program.
Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.
Completes and submits all necessary insurance forms in a timely manner as required by all third party payors for prior authorizations. Tracks and follow up on prior authorization request.
Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
Maintains frequent phone contact with provider representatives, third party customer service representatives, and pharmacy staff.
Reports any reimbursement trends/delays to supervisor.
Processes any necessary insurance/patient correspondence.
Provides all necessary documentation required to expedite prior authorization request. This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians.
Coordinates with inter-departmental associates as necessary.
Communicates effectively to payors to ensure accurate and timely benefit investigations.
Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action.
Reports all Adverse Events (AE) disclosed in alignment with training and Standard Operational Procedures (SOP)
Typically receives little instruction on day-to-day work, general instructions on new assignments.
Other duties as assigned – Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.
Qualifications EXPERIENCE AND EDUCATIONAL REQUIREMENTS:
High School, Diploma, or GED required
Previous 1+ years of experience in a specialty pharmacy, medical insurance, physician’s office, healthcare setting, and/or related experience.
MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:
Ability to communicate effectively both orally and in writing.
Ability to build productive internal/external working relationships.
Strong interpersonal skills.
Strong negotiating skills.
Strong organizational skills; attention to detail.
General knowledge of pharmacy benefits, and medical benefits.
Global understanding of commercial and government payers preferred.
Ability to proficiently use Microsoft Excel, Outlook and Word.
Ability and initiative to work independently or as a team member.
Ability to problem solve.
Strong time management skills.
Customer satisfaction focused.
Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit.
The employee must occasionally lift and/or move up to 10 pounds.
Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
Schedule
Must be flexible on schedule and hours
Overtime may be required from time to time
Must be willing to work weekends if required to meet company demands
CareMetx considers equivalent combinations of experience and education for most jobs. All candidates who believe they possess equivalent experience and education are encouraged to apply. At CareMetx we work hard, we believe in what we do, and we want to be a company that does right by our employees. Our niche industry is an integral player in getting specialty products and devices to the patients who need them by managing reimbursements for those products, identifying alternative funding when insurers do not pay, and providing clinical services. CareMetx is an equal employment opportunity employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race, color, sex, sexual orientation, gender identity, religion, disability, age, genetic information, veteran status, ancestry, or national or ethnic origin.
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