Medical Benefit Review Services Associate II

Employer: Conduent

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments creating exceptional outcomes for our clients and the millions of people who count on them.

You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

Job Description

  • Retrieves and analyzes health insurance eligibility policy information from health insurance claim systems related to third party liability accidents.
  • Monitors and completes requests.
  • Investigates and communicates questionable situations.
  • Inputs medical claims information.
  • Completes updates in the client system related to the member eligibility.
  • May also initiate and adjust claims in the client system for offsets.

Closing
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the Submit button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form. You may also click here to access Conduent’s ADAAA Accommodation Policy.

At Conduent, we value the health and safety of our associates, their families and our community. Under our current protocols, we do not require vaccination against COVID for most of our US jobs, but may require you to provide your COVID vaccination status, where legally permissible.

APPLY HERE

Care Review Processor

Employer: Molina Healthcare

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

KNOWLEDGE/SKILLS/ABILITIES

  • Provides telephone, clerical, and data entry support for the Care Review team.
  • Provides computer entries of authorization request/provider inquiries, such as eligibility and benefits verification, provider contracting status, diagnosis and treatment requests, coordination of benefits status determination, hospital census information regarding admissions and discharges, and billing codes.
  • Responds to requests for authorization of services submitted via phone, fax, and mail according to Molina operational timeframes.
  • Contacts physician offices according to Department guidelines to request missing information from authorization requests or for additional information as requested by the Medical Director.

Job Qualifications

Required Education

HS Diploma or GED

Required Experience

1-3 years’ experience in an administrative support role in healthcare.

Preferred Education

Associate degree

Preferred Experience

3+ years’ experience in an administrative support role in healthcare, Medical Assistant preferred.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

APPLY HERE

Order Fulfillment Coordinator

Employer: Amplify Education

A pioneer in K12 education since 2000, Amplify is leading the way in next-generation curriculum and assessment. Our core and supplemental programs in ELA, math, and science engage all students in rigorous learning and inspire them to think deeply, creatively, and for themselves. Our formative assessment products help teachers identify the targeted instruction students need to build a strong foundation in early reading and math. All of our programs provide educators with powerful tools that help them understand and respond to the needs of every student. Today, Amplify serves more than 10 million students in all 50 states. For more information, visit amplify.com.

Amplify is seeking an Order Fulfillment Coordinator to join the Business Operations team. . The Order Fulfillment Coordinator will work cross-departmentally to ensure orders have been successfully processed and received by our vendors. This position includes order entry and administrative duties with oversight into shipping and tracking of orders to ensure orders are processed in accordance with the organization’s customer service standards. The position will work through data entry, email monitoring, reporting, and various other duties as required to ensure the workload is appropriately dispersed and managed. Data entry skills with Excel and some customer interaction required. Salesforce and ERP experience is a plus.

**This role may be remote or based in our Alpharetta, Georgia office.

Responsibilities:

  • Prioritize issues in accordance with their severity and Service Level Agreement (SLA)
  • Participate in training for relevant technology and products including networking, hardware and mobile device management
  • Interpret instructional and technical documentation
  • Contribute to the continual improvement of team training programs, ticketing process, and best practices

Basic Qualifications:

  • Bachelor’s degree in Business or a related field
  • Proficiency with office software including Google products (docs, search) and Microsoft products (Excel, Word)
  • Experience using a variety of operating systems with knowledge of networking, connectivity, and internet protocol
  • Customer service experience in a fast-paced, professional work environment

Preferred Qualifications:

  • Experience using Salesforce software
  • Ability to efficiently complete multiple projects simultaneously, while maintaining acute attention to customer care and details
  • Instructional and technical writing experience

We celebrate diversity and are committed to creating an inclusive environment for all employees. To that end, we seek to recruit, develop and retain the most talented people from a diverse candidate pool.

Amplify is an Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities.

This position may be funded, in whole or in part, through American Recovery & Reinvestment Act funds.

Amplify Education, Inc. is an E-Verify participant.

APPLY HERE

Payment Representative

Employer: 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: Remote (Anywhere in U.S.)

Company: 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.

Position: As a Payments Representative, you will receive payments and prepare payments for deposit and forward to appropriate financial institution.

Core Responsibilities:

  • Receive payments and prepare payments for deposit and forward to appropriate financial institution.
  • Responsible for posting payments, rejections and LOA’s to accounts and making corrections to misapplied payments.
  • Reviews claims to make sure that payer specific billing requirements are met, follows-up on billing, determines and applies appropriate adjustments, answers inquiries, and updates accounts as necessary.

Requirements:

  • High School Diploma or equivalent
  • Entry level work experience
  • Posting experience preferred
  • Good understanding of posting process
  • 6,000 kph Alpha Numeric required
  • 5% error rate
  • MS Office experience specifically Excel
  • Detail oriented
  • Works well without supervision
  • Working Conditions / Physical Requirements:

General office demands
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

Diversity and Inclusion:

  • At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.
  • Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs.

Diversity and Inclusion:
At Change Healthcare, we include all. We celebrate diversity and inclusivity, respect each other and value our unique experiences. By being our authentic selves, we bring different perspectives into our work and relationships.
Business Resource Groups (BRGs) play a central role in advancing diversity and inclusion at Change Healthcare. They deepen our understanding of different cultures, people, and experiences, and help foster an inclusive workplace. Change offers eight (8) BRGs.

COVID Vaccination Requirements
We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and, when job-related and consistent with business necessity, we may require periodic testing for certain roles. Some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.

Equal Opportunity/Affirmative Action Statement
Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.

California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information.

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

About Us
Careers Transforming the Healthcare System

Who is Change Healthcare? We are a leading technology company inspiring a better healthcare system. Through innovative technology solutions like cutting-edge cloud technology, artificial intelligence, and data insights, we drive better patient outcomes, reduce costs, and create value for our partners.

Positive Impact and Shared Purpose. Through visionary leadership and a culture of collaboration, we share a common purpose to positively impact our communities by creating a stronger, better coordinated, increasingly collaborative, and more efficient healthcare system.

Employee Experience, Cultural Values, and Total Rewards. We celebrate diversity and earn trust with our employees by promoting innovation at every level within the organization. Our teams are agile, and their work is fast paced and engaging. We’re committed to providing competitive compensation that rewards and recognizes performance, offer well-being programs that empower your overall health, and provide learning and development opportunities to accelerate your professional growth.

Find Your Path. Whether you’re ready to make an impact in technology and product innovation or support our mission to inspire a better healthcare system in a variety of career areas, find your path and accelerate your career. What are you waiting for?

APPLY HERE

Order Entry Representative

Employer: Exemplis

Position Summary:

Welcome to Exemplis, home of custom office products, can I take your order? Don’t worry, no uniforms, fast food restaurants or orange soda included with our awesome Order Entry role! As an Order Entry Representative, you will be an integral part of the team that ensures 400+ orders per day are entered with the highest level of urgency and accuracy in a fast paced, metric driven environment where no order (or day) will look the same. Will you be the Kel to our Keenan?!

Responsibilities and Essential Functions:

  • Enter orders from 1st in queue system – minimum daily order requirement must be met.
  • Responsible for processing and entering all sales orders accordingly. This includes entering GSA/State contract sales orders into government checklist when necessary.
  • Assist Customer Support Representatives with proofing of acknowledgments.
  • Running necessary Order Entry reports as required
  • Matching acknowledgments to sales orders
  • Alert both IT and Manager with all system errors, pricing errors, engineering errors, etc. to avoid product holds on incoming orders
  • Assist in parts entry, literature fulfillment and other administrative duties to improve performance to the customer
  • Clarify open issues such as pricing and missing order information

Qualifications, Skills and Education

  • High School Diploma or GED
  • 2 + years work experience in data entry
  • Ability to pass assessment measuring typing speed and accuracy

About Us:

Exemplis is the fastest-growing office furniture and e-commerce company in the industry! We’re an entrepreneurial company offering infinite possibilities. Being a one-stop-shop means our customers can have everything they need to create exactly what they want. Our world-class customer service, fastest shipping, biggest textile program, and award-winning designs have made us the industry leader for over 25 years. Our SitOnIt Seating brand was created to give our customers what they want, how they want it, when they want it. Today, we’re constantly reimagining how space, textile, and design can help everyone—from medical offices to Fortune 500 companies to home offices across North America—get more out of their day.

People are at the core of our business, and on our team, everyone makes an impact. We absolutely owe our success to our incredible group of talented employees who bring equal parts skill, passion, drive – and of course, fun — to the table each and every day. We have created a workplace that is inclusive and diverse — where everyone can be their authentic self, and where that authenticity is celebrated. By creating an environment where people from every background can thrive, Exemplis becomes a better and more successful company.

We’re proud to be a company that gives back to the very communities that our team members live and work in. Our giving ethos focuses on three buckets of impact: sustainability, community outreach and transparent operations. From donating lobby seating to medical clinics in low-income neighborhoods—to our yearly giving week and toy drive for Toys for Tots – we believe collaboration, kindness and authenticity are essential to our humanity.

Exemplis is an Equal Opportunity Employer, and our company adheres to the equal employment opportunity guidelines set forth by federal, state and local laws. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, marital status, national or ethnic origin, protected veteran status, disability status, or any other characteristic protected by applicable state or federal civil rights laws that is not related to job requirements.

APPLY HERE