Claims Analyst

Due to Covid–19 we are working 100% remotely, this includes the hiring process. When it is safe to do so, we will return to a hybrid of onsite and remote work for some positions.

Why This Role Is Important To Arcadia

The Claims Analyst role is responsible for claims processing, reviewing, auditing and investigation of high-level coding review and processing discrepancies. Average number of claims entered weekly 800-1100, depending on level of difficult claims being worked that week.

What Success Looks Like
In 3 months

  • Familiar with basic navigation in the Eldorado processing system
  • HCFA and UB92 Workflow Queues in Eldorado System
  • HCFA and UB92 Pended Claims and Exception Reports
  • Auditing weekly reports

In 6 months

  • Review and Finalize 095 report of claims sent to BCBS needing MG review and status of approval.
  • Working special projects
  • Familiar with BlueCross portals
  • Familiar with internal portals, MCG, Arcadia share point, Appeal Module
  • Processing the minimum requirement of 20 claims per hour.

In 12 months

  • Assist with other coworker’s workflow when assigned client based primary responsibilities are caught up.
  • Meeting and maintaining production expectations 23-27 claims per hour on commercial accounts
  • Meeting and maintaining production expectations 18-22 claims per hour on Medicare Advantage.
  • Meeting quality expectations of an average of 95% or higher
  • Full understanding of Eldorado system
    What You’ll Be Doing
    HCFA and UB92 Pended Claims and Exception Reports
    HCFA and UB92 Workflow Queues in Eldorado System
    Audit Reports such as possible duplicates, timely filing review
    Work special reports such as Anesthesia, Mental Health, etc.
    Review and Finalize claims appeals received by providers/members
    Review Pre-payment audit reports
    Review and Finalize 095 report of claims sent to BCBS needing MG review and status of approval.
    Assist with other coworker’s workflow when assigned client based primary responsibilities are caught up.
    What You’ll Need to Have
    High School diploma or equivalent
    1 -3 years medical claims adjudication experience (HMO claims preferred)
    Proficiency in Microsoft Office Applications, high Excel proficiency
    Excellent verbal and written communication skills
    Good attention to detail and commitment to quality
    Positive mental attitude
    Ability to multi-task
    Deadline oriented
    Ability to work independently with minimal supervision
    Would Love for You to Have
    Coding certification
    Excel
    Access
    What You’ll Get
    Join a high performing team who brings all data into one of the top Healthcare Analytics companies in the US
    Be a part of a mission driven company that is transforming the healthcare industry by changing the way patients receive care
    A flexible, remote friendly company with personality and heart
    Employee driven programs and initiatives for personal and professional development
    Be a member of the Arcadian and Barkadian Community

APPLY HERE

Social Media Team Lead (Social Media Team)

Description
Interview
Team
Hi there!

We are Semrush, a global IT company developing our own product—a platform for digital marketers.

And this is our Social Media Team Lead role for idea generators, planning geniuses, and natural-born analysts.

Tasks in the role

Think of this role as the leader of a mini in-house social media agency. As the Social Media Team Lead, you will lead the team of four social media managers responsible for the brand’s organic social media presence on various platforms (Twitter, LinkedIn, Instagram, Facebook, TikTok) across all of Semrush’s key markets.

We expect you to:

Own and refine the social media plan and its associated budget across campaigns & channels to achieve our ambitious goals and look for ways to grow even further.

Launch, optimize, and facilitate the team’s processes and initiatives that help to move the team forward toward ambitious goals.

‘Hands-on’ support for English-speaking-region social media initiatives.

Be the main point of contact in the social media team for internal customers across various brand and product marketing teams.

Stay up-to-date with the latest social media trends, best practices, and technologies.

Propose new ideas and organize experiments to improve Semrush’s social media presence.

Who we are looking for

We think that these types of experience and competencies will help our future colleague to join the team.

5+ years of experience in social media marketing.

2+ years of experience leading a social media team.

You are fluent in English with exceptional writing skills, correct grammar, and an appreciation for the power of tone, brevity, and microcopy.

You have a combination of creative, analytical, and strategic thinking skills.

You have a strong portfolio of cases in a related field that you are proud of.

You are a social media geek on top of the latest social channels and trends and are creative and detail-oriented.

You have a keen eye for content, and you can quickly understand what type of content is meaningful, appropriate, and valuable in each situation or on each platform.

Highly creative, ‘hands-on’ leader who embraces ambiguity and defines a way forward.

The agility at one moment to discuss strategy and planning, and the next to execute it.

They say there are no perfect candidates, but that might well be you, if

You have ever used Semrush and are familiar with our social media efforts.

Have a passion for, or are proficient in, digital marketing.

Have experience working with international teams.

A bit about the team

You can get to know the team better at one of the interviews, but some brief information about future colleagues will be useful now.

The Social Media Team is in charge of defining the strategy, creating content, and promoting brand and product campaigns on social media channels.

We will try to create all the right conditions for you to work and rest comfortably

This offer stands for the remote work format. Digital nomadism, #wfh—call it what you like ;).

Flexible working day start.

Health insurance coverage.

Annual leave as per the employment legislation of the country of stay (employment).

Training, courses, conferences.

Gifts for employees.

APPLY HERE

EMR Remote Processor

Overview
Who we are…

Ciox Health merged with Datavant in 2021, creating the nation’s largest health data ecosystems, powering secure data connectivity on behalf of thousands of providers, payers, health data analytics companies, patient-facing applications, government agencies, research institutions and life science companies. The combined company is focused on improving patient outcomes and reducing costs by removing impediments to the secure exchange of health data. Ciox, a Datavant company will offer the ability to access, exchange, and connect data among the thousands of organizations in its ecosystem for use cases ranging from better clinical care and value-based payments to health analytics and medical research.

What we offer…

At Ciox Health we offer all employees a place to grow and expand their current skills so that they can not only help build Ciox Health into the greatest health technology company but create a career that you can be proud of. We offer you complete training and long-term career goals. Our environment is what most of our employees are the proudest of and our Architecture Group is comprised of some of the brightest and most talented individuals. Give us just a few moments to explain why we need you and hope you will help us change how the health Industry manages its’ medical records.

What we need…

The EMR Remote Processor serves as a key member of the EMR Remote team. This position is responsible for processing Release of Information (ROI), specifically medical record requests in a timely and efficient matter, ensuring accuracy and individual metrics are met. Verifying and analyzing data to affect the efficient and effective retrieval of charts in accordance with the core business function of Ciox Health. Associate must always safeguard and protect the patient’s right to privacy by ensuring that only authorized individuals have access to the patient’s medical information and that all releases of information are in compliance with the request, authorization, company policy and HIPAA regulations.

Come be a part of a team where we win together, deliver awesome and make a difference in not only the lives of our employees but by transforming the exchange of clinical data using the most advance technology available.

We are looking to fill a remote, work from home position.

•Full-Time: Monday-Thursday 6:00am-5:00pm (Voluntary and Mandatory Hours)
•Comfortable working in a high-volume production environment.
•Processing medical record requests by taking calls from patients, insurance
companies and attorneys to provide medical record status
•Documenting information in multiple platforms using two computer monitors.
•Proficient in Microsoft office (including Word and Excel)

We offer:

Comprehensive virtual training program followed by job shadowing with an assigned mentor

Company equipment will be provided to you (including computer, monitor, virtual phone, etc.)

Full Benefits: PTO, Health, Vision, and Dental Insurance and 401k Savings Plan and tuition Assistance

Responsibilities
Enter accurate data when assigned by team lead/coordinators
Remote processing of electronic medical records through various EMR systems as directed
Ability to work with minimum supervision responding to changing priorities and role needs
Report any technical difficulties that you may experience as soon as they occur.
Meet required metrics for your role (CPH – Charts Per Hour), Attendance.
Actively participate in all training that is assigned to you by your supervisor
Maintain high standards of Confidentiality to safeguard and protect Patient’s Right and comply with all company and facilities policies and HIPPAA regulations
Read all documentation and follow written instructions provided to ensure compliance and accurate job completion.
Immediately report to team lead/coordinator/supervisor or management any security breaches, unsafe behavior witnessed or any site difficulties.
Support a service environment that focuses on quality processes
Ensure that deadlines are met and respond to emails and other requests for information timely
Qualifications
Six months data entry experience required
High School Diploma/GED required
Adhere to company policies
Experience in a healthcare environment or office setting is strongly preferred.
Work effectively with co-workers in a constructive and positive manner
Listen to and objectively consider ideas and suggestions for improvement
Address problems constructively to find acceptable solutions
Demonstrate accuracy and attention to detail
Computer skills including Windows based applications (Word, PowerPoint, Excel, Access, Outlook)
Excellent organizational skills
Adaptable to changing business environment
Demonstrated ability to work within a diverse group of individuals
Perform other duties as assigned
To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Ciox Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

For remote work, this position requires that you provide a high-speed internet connection, subject to applicable expense reimbursement requirements (if any), and a work environment free from distractions.

With very limited exceptions (medical conditions or sincerely held religious beliefs that prohibit you from getting the vaccine), one of the requirements for this job is that you be fully vaccinated against COVID-19.

*Except for states where legally prohibited to enforce mandates.

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APPLY HERE

***REMOTE*** Order Entry Specialist I

Overview
Let’s face it.

You wouldn’t be on our career page reading this if you weren’t in the job market looking for a change. Intrigued?

So are we.

ABI is seeking a Data Entry Clerk (internally known as Order Entry Specialist) role is to process new orders. The primary objective of the position is to establish correct information in preparing legal documents to be sent to all appropriate parties.

This role is 100% REMOTE. The hours will be Monday-Friday, 8:00am-5:00pm EST. It may be necessary to work overtime depending on business needs.

Responsibilities
Essential Functions – All

Identify orders that cannot be processed without additional information, documentation, or clarification, and flag the order accordingly.
Maintain client, court and facility databases as required.
Assist with department clerical work and/or any other duties as indicated by the supervisor/manager.
Determine when an order has corrections to be made and return it to the individual who entered the order for any corrections and/or questions. Enter the appropriate status in the system that the order has been “reviewed”; and that the order has been sent to print.
Ensure all necessary legal documents, internal forms or client attachments are included with the order.

Data Entry

Clerical

Administrative

Qualifications
High School Diploma or equivalent required.
Prior work experience in data entry.
Preferred work experience in a medical, legal, or insurance claims office.
Typing proficiency, preferred level of at least 45 wpm accuracy, no errors.
Has some understanding of the internal processes of medical facilities and med-legal terminology.

ABI Document Support Services is the largest nationwide provider of records retrieval, subpoena services, and document management for the legal and insurance industries. There is no other company in the market that provides the volume of successfully retrieved records or the document management solutions that ABI offers. Our singular focus is records retrieval and the most advanced technology solutions for our clients to manage, analyze and summarize those retrieved records. We are committed to continually raising the bar for cost effective record retrieval and more thorough analysis and summarization.

ABI offers a fast-paced team atmosphere with competitive benefits, paid time off, and 401k.

APPLY HERE

Part Time Sophia Grader

locations
Remote
time type
Part time
posted on
Posted 15 Days Ago
job requisition id
R17636
Graders provide to support the faculty by grading written student work product. The Grader is expected to evaluate subject content and grammar for accuracy and provide constructive feedback..
Accurately read and measure student performance based upon a grading rubric
Fill in grading rubrics and leave detailed feedback
Check student submissions for plagiarism and for grammatical mistakes.
Education:

Bachelor’s degree from an accredited institution is required
Work Experience:

Previous experience teaching or working at an academic institution
Job Skills:

Must be able to maintain confidentiality
Exhibits sound judgment in making decisions
Ability to keep accurate records
Strong verbal and written communication skills
Must have strong computer skills (Excel, PowerPoint, etc.)
Certificates, licenses and registrations:

None
Other:

Access information using a computer
Effectively communicate, both up and down the management chain
Effectively cope with stressful situations
Strong mental acuity

APPLY HERE