by twochickswithasidehustle | Sep 21, 2024 | Uncategorized
The Appeal Specialist is responsible for developing persuasive letters of appeal to third-party payers to allow reimbursement at the highest level for patients and the organization. Key elements include effective education of payers on company products and the ability to apply a strong knowledge of insurance processes to navigate the appeal process across numerous health insurance companies (payers). This position will report to the Manager, Payer Operations on the Payer Operations team. The role is full time, exempt and will work remotely.
Description
Essential Duties and Responsibilities
The essential functions include, but are not limited to the following:
Draft persuasive letters of appeal to third-party payers to ensure maximum reimbursement potential utilizing patient clinical documentation
Ability to confidently educate health plan decision makers that include Medical Directors, Administrative Law Judges, health plan legal representatives regarding operation and use, features and benefits of Company products
Review clinical documentation and develop appeal strategies based on payer, strength of case and potential for approval
Provide advocacy and support to patients who are denied insurance coverage for products
Ability to engage patients when needed to assist in the appeal process
Identify payer trends and establish specific payer strategies to obtain coverage
Maintain a high level of accuracy while meeting productivity and quality requirements
Work with other departments to ensure accurate processing of patient orders and payer approvals and denials
Identify trends for process improvement and communicate to leadership
Assist in the development of internal processes and best practices for the payer operations department
Benefit and authorization process investigation
Follow all compliance and HIPAA requirements
Other duties as assigned
Minimum Qualifications
Education, Experience and Training
Bachelor’s degree or equivalent work experience
Previous experience in the medical device industry, payer appeals, Administrative Law Judge hearings, clinical record review or related field
Knowledge, Skills and Abilities
Excellent written and verbal communication skills
Excellent problem solving and analytical skills
Knowledge of regulatory guidelines for appeals and denials
Ability to produce grammatically accurate appeal and patient correspondence
High attention to detail
Ability to work under pressure to deliver accurate, and timely results
Proven ability to work independently, multitask, prioritize and meet required deadlines
Ability to be persuasive and credible with payers
Confidently speak about the operation and use of company products
Working knowledge and expertise of insurance processes
Technology savvy and able to navigate payer portal systems
Ability to work independently and in collaboration with a team
Able to provide clear and concise communication to payers, field reps, clinicians, peers and management via phone, email, video conference and/or in person
Core Competencies
Change Agent
Influencing
Communication
Process Management
Priority Setting
Peer Relationships
Critical thinking
Time Management
Drive for Results
Tools and Technology
Google Suite, Adobe, Salesforce CRM
Physical Functions and Work Environment
The physical functions described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.
While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers; handle or feel objects, tools, or controls. The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is usually low to moderate.
Note
This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any Koya manager authorized to provide instruction or assign work. Duties, responsibilities, and activities may change at any time with or without notice. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.
by twochickswithasidehustle | Sep 21, 2024 | Uncategorized
Position Details
Position Information
Position Title Part-Time Student Employment & Loan Specialist (REMOTE) – Financial Aid
Job Description
The main functions of the Financial Aid Office are to effectively and comprehensively assist students and parents through the financial aid process and efficiently manage federal, state, and institutional financial aid programs. The part-time Student Employment & Loan Specialist assists the office in coordinating efforts to ensure that best practices and regulations are followed for all students as it relates to the Federal Work Study program and federal and private student loans. The Student Employment & Loan Specialist will interact with specific internal departments and outside agencies to facilitate the student eligibility process and is accountable for ensuring compliance with federal and state regulations. This position will assist in overseeing the compliant execution of the federal work study program as well as support the Loan Counselor in the proper awarding of loan programs including the Direct Student Loan program and private loans from various lenders. The part-time Student Employment & Loan Specialist if a fully remote position.
Conducts needs analysis in compliance with federal, state, and institutional regulations and policies to determine relative eligibility of each financial aid applicant.
Determines the types and amounts of student loans to be awarded to the student through the packaging process according to federal, state, and institutional requirements.
Utilizes reporting tools to identify federal loans that require action including awarding federal PLUS loans, origination & actualization of requested loans
Processes loan adjustments resulting from R2T4 calculations or other requested changes by staff members through the use of the Etrieve system
Evaluates loan records to identify variances and uses professional judgment to determine if action is required in order to remain in compliance with federal regulations
Utilizes external servicers to identify, certify, and actualize private student loans
Reviews and processes all on-campus student work authorization forms to ensure accuracy and eligibility for the federal work study program
Counsels students throughout the hiring process for on-campus positions
Assists with federal work study data collection and reporting
Serves as the on-campus supervisor and manager for the America Reads and America Counts FWS tutoring programs including acting as a liaison between tutors and K-12 teachers in the matching process
Sets schedules, manages staffing and processes time sheets for tutors
Completes other tasks as requested by the Assistant Director of Compliance and Director of Operations
Required Qualifications
High School completion required
One (1) to two (2) years of office experience or related field
Proficient with Microsoft Office Suite software, particularly Microsoft Excel
Excellent verbal and written communication, judgement, analytical, problem-solving, critical thinking and interpersonal skills
Effective organization and planning abilities
Skill in conducting research and analysis
Ability to perform assigned tasks with increasing independence and an understanding of priorities and deadlines
Ability to prioritize and manage a significant caseload
Ability to adhere to data confidentiality regulations and adhere to data security policies
Preferred Qualifications
Associate’s degree preferred
Proficiency with Ellucian Colleague system preferred
Familiarity with NSLDS, COD preferred
Physical Demands
Anticipated Start Date of New Hire 09/30/2024
Anticipated Number of Hours Working per Week 24
Shift Required? First
Job Duties
Posting Detail Information
Posting Number S861P
Number of Vacancies 1
Desired Start Date 09/30/2024
Job Open Date 09/18/2024
Job Close Date
Open Until Filled Yes
Special Instructions to Applicants
by twochickswithasidehustle | Sep 21, 2024 | Uncategorized
Truework is on a mission to create trust in every financial transaction. Our core product, Truework Income, provides access to crucial employment and income information needed for mortgage loans, apartment rentals, background checks and the like. We are disrupting a $5B+ industry, previously controlled by legacy credit agencies, with a better product and intense customer focus. We handle hundreds of thousands of income and employment verifications every month, and continue to grow our market share in the mortgage lending and tenant screening markets.
We are looking for an Operations Specialist to join our team! As an Operations Specialist (part-time, 25 hours) at Truework, you will play a key role in helping us deliver our verification product to our customers on a daily basis. Our operations team sits between our customers and back-end platform, playing a critical role in delivering a best-in-class experience to the hundreds of thousands of unique users our product and web application serves each month.
This is a remote and part-time position, which means that we are looking for this individual to work remotely Monday-Friday, 5 consecutive hours a day each of those days. Exact hours to be determined and agreed to by both this individual and their manager.
In this role you will be reaching out through multiple channels: phone, email, chat, online forms, fax (frequently multi-tasking different methods of communication) to company representatives, often HR, to obtain information needed to complete verification requests. You must be a strong written and verbal communicator with intrinsic motivation and drive. We are looking for competent multitaskers with an ability to quickly learn and use multiple technical platforms who have a strong interest in creating a culture of operational excellence. We value ambition, creative problem solving, and curiosity.
At Truework, you would be responsible for:
- Reach out to company representatives (HR or other contacts) to obtain information to complete verifications
- Tenaciously and creatively solve problems to complete verifications within the targeted time frame
- Build professional relationships through multiple channels of communication (phone, email, chat, online forms, fax) with our customers as well as internal teams
- Multi-task and maneuver through different systems simultaneously to create a reliable and efficient workflow. At the end of the day, you are accountable and responsible for your results
- Self-manage the pipeline of inbound verification inquiries and workload throughout the day according to incoming request volume
- Understand the nuances of income and employment verification to continually present solutions to improve the process or identify bottlenecks
- This role requires advanced problem solving, research, and follow through while constantly adapting your workflow to effectively execute on different tasks
What we’re looking for:
- Are highly disciplined, organized, and can juggle multiple moving pieces and details at once
- Enjoy following a process and are motivated to point out areas for continuous improvement
- Hold yourself to a high bar when it comes down to organization and efficiency
- Thrive in a fast paced, collaborative environment
- Have a proven track record of excellence
- Are adaptable and motivated with a strong work ethic
- Prioritize security in your personal and professional lives. We handle sensitive personal data and put security above all else when making critical business decisions
- Innate tenacity and exceptional problem solving skills
What would be nice to have:
- Experience working for a startup or similar environment
- Experience working with inbound and outbound call management
About your team at Truework and who you will work with:
- Manager:
- Jordan Yeadon is our Outreach Manager at Truework. Jordan started her career in outreach but has become a subject matter expert in all parts of the verification process.
- Team:
- The Outreach team works closely with our other Operations teams: Customer Support, Pending, and Transcription, who all contribute to the Truework verification process.
Cash Compensation:
Our cash compensation for this role is targeted at $16-18 per hour. Final offer amounts are determined by multiple factors including candidate expertise and may vary from the amounts listed above.
Bring Your TRUE Self to Work.
One of our 4 values at Truework is Valuing Diverse Perspectives, and we are on a mission to create a company that is the right fit for every person inside of it. Diversity and Inclusion are the hard-and-fast principles guiding how we build our teams, cultivate leaders, and create a company where our employees are comfortable bringing their authentic, true selves to work.
Truework is proud to be an Affirmative Action, Equal Opportunity Employer. We do not discriminate in hiring or any employment decision based on race, color, religion, national origin, age, sex (including pregnancy, childbirth, or related medical conditions), marital status, ancestry, physical or mental disability, genetic information, veteran status, gender identity or expression, sexual orientation, or other applicable legally protected characteristic. Truework considers qualified applicants with criminal histories, consistent with applicable federal, state and local law. Truework is also committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans in our job application procedures. If you need assistance or an accommodation due to a disability, please let your recruiter know. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire.
by twochickswithasidehustle | Sep 21, 2024 | Uncategorized
WHO WE ARE: At Fors Marsh, we take on issues that matter. We are a team of researchers, advisors, and communicators working together to shape the systems that shape our lives. We look at human behavior from all angles to design targeted solutions that influence decision-making and move people to action. We are committed to the problem, not just the project, and we are intentional about taking on work and forming partnerships that balance purpose, people, planet, and profit. We are a certified B Corporation, a Just employer, and a 2019-2024 Top Workplace. We hold ourselves accountable to the values that have always defined us. And those values drive us to be the best possible versions of ourselves-for each other, our communities, our clients, and the world.
WHO WE ARE LOOKING FOR: Fors Marsh is currently looking for a self-motivated and competent individual for a position as a Social Media Support Specialist to work full time remote. The Social Media Support Specialist will provide a basic level of customer support via social media platforms with the goal of referring them to official recruiting websites to have more complex questions answered by other staff members.
Responsibilities include:
- Responsible for regular interaction with potential recruits through social media to answer any questions regarding the Army National Guard with goal of prequalifying these individuals.
- Actively responds to and moderates comments, and monitors activity in online communities (as identified by strategy team) to support marketing initiatives.
- Direct and facilitate interested ARNG candidates to the Call Center or website.
- Track and report every action that has been taken during your shift (Number of Likes, Deleted Comments, Approved Comments, etc.).
- Engage and lead conversations to topics that reference joining the National Guard.
- Advise visitors on enlistment eligibility according to ARNG enlistment criteria.
- Promptly complete all projects and administrative tasks as assigned; following operating procedures is key.
- Communicate effectively via telephone or chat and maintain the flow of information while keeping supervisors informed of any issues that may occur.
- Gain functioning knowledge of the portal software used to process applications.
- Complete and submit daily time reports.
- Represent Fors Marsh in a professional manner with all clients and partners.
Qualifications:
- High school diploma or equivalent is required.
- 1-3 years of experience monitoring social media activity, regularly responding to and moderating comments, and interacting in online communities is required.
- Thorough knowledge of social media platforms, especially: engaging on Facebook, LinkedIn, Twitter, and Instagram is required.
- Ability to multitask with multiple communication tools in order to provide an exceptional level of customer service is required.
- Ability to work evening/night shift (4:00 pm – 12:00 am EDT) if needed is required.
- Familiarity with Sprout Social, Meltwater, and/or Salesforce is preferred.
- Experience monitoring trending topics is preferred.
- Knowledge and experience in how to encourage greater social media participation is preferred.
- Applicants may be subject to a low-level government security investigation and must meet eligibility criteria for access to sensitive information.
- Must be a U.S. Citizen and consent to a full background check due to our federal contract requirements.
We Offer:
Our benefits typically meet or exceed our competitors’ packages. Ways we are unique?
- Ability to make an impact on people’s lives, both internal and external to the organization.
- Top-tier health, dental, vision, and long and short-term disability coverage all covered at 100% for employee coverage.
- Remote work.
- Our company culture, which values balance and allows each employee to take leave as they require it to balance the responsibilities of both their work and home lives without worrying about depleting their available leave hours.
- We provide a floating holiday bank so you can celebrate the days you value.
- Generous matching retirement contributions and no vesting period starting the third month of employment.
- Dedicated training and development budgets to expand your expertise and grow your skillset.
- You can volunteer your way with paid time off.
- You can participate in Fors Marsh staff-led affinity groups.
- Our employees receive product and service discounts through the certified B Corp network.
Salary: $50,000 – $55,000
FM Career Map: Social Media Support Specialist I-II
Location: Remote, United States Residents only
EOE: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran
by twochickswithasidehustle | Sep 21, 2024 | Uncategorized
We are on the hunt for some epic talent to join our CampusPress family.
You’ll be working on various WordPress projects across CampusPress, and Edublogs.
We’re looking for a person available to work on the following schedule:
Responsibilities
The role will involve:
- Providing support by email to our Edublogs and CampusPress customers.
- Assisting with and solving all manner of WordPress questions, with style!
- Contributing to testing and QA with updates to WordPress core, plugins, and themes.
- Coordinating with developers over bugs, features and cool new stuff.
- Being an active part of the Incsub team.
Reach for the skies, we have a heap of many challenges and opportunities for those who aspire to do more!
Qualifications
Requirements:
- Have a really good familiarity with WordPress, might even be able to code (PHP, MySQL, and/or HTML, CSS) a bit, or a lot, even better
- Experience in WordPress Multisite Networks
- Amazingly great communication skills
- Impressive response times, typing speed (it matters)
- Interpersonal skills, including the power to swiftly build rapport with both current and potential customers
- Are a great team player, keen on working in an expanding, motivated, distributed support team
- Enjoy collaborating with others, and don’t back down from a challenge
- Love people and love yourself!
We like all staff to be working 40 hours a week, but if you did want to work more hours, that’s also cool with us.
SKILL-SET
WordPress, Multisite Networks, Customer Support, Education Industry Knowledge, English language, Communication, PHP, MySQL, HTML, CSS
Job benefits
- Flexibility
- Very attractive working conditions for the right candidate
- 28 days paid leave per annum (up to 35 days)
- Opportunities for paid travel to attend WordCamps and other industry conferences
- Long service leave (3 months off paid) after you’ve been with us for a while
- Up to 2 months salary bonus based on company growth targets
- Technology budgets every three years; the longer you serve, the higher you deserve
- General expenses budget yearly; the longer you work, the more you get
What should I do now?
Download our CP Support Enthusiast Task Sheet, answer those questions and then submit your application. It’s that simple!
*** We are unable to consider applications that fail to demonstrate a high level of written communication.
HIRING PROCESS
Our hiring process includes the attached task and an interview with our management team, enclosing a 2nd task.
Good luck!
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