Bilingual Eligibility Specialist

Employer: Vesta Healthcare

Nice to meet you, we’re Vesta Healthcare.

Vesta Healthcare is a startup with a simple mission: Delivering extraordinary outcomes by unlocking the power of caregivers. We enable people with personal assistance to thrive at home, in their community by assuring their caregivers have the resources, data, and support they need. We achieve this through a combination of analytics, technology, services, and deep healthcare expertise.

Our program monitors in real-time, identifying issues before they become health events, and helping connect those in need with those who can help via technologies such as video, chat, and telephone. Our technology platform includes home-based mobile applications, a clinical dashboard, and data analytics on data not previously available to health professionals. We are disrupting a $109 billion industry and have recently closed our latest funding round with a blue-chip list of investors.

We’re looking to add to our team of experts who care deeply about our mission.

Our team is passionate, driven, collaborative, intellectually curious, and excited about the opportunity to transform our healthcare system. We’re inspired by caregivers and seek to create a platform that recognizes, utilizes and supports the vital role they play. We strive to continuously learn, explore, experiment and achieve results. We are here to improve the quality of life for caregivers and care recipients, allowing them to focus on the important things (like going to the mall with their grandkids)

The ideal teammate would be…

A proactive individual eager to learn about healthcare operations at a fast-paced, dynamic startup. This will involve remote administrative support for multiple, cross-functional teams within Business Operations, and comprehensive coordination of key processes that are foundational to the growth of the company. In this capacity, this individual will need to marry critical thinking and analytic skills to execute on assigned tasks with rigor, efficiency, and quality.

The ideal teammate would be able to:

  • Process and upload referrals accurately and efficiently utilizing all available resources to ensure all eligible referrals are put in outreach.
  • Determine insurance eligibility through the use of various platforms
  • Execute on data entry with close attention to detail and accuracy in support of internal reporting and workflow platforms
  • Remain organized while working with several projects simultaneously
  • Follow established workflows while continually striving to find ways to optimize and gain efficiencies
  • Understand the needs and opportunities across our internal and external stakeholders

Would you describe yourself as someone who has:

  • Advanced Excel Skills including VLOOKUP’s, PIVOT Tables, IF/THEN (required)
  • Knowledge of revenue cycle and insurance plans (preferred)
  • Prior healthcare insurance experience (required)
  • A strong proficiency in computer software navigation
  • Strong problem solving skills; able to identify problems and escalate when appropriate
  • A fundamental knowledge of GSuite
  • Bilingual English and Spanish (required)
  • Strong organizational skills, including the ability to prioritize and work several complex projects simultaneously
  • A demonstrated ability to work effectively as a member of an interdisciplinary team, displaying good judgment and decision-making skills
  • Passion about healthcare and affecting change in the current healthcare environment
  • Comfortable in a dynamic and always evolving start-up environment

In addition to amazing teammates, we also offer:

  • Health, dental, and vision insurance with a choice of many different plans/costs partially subsidized by us
  • Paid vacation
  • Paid Sick/personal days
  • 10 paid holidays
  • One time reimbursement to set up your home office
  • Monthly reimbursement for internet or other home office expenses
  • Monthly gym reimbursement to be used for gyms, home equipment, online classes, etc
  • Basic Life & AD&D, Short-term and Long-term Disability Benefits paid fully by us
  • Voluntary benefits such as Pet, Home and Auto, Legal Insurance plus more
  • Pre-tax Flex Spending/Dependent Care/Transit accounts
  • 401k

We look forward to speaking with you!

Pay range is $16.50-$18 hourly.

Vesta Healthcare is committed to leveraging the talent of a diverse workforce to create great opportunities for our business and our people. Vesta Healthcare is an Equal Opportunity/Affirmative Action Employer. Candidates are selected without regard to race, color, religion, sex, national origin, disability, marital status, or sexual orientation, in accordance with federal and state law.

APPLY HERE

Examiner I

Employer: American Specialty Health

Description

American Specialty Health Incorporated is seeking a Data Entry Examiner to support our Medical Necessity/Benefit Administration Department. This position is responsible for entering data from Medical Necessity Review Form (MNR Form) and Clinical Quality Evaluator (CQE) worksheets.

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

· Enters data from MNR Form and/or CQE worksheets. Employee must maintain a minimum level of production of 20 MNR Forms per hour and maintain quality at or above 98.0% Employee must process a minimum level of back end treatment forms as required.

· Reviews MNR forms to be sure all information is complete. Verifies member eligibility and creates patient records.

· Checks patient and provider information on MNR Forms against information on the eligibility tape in the Integrated Health Care System (IHIS).

· Inputs all required data from MNR forms into Integrated Health Care System (IHIS) in accordance with MNA guidelines; including but not limited to Out of Network: Administrative Partial and Complete Denials; submission Timeframe Denials and Network Access Denials.

· Forwards MNRs to the Clinical Quality Evaluators’ designated bins for clinical review.

· Retrieves patient files or history for the CQEs as necessary.

· Reviews CQE’s worksheets to make sure they are complete.

· Inputs all required data from worksheets into Integrated Health Care System (IHIS).

· Processes CQE worksheets in accordance to the MNA guidelines.

· Forwards worksheets to the Administrative Support staff for final processing.

· Demonstrates proficiency in eligibility verification, provider verification, identifying and pre-screening different form types.

· Add new members and sequence numbers in Member Maintenance.

· Researches via CHIP logs.

· Performs production query via Access.

· Forwards eligibility research to Membership.

· Process Duplicate request.

· Contact provider’s office to clarify missing or illegible information on the MNR forms.

· Completes daily tally sheets and production reports for Supervisor.

Qualifications

· High School diploma required.

· 2 years data entry experience (10,000 keystrokes per hour – minimum) and working knowledge of the computer keyboard.

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.

· Demonstrated accuracy and productivity in a changing environment with constant interruptions.

· Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.

· 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 oral 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) environment.

APPLY HERE

Claims Examiner I

Employer: American Specialty Health

Description

American Specialty Health Incorporated 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 American Specialty Health’s offerings to empower people to live longer and healthier lives. We’re 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

This job posting is not applicable in CO.

APPLY HERE

Data Entry Professional

Employer: Amplify Education

A pioneer in K–12 education since 2000, Amplify is leading the way in next-generation curriculum and assessment. Our captivating 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 turn data into practical instructional support to help students at every skill level build a strong foundation in early reading and math. Our programs provide teachers with powerful tools that help them understand and respond to the needs of all their students. Today, Amplify serves over eleven million students in all 50 states.

The Amplify Data Analytics and Data Governance team is looking for a Data Entry professional. This role will assist various Customer Care and Support departments with manual data entry and manual data cleanup initiatives. To do well in this role you need a very fine eye for detail, outstanding typing skills, and familiarity with excel or google sheets. This is a short term contract position and could be perfect for students or teachers over the summer months.

Responsibilities:

  • Meet with Team lead briefly in the morning to raise any issues/concerns/roadblocks regarding your task assignments
  • Coordinate with departmental directors or their managers to gain an understanding of the data entry or data cleanup needs
  • Manage timeline and set expectations appropriately
  • Ability to self-manage, set and meet deadlines, and ask for help when needed

Basic Requirements:

  • At least 18 years of age
  • Proficient typing (and spelling) skills
  • Demonstrated knowledge of and skill in word processing and spreadsheets
  • Experience using:
    • G Suite
    • Google Sheets

Preferred Qualifications:

  • Experience with technologies and tools such as:
    • Salesforce/NetSuite
  • Process oriented with great documentation skills

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

Senior Data Entry Clerk

Employer: Robert Half International

Robert Half is candidates for a CONTRACT Senior Data Entry Clerk in the Healthcare industry for a client. This position is a REMOTE position for residents in the United States.

  • Preparing source data by opening and sorting emails
  • Verifying and logging received data
  • Checking data for deficiencies and establishing priority entry
  • Accurate, high speed data entry

The schedule for this role is based in central time and would be 8am-5pm CST, Mon-Fri.

Requirements

  • High school diploma or GED equivalent
  • 1-3 years of heavy data entry experience
  • 1-3 years’ administrative experience in Medical/Insurance settings
  • Strong typing, compute, and written skills

APPLY HERE