by Terrance Ellis | Jul 18, 2025 | Uncategorized
(Remote – U.S.)
🧾 About the Role
WVU Medicine is hiring a full-time Insurance Authorization Specialist III to handle infusion and injection pre-authorizations. This remote role plays a critical part in securing timely approvals, ensuring financial clearance, and protecting the patient experience. You’ll collaborate closely with clinical and pharmacy teams to navigate documentation, coding, and payer requirements.
✅ Position Highlights
• Pay: Not listed
• Schedule: Full-Time (Day shift)
• Location: Remote (U.S.)
• Employment Type: Non-Exempt
• Department: Hospital Authorization Unit
📋 What You’ll Own
• Obtain prior authorizations for elective infusions and injections
• Review clinical notes and support approval or appeal processes
• Submit and follow up on authorizations via portals or phone
• Act as a liaison between providers, pharmacists, and insurance payers
• Interpret and verify CPT/ICD-10 codes and insurance policies
• Manage Epic work queues, in-baskets, and Outlook communication
• Handle peer-to-peer reviews, denials, and retro authorizations
• Submit inpatient chemo admissions and observations for approval
• Attend team meetings and monthly check-ins
🎯 Must-Have Traits
• High school diploma + 2 years of medical office or insurance experience
OR Associate’s degree + 1 year of relevant experience
• Proficiency in medical terminology, ICD-10, CPT coding, and insurance protocols
• Strong communication, organizational, and multitasking skills
• Proficient in Microsoft Office and comfortable with fast-paced workflows
• Minimum 25 WPM typing speed
💻 Remote Requirements
• Reliable internet, computer, and phone
• Ability to sit for extended periods
• Comfortable navigating Epic, payer portals, fax software, and productivity tools
💡 Why It’s a Win for Remote Job Seekers
• 100% remote with stable day shift
• Supportive team culture with structured onboarding
• Opportunity to grow within one of the nation’s largest academic health systems
• Clear responsibilities and meaningful behind-the-scenes impact
✍️ Call to Action
If you’re experienced in healthcare authorizations, fluent in payer processes, and thrive in fast-paced environments—apply now and join WVU Medicine’s remote authorization team.
by Terrance Ellis | Jul 18, 2025 | Uncategorized
(Remote – U.S.)
🧾 About the Role
Velera is hiring a full-time Fraud Detection Representative to help identify and stop suspicious debit and credit card activity before losses occur. You’ll join a fast-paced fraud call center, working directly with account alerts, flagged activity, and member outreach. This remote role starts with paid training on September 2, 2025 and plays a direct role in financial risk prevention.
✅ Position Highlights
• Pay: $17.87 – $18.03 per hour
• Schedule: Full-Time; includes nights, weekends, and holidays (24/7/365 operations)
• Start Date: September 2, 2025
• Location: Remote (U.S.-based)
• Equipment: Tech setup and Ethernet cable provided
• Internet Requirement: 100 Mbps down / 30 Mbps up minimum
📋 What You’ll Own
• Monitor and investigate debit and credit fraud cases via Falcon system
• Make outbound verification calls and respond to real-time inbound alerts
• Flag suspicious patterns and support proactive fraud prevention steps
• Process lost/stolen account reports with attention to compliance
• Log accurate notes and ensure appropriate next steps to protect members
• Stay current with emerging fraud trends and contribute to reporting
• Meet performance metrics for call volume, accuracy, attendance, and quality
🎯 Must-Have Traits
• High school diploma or GED
• Minimum 6 months customer service experience (call center preferred)
• 1+ year experience in fraud detection or investigation (preferred)
• Proficient with PC-based tools and multiple platforms
• Calm, focused, and quick under pressure
• Strong multitasking and communication skills
• Detail-oriented and committed to safeguarding customer data
💻 Remote Requirements
• Quiet, dedicated home office
• Reliable hardwired internet connection (100 Mbps down / 30 Mbps up minimum)
• Smartphone or tablet running iOS 15+ or Android 8.0+
• Must provide proof of internet speed and connectivity as requested
💡 Why It’s a Win for Remote Job Seekers
• No commute, full benefits, and a purpose-driven role in fintech
• Paid holidays, PTO, and volunteer time off
• Mental health support and tuition reimbursement
• 401(k) with match, healthcare options, and room for advancement
• Inclusive culture rooted in innovation, growth, and integrity
✍️ Call to Action
If you’ve got a sharp eye for fraud, a steady voice under pressure, and a drive to protect people from financial risk—apply now to join Velera as a Fraud Detection Representative. Help stop fraud before it starts and build a lasting remote career.
by Terrance Ellis | Jul 18, 2025 | Uncategorized
(Remote – U.S.)
🧾 About the Role
R1 RCM is hiring a full-time Revenue Cycle Adjustments Specialist to work remotely on denied hospital claims. This role focuses on resolving complex inpatient claim issues—especially for Blue Cross Blue Shield payors in Texas and Louisiana—by analyzing denials, submitting appeal letters, and posting adjustments in Epic and Meditech. It’s a great fit for someone experienced in denial resolution and ready to thrive in a metrics-driven environment.
✅ Position Highlights
• Pay: $18.23 – $27.14 per hour
• Schedule: Full-Time
• Location: Remote (U.S. only)
• Deadline to Apply: August 8, 2025
• Company: R1 RCM
📋 What You’ll Own
• Analyze and resolve denied hospital and inpatient claims
• Draft and submit appeals, primarily to BCBS payors
• Perform account adjustments and inflows in Epic and Meditech
• Manage both backlog and new denied claim inventory
• Conduct root cause analysis and provide resolution strategies
• Communicate directly with payors for updates and status verification
• Document updates based on payer correspondence
• Work with a mentor and collaborate with support teams to meet goals
🎯 Must-Have Traits
• High school diploma or GED
• Proven experience handling Blue Cross Blue Shield denials (TX and LA)
• Background in denied inpatient or hospital claims
• Skilled in writing appeal letters to insurance providers
• Familiarity with Epic and Meditech systems
• Detail-oriented with strong analytical skills
• Comfortable working independently in a high-volume, fast-paced setting
💻 Remote Requirements
• Reliable home office with high-speed internet
• U.S.-based
• Self-motivated and accountable in a remote work structure
💡 Why It’s a Win for Remote Job Seekers
• Specialized focus on payor-specific claims
• Clear performance goals with mentoring and growth support
• Strong team culture with up-to-date systems and tools
• Meaningful impact in the healthcare revenue cycle
✍️ Call to Action
If you know your way around denied claims, appeal strategies, and payor systems—and want to join a team driving innovation in healthcare finance—apply by August 8, 2025, and help R1 RCM streamline reimbursement from the inside out.
by Terrance Ellis | Jul 18, 2025 | Uncategorized
(Remote – U.S.)
🧾 About the Role
The West Virginia University Health System is hiring a Hospital Coding Specialist III for a fully remote, full-time position. In this role, you’ll focus on complex inpatient and interventional radiology (IRAD) coding, ensuring accurate MS-DRG assignment and compliant billing. You’ll collaborate across departments to support fast, clean claims and optimize revenue cycle performance.
✅ Position Highlights
• Schedule: Full-Time (40 hours/week)
• Location: Remote (U.S. only)
• Employment Type: Non-Exempt
• Team: System HIM Coding Analysis
• Pay: Not listed
• Company: WVU Health System
📋 What You’ll Own
• Code inpatient and IRAD records 90% of the time
• Assign accurate ICD-10-CM, ICD-10-PCS, CPT, and modifier codes
• Ensure proper MS-DRG grouping and charge capture
• Code high-complexity patient classes
• Work with providers and departments to clarify and complete documentation
• Review records for discrepancies and ensure clean claims
• Stay up to date on coding changes and best practices
• Meet or exceed daily productivity and accuracy benchmarks
• Support quality initiatives, audits, and team training
🎯 Must-Have Traits
• High school diploma or GED required
• One of the following credentials: RHIT, RHIA, CCS, COC-A, COC (formerly CPC-H), or CIC
• At least 3 years of inpatient or interventional radiology coding experience
• Deep understanding of ICD-10-CM/PCS, CPT, MS-DRGs, anatomy, and medical terminology
• Strong attention to detail, prioritization, and focus under deadlines
• Excellent communication and documentation skills
💻 Remote Requirements
• Secure and reliable home office setup
• Self-directed work ethic with strong time management
• May require occasional travel
💡 Why It’s a Win for Remote Job Seekers
• 100% remote role with consistent hours
• Join one of the largest and most respected healthcare systems in the region
• Specialized, high-impact work with clear goals and training support
• Collaborative remote team culture with opportunities for advancement
✍️ Call to Action
If you’re a credentialed coder ready to tackle high-complexity inpatient and IRAD records from the comfort of home, this role is your next step. Apply now to bring your precision and expertise to WVU Medicine’s Health Information team.
by Terrance Ellis | Jul 18, 2025 | Uncategorized
(Remote – U.S.)
🧾 About the Role
The West Virginia University Health System is hiring a remote Epic Systems & Contracts Analyst to manage and maintain EPIC HB contract builds, drive technical analysis, and support revenue optimization efforts. In this full-time role, you’ll work cross-functionally to streamline workflows, identify reimbursement opportunities, and ensure compliance with government and payer regulations.
✅ Position Highlights
• Schedule: Full-Time (40 hours/week)
• Location: Remote (U.S.-based only)
• Employment Type: Exempt
• Team: System Contract Management
• Pay: Not listed
• Company: WVU Health System
📋 What You’ll Own
• Build and maintain Epic HB contracts and pricing structures
• Perform in-depth technical analysis on Epic rules, extensions, and components
• Identify reimbursement opportunities and monitor contract outcomes
• Develop advanced Excel models and maintain Access databases
• Manage reporting across platforms like Reporting Workbench, WEBI, StrataJazz, and SQL
• Collaborate with PFS, IT, and payer representatives
• Ensure contract compliance with government and payer regulations
• Recommend system enhancements and implement process improvements
• Support Epic upgrades, migrations, and user training initiatives
• Maintain accurate documentation and communicate with leadership
🎯 Must-Have Traits
• Bachelor’s in Business, Healthcare Administration, or related field + 2 years of experience
OR high school diploma + 6 years of relevant experience in healthcare data/systems
• EPIC Contracting Certification (required within 1 year of hire)
• Strong technical skills in Excel, Access, and SQL
• Understanding of Epic HB workflows, reimbursement models, and contract logic
• Working knowledge of DRG, CPT, OPPS, and other payer methodologies
• Excellent communication and problem-solving skills
• Ability to work independently and manage confidential data
💻 Remote Requirements
• Reliable, quiet home office setup
• High-speed internet and comfort with collaboration tools
• Willingness to attend occasional virtual or in-person meetings and trainings
💡 Why It’s a Win for Remote Job Seekers
• Work remotely with a respected healthcare leader
• Gain hands-on experience with Epic systems and reimbursement strategy
• High-impact role with access to cross-functional collaboration and career growth
• Support 20+ hospitals in optimizing payer performance
✍️ Call to Action
If you’re a tech-savvy healthcare analyst ready to take charge of Epic contract workflows and drive revenue insights, this is your chance to make an impact. Apply today and join WVU Medicine in transforming healthcare operations from the inside out.
by Terrance Ellis | Jul 18, 2025 | Uncategorized
(Remote – U.S.)
🧾 About the Role
The West Virginia University Health System is hiring a Reimbursement Analyst to focus on audit and regulatory functions. This full-time, fully remote role is ideal for finance professionals who thrive on data accuracy, compliance, and strategic cost analysis. You’ll manage Medicare/Medicaid cost reports, coordinate audits, and ensure financial integrity across multiple departments.
✅ Position Highlights
• Schedule: Full-Time (40 hours/week)
• Location: Remote (U.S.-based only)
• Employment Type: Exempt
• Department: System Finance & Reimbursement
• Pay: Not listed
• Company: WVU Health System
📋 What You’ll Own
• Prepare and amend third-party cost reports (Medicare, Medicaid, CHAMPUS)
• Coordinate audits and collect accurate financial data across departments
• Analyze complex data sets to ensure accuracy and consistency
• Maintain and update cost reporting software
• Build and monitor reimbursement budget models aligned with regulations
• Track interim rates, settlements, and third-party receivables
• Handle Medicaid DSH surveys and associated audits
• Perform monthly contractual reserve analyses and journal entries
• Manage wage index reporting, occupational mix surveys, and Medicare responses
• Contribute to cross-functional planning and improvement projects
🎯 Must-Have Traits
• Bachelor’s degree in Accounting, Finance, or Business Administration
• 3+ years of experience in finance or accounting
• Advanced analytical skills and high attention to detail
• Proficient in Excel and financial software systems
• Strong communication skills for audit coordination and team interaction
• Comfortable working independently in a remote environment
• Knowledge of federal and state reimbursement rules preferred
💻 Remote Requirements
• Quiet, distraction-free home office
• Reliable internet and ability to work full days on a computer
• Strong written and verbal communication for audit-heavy documentation
💡 Why It’s a Win for Remote Job Seekers
• 100% remote position with stable full-time hours
• Contribute to the financial backbone of a respected health system
• No commute, flexible environment, and meaningful analytical work
• Be part of a team managing reimbursement across more than 20 hospitals
✍️ Call to Action
If you’re a detail-driven finance professional who understands the importance of regulatory compliance and cost accuracy, step into a role where your work truly matters. Apply now and help WVU Medicine strengthen its financial operations from anywhere in the U.S.
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