SIU Specialist Investigator
investigator working from their residence and servicing in the Inland Empire/Temecula-Riverside area. Basic functions include: Investigation of claims, analysis and development of facts and evidence, and conducting and/or directing Examinations Under Oath. This investigator will coordinate investigations with outside SIU contacts, the Department of Insurance Fraud Division, NICB, and various law enforcement agencies. A laptop computer, cell phone and digital camera, MP3 recorder and other office equipment will be provided. Applicants must have the ability to travel throughout the Inland Empire/Temecula-Riverside area.
Position Responsibilities:
- Attends necessary training schools and participates in training to develop and improve skills, develops contacts and meets state regulatory educational requirements.
- Investigates files by using appropriate field, computer and telephone investigative techniques and provides appropriate documentation of actions in a thorough timely manner.
- Maintains a diary system on all assigned files. Diary system is to be worked so that the tempo is sufficient to assure prompt and timely recommendations.
- Prepares necessary reports for state fraud bureaus and cooperates with state agencies as required by law and management. Keeps the Special Investigation Unit and field managers advised of all critical situations.
- Reports findings of all investigations and makes recommendations to the responsible manager or other designee in a timely manner to facilitate prompt decisions.
- Develops and maintains contacts with other special investigative units and fraud related organizations.
- Acquires and maintains current knowledge in all appropriate jurisdictions regarding changes in law to ensure operations are within proper parameters established by law.
Position Qualifications:
- Three years of insurance claims investigation experience or professional investigation experience with law enforcement agencies; or
- Five years of professional investigation experience involving economic or insurance related matters; or an authorized medical professional to evaluate medical related claims.
- College Degree or equivalent work experience
- Must have a working knowledge of Digital photo and document metadata and have experience with using the internet and social networking for investigative purposes.
- The candidate must possess knowledge of the principles of casualty insurance and the auto casualty claims adjustment process.
- Investigative and legal expertise needed for this position.
- Completion of the NICB Basic and/or Advanced Academies and the Reid Interviewing and Interrogation Courses are desirable.
- Must have excellent communication skills and thorough working knowledge of Microsoft office applications.
- Must demonstrate a thorough knowledge of the workings of related state and federal agencies. The SIU investigator must possess oral and written communications skills and promote a favorable company image to the public.
- Fraud Claims Law Specialist (FCLS) or Fraud Claims Law Associate (FCLA) designations and Certified Insurance Fraud Investigator (CIFI) or Certified Fraud Examiner (CFE) designations are preferred.
- A valid driver’s license and clean driving record is required.
- Sponsorship is not accepted for this opportunity.
- Applicants must have the ability to travel throughout the Inland Empire/Temecula-Riverside area.
- The range for this position is $25.77 – $45.05 per hour. When determine candidate offers, we consider experience, skills, education, certifications, and geographic location among other factors. this job is also eligible for our Kemper benefits package (Medical, Dental, Vision, PTO, 401k, etc.)
Kemper is proud to be an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, disability status or any other status protected by the laws or regulations in the locations where we operate. We are committed to supporting diversity and equality across our organization and we work diligently to maintain a workplace free from discrimination. Kemper does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Kemper and Kemper will not be obligated to pay a placement fee.
Kemper will never request personal information, such as your social security number or banking information, via text or email. Additionally, Kemper does not use external messaging applications like WireApp or Skype to communicate with candidates. If you receive such a message, delete it.
#LI-JO1
#LI-REMOTE
Software Support Engineer
As a Software Support Engineer, you play a crucial role in bridging the gap between Customer Support and our Engineering teams responsible for Data Management (tables, queries, data sharing), Automations and Connectivity (scripting, automated API requests and data transformation) , Public API (Workiva’s APIs and documentation), and Spreadsheets. Your primary responsibility is to provide technical support to our Customer Success team members, ensuring timely resolution of customer issues and delivering exceptional customer experiences. You’ll collaborate with multiple development teams to identify root causes and implement effective solutions, contributing to our commitment to customer satisfaction.
What You’ll Do
- Understand and clearly articulate customer needs and requirements
- Work with Software Engineers to design innovative components of back-end systems or solutions to meet internal customer needs
- Brainstorm and implement ways to streamline processes for fast and adaptable support structures
- Identify, verify, and reproduce difficult issues to solve customer problems from various sources.
- Manage relationships with Customer Support, Success, and Development teams to ensure required features are delivered for successful product delivery
- Act as a first line of support for Customer Success staff to diagnose and troubleshoot customer issues
- Collaborate with functional testers in Quality Assurance for testing and regression analysis.
- Facilitate resolution of complex issues involving multiple teams
- Interact as part of multiple development teams to find customer solutions
- Incident Management: Manage service disruptions within the organization while minimizing impact on business operations and ensuring timely resolution
- Take ownership of incidents, coordinating resources from engineering and customer facing teams for quick resolution and timely communication to customers and stakeholders
- Ensure accurate documentation of incidents, including summaries, post-incident reviews, and lessons learned for knowledge sharing and continuous improvement
What You’ll Need
Minimum Qualifications
- 2+ years of experience (in software, QA, Support or applicable related IT fields)
- Bachelor’s Degree or equivalent experience – an advanced degree will be considered in lieu of experience
Preferred Qualifications
- Coursework or experience in supporting software development teams
- Experience with SQL or general understanding of databases and querying tables
- Understanding of APIs and some modern API testing tools (Postman, Insomnia)
- Understanding of spreadsheet formulas and functionalities common in industry standard spreadsheet editing software
- Experience providing software support to non-technical users
- Experience troubleshooting and conducting root cause analysis of a software platform
- Strong communication skills
- A sense of urgency allowing for fast response to issues that need to be addressed in a timely fashion
- Nice to have – Experience with logging tools such as Splunk, Sumologic, New Relic, and/or Datadog
Travel Requirements & Working Conditions
- Minimal Travel
- Ability to be on a rotating on-call schedule (minimal disruption)
- Reliable internet access for any period of time working remotely, not in a Workiva office.
How You’ll Be Rewarded✅ Salary range in the US: $61,000.00 – $104,000.00
✅ A discretionary bonus typically paid annually
✅ Restricted Stock Units granted at time of hire
✅ 401(k) match and comprehensive employee benefits package
The salary range represents the low and high end of the salary range for this job in the US. Minimums and maximums may vary based on location. The actual salary offer will carefully consider a wide range of factors, including your skills, qualifications, experience and other relevant factors.
Workiva is an Equal Employment Opportunity and Affirmative Action Employer. We believe that great minds think differently. We value diversity of backgrounds, beliefs, and interests, and we recognize diversity as an important source of intellectual thought, varied perspective, and innovation. Employment decisions are made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression genetic information, marital status, citizenship status or any other protected characteristic. We strongly encourage and welcome people from historically marginalized groups to apply.
Workiva is committed to working with and providing reasonable accommodations to applicants with disabilities. To request assistance with the application process, please email [email protected].
Workiva employees are required to undergo comprehensive security and privacy training tailored to their roles, ensuring adherence to company policies and regulatory standards.
Workiva supports employees in working where they work best – either from an office or remotely from any location within their country of employment.#LI-JW1
Senior Coder-Anesthesia
POSITION SUMMARY:
The Senior Coder-Anesthesia position is responsible for reviewing documentation in the outpatient/inpatient EHR. This position is responsible for assigning ICD-10-CM diagnosis codes and CPT, ASA, HCPCS II and appropriate modifiers to patient records from BMC Anesthesia Departments. The Senior Coder-Anesthesia position is a resource for the physicians and other health care providers in regard to coding and to review medical documentation to insure appropriate physician coding and billing.
Position: Senior Coder-Anesthesia
Department: FPF Prof. Billing Office
Schedule: Full Time
ESSENTIAL RESPONSIBILITIES / DUTIES:
- Perform coding and related duties of moderate and high complexity anesthesia work using established guidelines in an accurate and timely manner.
- Review medical documentation and system generated charges or paper encounter forms. Appropriately assign CPT, ASA, ICD-10, HCPCS II, and modifiers based on documentation and payor requirements
- Research billing rules and regulations for moderately complex new and existing procedures
- Demonstrate a commitment to integrating coding compliance standards into daily coding practices. Identify, correct and report coding problems.
- Maintains knowledge of coding and professional skills, including maintaining yearly coding credentials through attendance at in-service programs, conferences, workshops, review of current literature and other educational programs.
- Resolves complex coding edits and denials in a timely manner. Identify opportunities to reduce denials and enhance revenue.
- Provide cross coverage of multiple specialties
- Function as a resource to external customers. Research and resolve complex coding inquiries. Make recommendations for coding policy changes.
- Perform peer to peer quality assurance reviews of all Physician Practice Coders in equal or lower complexity areas of expertise
- Functions as subject matter expert for assigned specialties
- Develop and maintain division specific coding procedures and/or billing area instructions
- Complete special projects as assigned by manager.
- Participate in coding education for providers and co-workers upon request.
- Maintain coding certification.
- Sequences diagnoses, procedures and complications by following ICD-10-CM, Medicare, Medicaid, and other fiscal intermediary guidelines.
- Maintains productivity standards set forth in Departmental Policies and procedures.
- Review and respond to coding questions.
- Ensure billed service is being accurately coded.
- Perform random chart audits.
- Performs other duties as needed.
Must adhere to all of BMC’s RESPECT behavioral standards.
(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).
JOB REQUIREMENTS
EDUCATION:
Associates Degree (or direct work experience equivalent to at least 2 years)
CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:
Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is required. Certification may include CPC, COC, COC-A, CANPC, CGSC, CIC, CCA, CPC-A, CCS, CCS-P, RHIT, or RHIA
EXPERIENCE:
Minimum of 2 years experience conducting Anesthesia coding/auditing in a surgical/procedural environment to include compliance, and billing processes.
KNOWLEDGE, SKILLS & ABILITIES (KSA):
- Advanced Proficiency in ICD-10, CPT, ASA, HCPCS, and modifiers for coding of professional fee services.
- Advanced knowledge of anatomy and physiology, medical terminology and insurance reimbursement policies and regulations.
- Excellent written and verbal communication skills and the ability to prioritize and organize work to meet strict deadlines are required.
- Able to code moderate/high complexity work.
- Understands, retains, and is able to research coding billing rules, regulations, and requirements.
- Able to critically think through processes in coding to recognize errors and/or problems. Understands reasons for actions on edits.
- Able to share/transfer knowledge or train co-workers, peers, billing managers on coding – Able to provide education with physicians in small group or one-on-one sessions as needed or requested.
- Able to provide feedback to billing managers, physicians, staff, and others independently with occasional guidance from manager.
- Able to provide cross-coverage of multiple specialties.
- Able to perform peer to peer quality assurance reviews in equal or lower complexity areas of expertise.
- Proficient with computer applications (MS Office etc), Excellent data entry skills
- Strong knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques required.
- Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
- Ability to work with accuracy and attention to detail
- Ability to solve problems appropriately using job knowledge and current policies/procedures.
- Ability to work cooperatively with members of the healthcare delivery team and staff, ability to handle frequent interruptions and adapt to changes in workload and work schedule and to respond quickly to urgent requests.
- Must be able to maintain strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulations.
Part-Time Scheduling
Employees are scheduled 25-29 hours per week, and up to 36 hours depending on our client’s needs during peak seasons.
Assigned hours will fall within the Call Center Hours of Operation: Monday through Friday 8am to 8pm EST, and Saturday 10am to 5pm EST.
Assigned shifts of 4 – 7 hours are established on a monthly basis.
Flexibility and reliability is required as schedules may occasionally change with little notice.+
Colorado / Florida / Georgia / Illinois / Indiana /
Iowa / Kansas / Missouri / Nevada / North Carolina /
Ohio / Oregon / South Carolina / Texas / Utah /
Virginia / Washington / Wisconsin /
Minimum requirements
High school diploma or equivalent
Experience with spreadsheets (Excel or Google Docs)
Language proficiency
Knowledge of customer service principles and practices
Experience in a call center or customer service environment
Knowledge of administration and clerical processes
Active Antivirus and Malware Software
Home office free of background noise and distractions
Minimum equipment requirements
Windows 7 or higher w/2 GB RAM or Internet Explorer 10 or higher
Private, hardwired internet connection and phone line (landline or qualified VoIP service, free of all features)
Noise cancelling headsets with mute function hardwired to phone and computer
Pay Rate
ACD Connect offers competitive hourly wages.
Periodic evaluations are conducted and pay increases are given at the company’s discretion.
Paid time off is awarded based on hours worked and can be used after an initial 6 month probation period.
Accounts Payable Assistant
Crunch Fitness is looking for energetic, enthusiastic people that are passionate about health and fitness! We are looking for an Accounts Payable Assistant to join our team.
Crunch is a gym that believes in making serious exercise fun by fusing fitness and entertainment and pioneering a philosophy of No Judgments. Our gyms are packed with the latest state-of-the-art cardio and strength training equipment, weight room, full service locker rooms with showers, tanning booths, HydroMassage® bed, and an extensive schedule of Crunch’s signature classes including Zumba®, BodyWeb with TRX®, Yoga Body Sculpt, Belly Butt and Thighs Bootcamp, and more.
About Us:
Fitness Holdings, LLC is a franchise of CRUNCH Fitness. We are headquartered in Greenwich, CT. Our mission is to launch a network of CRUNCH gyms across the northeastern United States. With franchise rights in Westchester County, NY, Philadelphia, PA, Northern New Jersey and Boston, MA, Fitness Holdings, LLC is on pace to build 50 clubs throughout the Northeast Corridor.
With a focus on low cost, high volume and superior customer service, Fitness Holdings, LLC’s first location opened in May 2013 in White Plains, NY and have grown to 26 clubs today, and still growing!
Why you should join our team:
We offer a very competitive salary and benefits package. We are a rapidly growing company that is looking for people to join our team that want to grow their careers with us. We believe in promoting within and ensuring growth opportunities for our employees.
Job Summary:
The Accounts Payable Assistant must multi-task in a fast-paced environment. This role will directly support the company’s finance team with day-to-day responsibilities.
Essential Job Responsibilities:
- Work with Finance team to handle all accounts payable, invoicing and financial reporting.
- Properly code and schedule all invoices for payment in a timely manner.
- Review and manage all corporate expenses, credit card statements and other items.
- Liaise with vendors to verify the accuracy of invoices, track missing invoices, payments, respond to requests, etc.
· Update daily and monthly sales, accounting, and operational reports
· Reconcile and audit all club cash deposits.
· Maintain and organize club licenses. Renew when necessary.
Qualifications:
· 1-3 years’ experience in finance and accounts receivable.
· Comfortable with Excel
- Strong attention to detail, self-directed and results-oriented
- Strong customer service and communication skills with ability to work independently as well as within a team
Please note: This job description was designed as a summary of the typical function of the job and is not a comprehensive list of all possible job responsibilities. The tasks and duties might differ from those outlined above and other duties, as assigned may be part of the job.
Flexible work from home options available.
Compensation: $25.00 – $40.00 per hour
Crunch Fitness is looking for energetic, enthusiastic people that are passionate about health and fitness to join our team.
Looking to combine work, fitness and fun? Crunch Fitness is looking for energetic, enthusiastic people that are passionate about health and fitness to join our team. Working at Crunch is more than a job, it’s an opportunity to inspire others to reach their fitness goals. Our ‘No Judgments’ philosophy attracts a diverse and welcoming group of professionals and makes Crunch an amazing company to work for.
Crunch is a gym that believes in making serious exercise fun by fusing fitness and entertainment and pioneering a philosophy of No Judgments. Our gyms are packed with the latest state-of-the-art cardio and strength training equipment, weight room, full service locker rooms with showers, tanning booths, HydroMassage® bed, and an extensive schedule of Crunch’s signature classes including Zumba®, BodyWeb with TRX®, Yoga Body Sculpt, Belly Butt and Thighs Bootcamp, and more.
Recent Comments