Remote No Phone Work Opportunities for 07/07/2023

Claims Representative – Remote:

Delivers straightforward administrative and/or other basic business services in Claims. Examines and processes paper claims and/or electronic claims. Determines whether to return, pend, deny or pay claims within policies. Determines steps necessary for adjudication. Settles claims with claimants in accordance with policy provisions.

Compares claim application and/or provider statement with policy file and other records to evaluate completeness and validity of claim. Interacts with agents and claimants by mail or phone to correct claim form errors or omissions and to investigate questionable entries. Issues tend to be routine in nature. Good knowledge and understanding of Claims and business/operating processes and procedures. Works to clearly defined procedures under close supervision.

Responsibilities:

-Review claim submissions to confirm required documents have been received, verify medical codes, eligibility, other insurance, authorizations, and account benefit plans.

-Follows established policies and procedures to pay, pend for additional information, or deny claims.

-Adapt to and positively influence change by accepting feedback with a growth mindset to continuously improve.

-Follow processes and work independently to meet or exceed Key Performance Indicators (KPI)

-Ability to effectively excel in a virtual work environment through active participation in team huddles, Supervisor 1×1 or check-ins, using a variety of virtual tools, i.e. Outlook email, Skype for Business, Cisco Web-Ex or other similar applications.

-Maintains a high level of accuracy in all duties performed.

Payroll Coordinator – Remote, US:

The Payroll Coordinator supports the payroll function at Firstup by working to ensure our payroll expenses and taxes are paid correctly and on time. This role ensures that payroll procedures are compliant, efficient and current.

Responsibilities:
-Timely and accurate processing for all US and International functions (Canada, Ireland, Italy and UK) including the preparation, processing and disbursement of all regular and off-cycle payrolls, incentive compensation, payroll taxes and employee benefit payments as well as deductions
-Research and determine payroll discrepancies and perform corrections as necessary
-Maintain Timecard entry, approval and importing to payroll
-Partner with Human Resources to process payroll system inputs including new hires, changes in salary, overtime, terminations, benefits, severance, commissions, bonuses, address updates, tax withholdings, annual elections, etc. for all salaried and hourly employees
-Complete payroll submission in payroll processing system
-Advanced knowledge of running payroll related reports in ADP
-Ensure ongoing compliance with relevant laws and internal policies for both our US and International entities
-Regularly audit information contained within relevant payroll systems and provide assistance on clean-up

UCA Scoring Director:

As a member of the School Event Operations team, the UCA Scoring Experience Director enhances the company’s competition/event department through coordinating the Training and Education of the UCA Score Sheets and scheduling of judges for the UCA Competitions. An individual focused on the training and education of all coaches, staff and judges on the UCA Score Sheet. 

Selecting and securing judges for UCA events. Energetic and self-motivated professional, with consistent reputation for working within deadlines.  Eye-for-detail, work with operations team as well as sales and marketing team for UCA competition success. Implements best practices and develops standards, policies, and procedures.

Hospital Credentialing Coordinator:

Summary:

This non-exempt position performs administrative duties requiring accuracy and attention to detail in the hospital credentialing/recredentialing process. Maintains continuous contact with internal and external customers, including practitioners, administrators and support staff.  Additionally, this position is responsible for communicating provider information to stated internal and external customers through established processes for privileging/credentialing/recredentialing.

Duties:

• Manual Entry of Practitioner information into the credentialing data base in a timely manner
• Ability to read, extract and interpret information comparing such to established departmental policies. Maintains a computerized database of practitioner data for use in the credentialing & enrollment process 
• Excellent verbal and written communication skills
• Self-motivated with the ability to complete projects independently within established timelines
• Ensures workload deadlines are being met in a consistent manner 
• Must be flexible and willing to work extra hours during peak workloads and deadlines
• Ability to problem solve, make decisions and effectively communicate
• Ability to work productively within a team
• Prepares and provides reports, recredentialing applications, status reports, expired items reports and completed file reports to assure time frames are met and filing and scanning when necessary
• Accurately perform a variety of administrative duties such as: placing calls, processing facsimile verifications, scanning, sending written inquires, filing and copying.
• Pursue incomplete information in reference to provider health plan enrollment

Revenue Recovery Representative:

The Revenue Recovery Representative will support the functions of the Revenue Recovery Team. The RRR will be responsible for securing payment on the identified revenue outlined by the Revenue Recovery Team in a production environment. The RRR must have an understanding of how the uncovered revenue was identified and the contract specifications that define the expected payment the client should receive.

This position requires an entry level understanding of client-payer relationships on the clients behalf. The RRR is expected to exercise judgement when working assigned accounts and develop a strategy to secure payment. Duties include ascertaining trends, basic understanding of payer contracts and demonstrating a clear and experienced understanding of the healthcare insurance industry.

Job duties include, but are not limited to:

-Understanding insurance contract terms

-Reviewing underpayments to determine if additional payment amounts can be requested

-Identifying trends in payment discrepancies amongst payers

-Auditing correct payment amounts to ensure accuracy of contract

-Working with contract management to identify opportunities when negotiating contracts with payers

Administrative Coordinator: (some phone duties)

The Administrative Coordinator – Risk Adjustment is responsible for day-to-day support in the administration and coordination of all Risk Adjustment projects. Assigned tasks will vary based on the needs of the programs at any given time but will include core tasks such as chart retrieval support, taking of meeting minutes, file organization, program tracking, scheduling meetings, and other related administrative tasks.

Key Functions/Responsibilities:

-Work with Performance Managers to address and resolve medical record retrieval pends
-Communicate via phone and email with provider offices when needed to address complications in retrieving medical records
-Assist Performance Managers with the implementation, management and administration of retrospective and prospective risk adjustment projects
-Provides document production support and assistance with spreadsheets, presentations, and other documents as needed
-Respond to inquiries and/or research information as needed
-Maintain department files and record-keeping systems
-Provide administrative support for regular meetings this includes the development of agendas, taking meeting minutes and circulating follow-ups as directed
-Identifies opportunities for improvement in administrative workflows and processes Other duties as assigned

Temporary Group Admin Remote:

Essential Functions:

• Analyze and interpret documentation received from Sales (EGI, NGI, Revisions, Client Fact Sheet, etc.) to determine Facets setup, configuration, and accurately build a variety of fully-funded benefit options, group structures, and enroll members.
• Communicate as required with internal/external customers regarding group and member status through Facets documentation, phone calls, written correspondence, and approved form letters.
• Maintain an understanding of state and federal requirements and accreditation standards that impact the group/member process.
• Works under close supervision with established policies/procedures.
• Participate in cross-functional training opportunities within Revenue Cycle during the non-peak open enrollment period.

Document Review Analyst:

Pay rate: $20 per hour 

Document Review Analysts will review documents for Personal Identifiable Information (PII) and Protected Health Information (PHI) using various electronic review platforms. This position is project-based and successful candidates will be considered temporary contingent employees.?

Responsibilities:

• Experience in electronically reviewing documents using our various review platforms including Relativity, Canopy, and Nebula is preferred but not required? 
• Experience utilizing Microsoft Office, specifically Microsoft Excel? 
• Experience in computer-based data entry is preferred but not required? 

• Experience with medical billing/coding or experience as medical records technician is desired 
• A secure home office with high-speed internet access and a Mac or PC with Windows 10 or newer operating system is required ? 
• Proficient in the use of modern technology, especially computers, and related remote work office equipment? 
• Strong attention to detail and ability to prioritize tasks? 
• Critical thinking skills and ability to retain complex work direction? 

• Excellent verbal and written communication skills? 

—
Please remember that we are not affiliated with these companies. Always do your due diligence before entering into a contract or agreement with said companies.