Intensive Community Manager
Case specialist job in Columbus, OH
We're unique. You should be, too.
We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.
The Intensive Community Care Manager (ICCM) is a Registered Nurse (RN) who works with our highest complexity patients, their primary care physicians, and other members of the care team that provides hyperfocus case management and field nursing interventions to prevent unnecessary hospital arrivals, keep patients engaged in our intensive primary care model and maximize their healthy time at home.
The Intensive Community Managers (ICCMs) will serve as a clinical lead for the Complex Care Team. They will assess, evaluate, and coordinate the team's efforts to stabilize our highest risk patients, with special areas of focus including safe transitions of care from facilities back to our primary care teams, stabilization of our highest risk ambulatory patients and outreach to patients who are assigned to us but are not engaged in care. This person will perform assessments and design comprehensive plans of care, and drive the actions needed to keep the most complex patients safely at home. This professional will also provide clinical supervision to other team members in delivering the plan of care and in other tasks necessary to meet their needs and engage them in care. As a clinical leader for the team, this person will also be deeply involved in prioritizing team efforts and may also become the direct supervisor for some team members. The Intensive Community Manager works in partnership with the PCPs to draft personalized care plans that address patient's immediate needs that cause a risk for unnecessary hospital arrivals.
This position adheres to strict departmental goals/objectives, standards of performance, regulatory compliance, quality patient care compliance and policies and procedures.
ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
Provides in-house, at facility, and telephonic visits to patients at high-risk for hospital admission and re-admission (as identified by CM Plan) with the main goal of preventing unnecessary hospital arrivals for patients that have consented to the program and after successfully completed full course of program.
Provides home visits to perform field nursing interventions, assess patient, and the development of care plan to identify the goals, barriers, and interventions that will be addressing during the follow up patient visits. Once a patient has completed their episode of care management the register nurse (RN) will review patient chart for discharge and conduct final discharge with patient. Discharge from program may require formal approval from Complex Care Leadership Team
Conducts supervisory visits with License Practical Nurse (LPN) and patient to provide any additional education patient may need and to oversee appropriate patient discharge from case management.
Performs clinical, fall prevention, and social determination of Heath screening (SdoH) assessments to include disease-oriented assessment and monitoring, medication monitoring, health education and self-care instructions in the outpatient in home setting.
Performs home field nursing interventions that have been agreed by PCP, Center Leadership, and Complex Care Leadership that would prevent hospital arrival. Such intervention may include taking vital signs, weighing patient, appropriate one time visits ordered by PCP and reviewed by the Manager for approval, and others as determined in Standard Operation Procedures (SOP)
Coordinate the Plan of Care:
Conducts/coordinates initial case management assessment of patients to determine outpatient needs and obtains patients consent to program.
Ensures individual plan of care reflects patient needs and services available in the community or review of their benefits.
Completes individual plan of care intervention with patients, family/care giver and care team members with a focus of incremental actions that will prevent unnecessary hospitalizations.
Assesses the environment of care, e.g., safety and security. Conduct fall risk assessment as needed.
Assesses the caregiver's capacity and willingness to provide care.
Assesses and educations patient and caregiver educational needs.
Coordinates, reports, documents and follows-up on multidisciplinary team meetings serving as host or lead for those conversations as needed.
Helps patients navigate health care systems, connecting them with community resources; orchestrates multiple facets of health care delivery and assists with administrative and logistical tasks.
Coordinates the delivery of services to effectively address patient needs.
Facilitates and coaches' patients in using natural support and mainstream community resources to address supportive needs.
Maintains ongoing communication with families, community providers and others as needed to promote the health and well-being of patients.
Establishes a supportive and motivational relationship with patients that support patient self-management
Monitors the quality, frequency, and appropriateness of HHA visits and other outpatient services.
Assists patients and family with access to community/financial resources and refer cases to social worker and other programs available as appropriate.
Collaborates closely with other members of the Complex Care and Clinica Strategy Team such as Hospital Care Managers and Post Hospital Care Coordinators and Manages to ensure patients in their program receive holistic care approval.
Home visit under the direction of the patient's primary care physician to meet urgent patient needed with the aim of preventing unnecessary hospital arrivals
Performs other duties as assigned and modified at manager's discretion.
KNOWLEDGE, SKILLS AND ABILITIES:
Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community
Critical thinking skills
Ability to work autonomously
Ability to monitor, assess and record patients' progress and adjust and plan accordingly
Ability to plan, implement and evaluate individual patient care plans
Knowledge of nursing and case management theory and practice
Knowledge of patient care charts and patient histories
Knowledge of clinical and social services documentation procedures and standards
Knowledge of community health services and social services support agencies and networks
Organizing and coordinating skills
Ability to communicate technical information to non-technical personnel
Proficient in Microsoft Office Suite products including Excel, Word, PowerPoint, and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software
Ability and willingness to travel locally, regionally, and nationwide up to 10% of the time
Spoken and written fluency in English. Bilingual a plus
This job requires use and exercise of independent judgment
EDUCATION AND EXPERIENCE CRITERIA:
Associate degree in Nursing required
Bachelor's Degree in nursing (BSN) or RN with bachelor's degree in home in a related clinical field preferred
A valid, active Registered Nurse (RN) license in State of employment required. Compact License preferred for states where compact license is available
A minimum of 2 years' clinical work experience required
A minimum of 1 year of case management experience in community case management experience highly desired
Certified Case Manager certification is preferred. Certification through the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired
This position requires possession and maintenance of a current, valid driver's license.
Basic Life Support (BLS) certification from the American Heart Association (AMA) or American Red Cross required w/in first 90 days of employment
PAY RANGE:
$35.8 - $51.17 Hourly
EMPLOYEE BENEFITS
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We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.
Current Employee apply HERE
Current Contingent Worker please see job aid HERE to apply
#LI-Onsite
Hospice Social Worker
Case specialist job in New Lexington, OH
As a Hospice Medical Social Worker, you will be called to care when you're needed most. As part of Interim HealthCare, you'll support a full range of patient services to bring comfort and dignity to our clients. will cover our Zanesville, OH region
What we offer our Hospice Medical Social Workers:
Competitive pay, benefits, and incentives
Truly flexible scheduling - a dedication to work/life balance (Full-time (FT)
Daily Pay option available
No Overtime Required
One-on-One patient care
Working at Interim HealthCare means a career unlike any other. With integrity at the center of all we do, we know that when we support you and your community, you'll change lives every day.
As a Hospice Medical Social Worker, you will:
Provide direct patient counseling services; support crisis interventions as needed
Assist patients and family in community resource planning and access
Help the patient and family navigate their ongoing healthcare journey
To qualify as a Hospice Medical Social Worker with us, you will need:
Education: Bachelor of Science in Social Work (BSW) or comparable undergraduate degree required; Master of Social Work (MSW) preferred
Licensure: Current unrestricted license to practice as a Licensed Social Worker (LSW) in the state associated with this position required; Licensed Independent Social Worker (LISW) preferred
One (1) year of experience practicing as a Licensed Social Worker in a hospice/palliative care or similar setting
Reliable transportation to/from care sites/ or work locations
At Interim HealthCare Hospice & Palliative Care, we know that being our best is non-negotiable - that's why we treat your family like our own. We take a patient-centric approach to address each individual's mind, body, and spirit, our caregivers work tirelessly to help their patients and families find peace. From our unmatched referral response times to our focus on quality improvement, the most beautifully complicated time of your life is our life's work.
We're 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 or disability status.
#Hospice1
Outpatient Therapist - Behavioral Health
Case specialist job in Columbus, OH
Outpatient Therapist
PRN
Your experience matters
Columbus Springs East is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As an Outpatient Therapist joining our team, you're embracing a vital mission dedicated to
making communities healthier
. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.
How you'll contribute
Conducts individual and group therapy sessions to educate patients regarding psychological, emotional, or substance abuse problems
Displays active involvement in treatment planning process
Provides family session counseling to all patients to ensure appropriate communication and involvement of family members and support groups
Actively communicates with clients, families, and outside referral sources
Demonstrates appropriate crisis intervention and de-escalation skills
Why join us
We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:
Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
Professional Development: Ongoing learning and career advancement opportunities.
What we're looking for
Master's degree in social work or counseling and current unencumbered clinical license per state of practice guidelines. Additional requirements include:
Prior experience with psychiatric and chemical dependency patients
CPR and CPI certified within 30 days of employment
May be required to work flexible hours
About us
Columbus Springs - East is a 72-bed behavioral health hospital located in Columbus, OH, and is part of Lifepoint Health, a diversified healthcare delivery network committed to
making communities healthier
with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone-your experience matters.
EEOC Statement
Columbus Springs East is an Equal Opportunity Employer. Columbus Springs East is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.
Counselor Full Time 2nd shift
Case specialist job in Columbus, OH
Licensed Professional Counselor (LPC) Wage: Between $120-$131 an hour Licensed Professional Counselor - Are you ready to launch or expand your private practice? Headway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. It's all on one free-to-use platform, no commitment required.
You're a fully-licensed Professional Counselor at a Master's level or above with LPC, LPCC, LCPC, LCPCS, LPCC-S licensure (accepted on a state by state basis), a valid NPI number, and malpractice insurance.
● You're ready to launch a private practice, or grow your existing business by taking insurance.
Every mental health provider who goes in-network with Headway supports people who'd otherwise be forced to choose between paying out of pocket, or not getting care at all. So far, we've helped over 50,000 providers grow their practices, reaching countless people in need.
Secure higher rates with top insurance plans through access to our nationwide insurance network.
Build stability in your practice with predictable bi-weekly payments you can count on.
At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license.
"
Remote Crypto & Stablecoin Commercial Counsel
Remote case specialist job
A leading financial technology platform is seeking a Commercial Counsel in Seattle. In this crucial role, you will support the Stablecoin & Crypto team, lead legal negotiations, and help build a scalable legal infrastructure. The ideal candidate will have over 6 years of experience in technology law, exceptional drafting skills, and a passion for innovative financial solutions. This position offers a flexible work location and competitive remuneration, making it suitable for professionals looking to contribute to a dynamic industry.
#J-18808-Ljbffr
Inpatient Therapist, Behavioral Health
Case specialist job in Dublin, OH
Full-time - Monday-Friday
Your experience matters
Columbus Springs Dublin is part of Lifepoint Health , a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As an Inpatient Therapist joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.
How you'll contribute
An Inpatient Therapist who excels in this role:
Conducts individual and group therapy sessions to educate patients regarding psychological, emotional, or substance abuse problems
Displays active involvement in treatment planning process
Provides family session counseling to all patients to ensure appropriate communication and involvement of family members and support groups
Actively communicates with clients, families, and outside referral sources
Demonstrates proactive communication with those involved with the patient's treatment
Works well with the interdisciplinary team including physicians, utilization review and nursing staff members
Why join us
We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:
Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
Professional Development: Ongoing learning and career advancement opportunities.
What we're looking for
Applicants should have a Master's degree in social work, counseling, or equivalent and a current clinical or social work license in the state of OH. Additional requirements include:
Prior experience with psychiatric and chemical dependency patients
CPR and de-escalation certification required within 30 days of hire
More about Columbus Springs Dublin
Columbus Springs Dublin is a 72-bed behavioral health hospital that has been offering exceptional care to the Dublin community for over 10 years. We are proud to be Accredited by The Joint Commission.
EEOC Statement
"Columbus Springs Dublin is an Equal Opportunity Employer. Columbus Springs Dublin is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.
Intervention Specialist
Case specialist job in Lancaster, OH
At The Learning Spectrum, we're committed to your growth. We encourage you to explore roles that align with your skills and career goals. Selection is based on qualifications, performance, and readiness to succeed.
As an Intervention Specialist at The Learning Spectrum, you'll design and lead individualized educational programs that integrate academic instruction, functional skill development, and behavior support. You'll collaborate across disciplines to ensure every student receives a whole-child education that empowers independence and success.
What You'll Need
Valid Ohio Intervention Specialist license and bachelor's degree in special education or related field
Experience developing, implementing, and evaluating IEPs for students with autism or developmental disabilities
Knowledge of behavior management, sensory regulation, and evidence-based teaching methods
Strong data tracking, documentation, and communication skills
Commitment to working collaboratively within a multidisciplinary team environment
What You'll Do
Develop and implement IEPs with measurable goals tailored to academic and behavioral growth
Plan and deliver structured lessons that support learning, life skills, and social-emotional development
Conduct assessments, record progress, and adjust strategies based on student data and team input
Guide and coach paraprofessionals and classroom staff in consistent instructional and behavioral practices
Collaborate with families, therapists, and related service providers to ensure holistic student support
Why You'll Love Working Here
Enjoy both paid time off and extra paid school breaks (for select roles), plus paid holidays
Wellness perks including gym discounts, mindfulness apps, and prescription savings
Tuition reimbursement, career development programs, and leadership training
401(k) retirement savings with a 4% company match and immediate vesting
Health, dental, and vision insurance
Free Employee Assistance Program with confidential counseling, life coaching, and mental health resources
Life insurance, disability coverage, and Health Savings Account (HSA) contributions at no cost to you
The Learning Spectrum is an equal opportunity employer, committed to diversity and inclusion in the workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy status, national origin, age, disability, genetic information, or status as a protected veteran, or any other characteristic protected by law. If you require reasonable accommodations during the application or interview process, please contact us at ...@newstory.com.
Insurance Subrogation Case Specialist (Hybrid - Dublin, OH)
Remote case specialist job
Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
Summary
HMS is hiring an Insurance Subrogation Case Specialist to join our growing team! In this role, you'll help identify, verify, and coordinate healthcare coverage for Medicaid members, while managing subrogation and claims-related cases.
If you have experience in insurance, healthcare claims, or call center operations-and you're looking for a mostly remote position with career growth potential-this is a great opportunity to join a mission-driven organization that helps make healthcare more affordable and efficient.
Your role in our mission
* Investigate and verify healthcare coverage and third-party liability information for Medicaid recipients.
* Review and analyze insurance policies, claims, and case documentation.
* Manage active subrogation case files and ensure all data is entered accurately and on time.
* Communicate with insurance carriers, employers, and members to obtain and confirm coverage details.
* Handle a high volume of inbound and outbound calls related to subrogation or claims.
* Prepare and maintain reports on open cases, enrollment updates, and payment processing.
* Support company goals for revenue recovery, accuracy, and program compliance.
What we're looking for
* 3-5 years of experience in insurance, healthcare, or government-sponsored programs.
* Experience handling customer service or call center inquiries (both inbound and outbound).
* Strong attention to detail and accuracy in data entry.
* Proficient with Microsoft Excel, Word, and internet research.
* Excellent communication, problem-solving, and organizational skills.
* Ability to work independently in a remote/hybrid environment.
What you should expect in this role
* Hybrid role - primarily remote with in-office presence 2 days per month in Dublin, Ohio.
* Monday to Friday schedule (daytime business hours).
* Video cameras must be used during all interviews, as well as during the initial week of orientation.
* To work effectively as a teleworker or hybrid positions with Gainwell, employees must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for optimal performance.
* To Test your internet download and upload speed:
* Go to Google.
* Search for Internet Speed Test or click here.
#LI-HYBRID #LI-JA1 #LI-CM1
The pay range for this position is $43,800.00 - $62,500.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Intake Specialist
Remote case specialist job
Purpose
The Intake Financial Clearance Specialist role belongs to the Revenue Cycle team and is responsible for coordinating all financial clearance activities by navigating all pre-registration (to include acquiring or validating patient demographic, insurance, and other required elements along with insurance verification activities), obtaining referral authorization, or precertification number(s). The role ensures timely access to care while maximizing reimbursement. This role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit's performance expectations. This position reports to the Intake Financial Clearance Manager and requires interaction and collaboration with important stakeholders in the financial clearance process including but not limited to insurance company representatives, patients, physicians, and practice staff.
**This is a fully remote role**
Responsibilities
Monitors accounts routed to registration, referral and prior authorization work queues and clears work queues by obtaining all necessary patient and/or payer-specific financial clearance elements in accordance with established management guidelines.
Maintains knowledge of and complies with insurance companies' requirements for obtaining prior authorizations/referrals and completes other activities to facilitate all aspects of financial clearance.
Acts as subject matter experts in navigating payer policies to get the appropriate approvals (authorizations, pre-certs, referrals, for example) for the ordered services to proceed. The Intake Financial Clearance Specialist is an important part of the larger patient care team and helps clinicians understand what payer requirements are necessary for the widest possible patient access to services.
Supports staff at all levels for hands-on help understanding and navigating financial clearance issues.
Uses appropriate strategies to underscore the most efficient process to obtaining insurance verification, authorizations, and referrals, including online databases, electronic correspondence, faxes, and phone calls.
Obtains and clearly documents all referral/prior authorizations for scheduled services
Works collaboratively with primary care practices, specialty practices, referring physicians, primary care physicians, insurance carriers, patients, and any other parties to ensure that required managed care referrals and prior authorizations are obtained and appropriately recorded in the relevant systems.
When it is determined that a valid referral does not exist, utilize computer-based tools, or contact the appropriate party to obtain/generate referral/authorization and related information. Record the referral/authorization in the practice management system.
Contact physicians to obtain referral/authorization numbers.
Perform follow-up activities indicated by relevant management reports.
Collaborates with patients, providers, and departments to obtain all necessary information and payer permissions prior to patients' scheduled services.
Communicates with patients, providers, and other departments such as Utilization Review to resolve any issues or problems with obtaining required referral/prior authorizations.
Work collaboratively with the practices to resolve registration, insurance verification, referral, or authorization issue to the extent that these unresolved issues impact the ability to obtain a referral/authorization.
Escalates accounts that have been denied or will not be financially cleared as outlined by department policy
Accept registration updates from various intake points, including but not limited to those received via paper forms, internet registration forms, telephones located in practices and direct calls from patients.
Ensure that all updated demographic and insurance information is accurately recorded in the appropriate registration systems for primary, secondary, and tertiary insurances.
Review all registration and insurance information in systems and reconcile with information available from insurance carriers. For any insurance updates, utilize any available resources to validate the updated insurance information, insurance plan eligibility, primary care physician, subscriber information, employer information and appointment/visit information. Contact patients as necessary if clarifications or other follow-up is required, and at all times maintain sensitivity and a clear customer friendly approach.
For self-pay patients or patients with unresolved insurance, and for financial counseling, refer patients Patient Financial Counseling.
Maintains confidentiality of patient's financial and medical records; adheres to the State and Federal laws regulating collection in healthcare; adheres to enterprise and other regulatory confidentiality policies; and advises management of any potential compliance issues immediately.
Demonstrates knowledge & skills necessary to provide level of customer experience as aligned with BMC management expectations.
Demonstrates the ability to recognize situations that require escalation to the Supervisor.
Establishes relationships and effectively collaborates with revenue cycle staff to support continuous improvement aligned with management expectations as outlined.
Takes opportunity to know and learn other roles and processes and works together to assist with process improvement initiatives as directed.
Consistently meets productivity and quality expectations to align performance with assigned roles and responsibilities.
Handle telephone calls in a timely fashion, following applicable scripting and customer service standards. Appropriately manage all calls by either working with the customer or referring the call to the appropriate party.
Communicate with all internal and external customers effectively and courteously.
Maintain patient confidentiality, including but not limited to, compliance with HIPAA.
Perform other related duties as assigned or required.
Requirements
Qualifications
High School Diploma or GED required, Associates degree or higher preferred.
1-3 years patient registration and/or Insurance experience desirable. At least one year of experience must be in a customer service role
General knowledge of healthcare terminology and CPT-ICD10 codes.
Complete understanding of insurance is required.
Demonstrated customer service skills, including the ability to use appropriate judgment, independent thinking and creativity when resolving customer issues.
Exceptional interpersonal skills, including the ability to establish and maintain effective relationships with patients, physicians, management, staff, and other customers.
Able to communicate effectively in writing.
Requires excellent verbal communication skills, and the ability to work in a complex environment with varying points of view.
Must be comfortable with ambiguity, exhibit good decision making and judgment capabilities, attention to detail.
Must be able to maintain strict confidentiality of all personal/health sensitive information.
Ability to effectively handle challenging situations and to balance multiple priorities.
Basic computer proficiency inclusive of ability to access, enter and interpret computerized data/information including proficiency in Microsoft Suite applications, specifically Excel, Word, Outlook and Zoom.
Displays a thorough knowledge of various sections within the work unit to provide assistance and back-up coverage as directed.
Displays a deep understanding of Revenue Cycle processes and applies knowledge to meet and maintain productivity standards as outlined by Management
Salary & Benefits
The estimated hiring salary range for this position is $22/hr - $24/hr. * The actual salary will be based on a variety of job-related factors, including geography, skills, education and experience. The range is a good faith estimate and may be modified in the future. This role is also eligible for a range of benefits including medical, dental and 401K retirement plan.
Appeals Intake Specialist
Remote case specialist job
Reliant Health Partners is an innovative medical claims repricing service provider, helping employers achieve maximum health plan savings with minimum noise. We tailor our services to each client's needs, providing everything from individual specialty claims repricing, to full plan replacement as a high-performance, open-access network alternative.
As an Appeals Intake Specialist, you will play a critical role in resolving post-payment disputes related to Workers' Compensation bills. This includes conducting provider outreach, negotiating disputed charges, and ensuring compliance with state-specific regulations. Your work will directly support our cost containment efforts and ensure appropriate bill reimbursement for our clients.
Primary Responsibilities
Responsible for screening/returning all voicemails and answering questions
Offer guidance to providers including sharing details on documents needed to process their appeal/reconsideration request
If the situation appears to have issues escalating to the senior appeal specialist for direction
Responsible for monitoring/managing the shared appeals inbox
Locating the bill in question and assigning to the appropriate team member for handling
Creation of appeal case in Salesforce or Claimsave
Update the attorney referred cases spreadsheet based on received emails
Bimonthly report updates shared with clients on cases referred to attorneys
Responsible for updating claim platform with new status received from attorneys
Work with senior appeal specialist on updates needed to the process SOP's
Insures accurate and thorough documentation in claims platform for every email and voicemail.
Demonstrates knowledge about workers' comp and Reliant processes
Adheres to our department TAT, either individual claim based or organization wide
Understands the support function of the job and assumes responsibility for assignments.
Establishes and prioritizes job tasks, desired solutions to problems and develops a realistic plan for their accomplishment.
Qualifications
1 -2 years of relevant experience in Workers' Compensation bills or appeals.
Strong understanding of Workers' Compensation reimbursement methodologies, state regulations, and provider billing practices.
Experienced communicator with providers and clients
Ability to collaborate with a variety of individuals both internally and externally.
Familiarity with claims processing systems and provider communications.
Excellent communication and organizational skills.
Requires organizational skills, communication proficiency, discretion, ethical conduct, decision making, technical skills
Individual compensation will be commensurate with the candidate's experience and qualifications. Certain roles may be eligible for additional compensation, including bonuses, and merit increases. Additionally, certain roles have the opportunity to receive sales commissions that are based on the terms of the sales commission plan applicable to the role.
Pay Transparency$50,000-$55,000 USDBenefits:
Comprehensive medical, dental, vision, and life insurance coverage
401(k) retirement plan with employer match
Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
Paid time off (PTO) and disability leave
Employee Assistance Program (EAP)
Equal Employment Opportunity: At Reliant, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business-and our society-stronger. Reliant Health Partners is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.
Auto-ApplyClaimant Outreach & Intake Specialist
Remote case specialist job
OverviewAt Advocate, our mission is to empower Americans to obtain the government support they've earned. Advocate aims to reduce long wait times and bureaucratic obstacles of the current government benefits application process by developing a unified intake system for the Social Security Administration, utilizing cutting-edge technologies such as artificial intelligence and machine learning, crossed with the knowledge and experience of our small team of EDPNA's and case managers.
We are seeking a dynamic and persistent Outreach & Intake Specialist to be the crucial first point of contact for potential claimants. In this role, you will engage new leads, guide them through the initial information gathering and contract signing process via our Onboarding Flow, and effectively convert interested individuals into Advocate claimants. You'll focus on initiating the claimant journey, ensuring potential claimants feel supported and informed from the very beginning. If you are results-oriented, possess excellent communication skills, and are passionate about helping people navigate complex processes, this role offers the opportunity to make a significant impact without managing ongoing case submissions.Job Responsibilities
Act as the first point of contact for potential claimants, managing inbound leads via phone, text, and potentially other channels.
Conduct prompt and persistent outreach to new leads (within 5 minutes) using tools like Salesforce and Aircall Power Dialer, following established contact sequences (calls, texts, voicemails).
Clearly articulate Advocate's value proposition and answer frequently asked questions to build trust and encourage engagement.
Guide potential claimants through Advocate's online Onboarding Flow, assisting them in providing necessary initial information and signing the representation contract.
Maintain accurate and timely records of all outreach activities, claimant interactions, and lead statuses within Salesforce.
Identify and appropriately handle leads who may not be eligible for services based on initial criteria.
Collaborate with the team to meet and exceed lead conversion goals.
Monitor Advocate's Intake communication lines for new client calls and texts, responding appropriately.
Qualifications
Proven experience in a high-volume outreach, sales, or customer engagement role (e.g., call center, intake specialist, sales development).
Excellent verbal and written communication skills, with an ability to explain processes clearly and empathetically.
Strong interpersonal and persuasion skills with a persistent approach to achieving goals.
Experience using CRM software (Salesforce preferred) and communication tools (Dialers like Aircall preferred).
Highly organized with strong attention to detail for tracking lead progress and documenting interactions.
Ability to work independently and manage time effectively in a remote setting.
Passionate about helping others and contributing to a mission-driven company.
Familiarity with the Social Security disability process is a plus, but not required.
This is a remote position and Advocate is currently a fully remote team. Advocate is an equal opportunity employer and values diversity in the workplace. We are assembling a well-rounded team of people passionate about helping others and building a great company for the long term.
Auto-ApplySpecialist - Outreach-Fixed Term
Remote case specialist job
Working/Functional Title
Simulation Program Manager
Michigan State University actively promotes dynamic research and learning environment in which qualified individuals of differing perspectives, and cultural backgrounds pursue academic goals with mutual respect and shared inquiry.
The MSU School of Social Work is dedicated to educating students for ethical, competent, responsive, and innovative social work practice, and to conducting and disseminating high quality research that improves the well-being of the most vulnerable in society. Our teaching, research, and outreach synergistically promote social justice, positive change, and solutions to the problems facing a wide cross section of individuals, families, groups, organizations, and communities. More than 650 students are enrolled in our CSWE-accredited BASW and MSW programs, and PhD program.
Michigan State University School of Social Work, in conjunction with other Michigan graduate schools of social work and through the support of the Michigan Department of Health and Human Services (DHHS), offers in-person trainings, live webinars, and online courses. This project, known as Child Welfare In-Service Training, provides free training opportunities for MDHHS and MDHHS-contracted private agency Children's Protective Services (CPS), family preservation, foster care, and adoption case managers and supervisors. This position will manage implementation of a pilot project to test and evaluation simulation-based training for CPS Specialists.
This position is grant-funded and only is available should the grant be re-funded.
The primary functions of this role include:
Develop a project plan for the pilot period and key project milestones.
Coordinate and manage project timelines and deliverables, ensuring alignment with contract requirements.
Facilitate communication and meetings with team members including the MSU Learning Assessment Center (LAC), child welfare faculty, and MDHHS leadership.
Monitor and evaluate project progress, identifying and mitigating risks or delays.
Support the development of simulation training curriculum, case study scenarios, evaluation tools, and IRB applications with team members and partners.
Coordinate the preparation and delivery of reports and updates for funders.
Oversee and attend simulation training sessions and implement improvements in subsequent sessions as needed.
Submit expenses for reimbursement and prepare invoices following university procedures.
Support dissemination of evaluation report and scalability planning, make recommendations including project expansion.
Supervise student workers.
Other duties as assigned.
Reports: Kalah Villagrana, Principal Investigator for the Grant.
Varied Work hours:
On campus position with allowable offsite/remote work, plus some required travel.
Equal Employment Opportunity Statement
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, age, disability or protected veteran status.
Required Degree
Masters -social work, counseling, psychology, or related field
Minimum Requirements
Master's degree in social work, counseling, psychology, or related field.
Desired Qualifications
5+ years of experience managing projects or programs, preferably in child welfare, human services, or education.
Knowledge of child welfare systems, policies, and best practices, particularly those related to CPS investigations and family services.
Experience with instructional design or simulation training, especially for adult learners.
Team management skills, including experience coordinating interdisciplinary teams with government agencies and academic institutions.
Organizational and project management abilities, including proficiency with project management tools.
Ability to manage timelines and deliverables across project phases.
Exceptional communication and interpersonal skills, both written and oral.
Ability to travel, as needed, for partner meetings or trainings.
Ability to manage several project aspects simultaneously and to adjust to needs of funders.
Required Application Materials
1) cover letter
2) current resume or curriculum vitae; and
3) The names of three references
Special Instructions
Review of application will begin October 3, 2025, and will continue until the position is filled.
Review of Applications Begins On
10/03/2025
Website
www.socialwork.msu.edu
Department Statement
Michigan State University has been advancing the common good with uncommon will for more than 160 years. One of the top research universities in the world, MSU pushes the boundaries of discovery and forges enduring partnerships to solve the most pressing global challenges while providing life-changing opportunities to a diverse and inclusive academic community through more than 200 programs of study in 17 degree-granting colleges.
MSU Statement
Michigan State University has been advancing the common good with uncommon will for more than 160 years. One of the top research universities in the world, MSU pushes the boundaries of discovery and forges enduring partnerships to solve the most pressing global challenges while providing life-changing opportunities to a diverse and inclusive academic community through more than 200 programs of study in 17 degree-granting colleges.
Bilingual Client Intake Specialist - Remote
Remote case specialist job
Job DescriptionDescription:
Keches Law Group, P.C. is a well-established, 50 attorney law firm with offices in Milton, Bridgewater, and Worcester, practicing in the areas of workers' compensation, personal injury, medical malpractice, and discrimination.
We are seeking bilingual Client Intake Specialists to join our team. This is a remote position.
Duties:
Receiving incoming client calls and initiates outbound calls to potential clients, as received electronically and by live transfer
Producing information by transcribing, formatting, inputting, editing, retrieving, copying, and transmitting text, data, and graphics
Using the firm software to enter all case and client details, and maintains detailed logs and task history within the database
Conveying accurate information to clients with regard to different case types with confidence and assurance
Setting the tone and pace of all calls, while maintaining a professional attitude and showing empathy and patience when speaking with potential clients
Demonstrating the ability to converse with varying client personalities to collect pertinent details to determine the viability of their claims
Maintaining client confidence by keeping client information confidential
Enhancing the reputation of the department and the organization by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to the position
Requirements:
Skills/Qualifications:
High School diploma or equivalent
1-2 years of customer service/call center experience or law firm experience is preferred
Multi-lingual abilities are required (Haitian Creole, Cape Verdean Creole, Spanish, or Portuguese require)
Ability to accurately translate verbal information into written correspondence
Ability to prioritize and escalate client calls appropriately
Strong phone, typing, and computer skills are a must; experience with Microsoft Office Suite is preferred
Ability to absorb, retain, and apply new information
Strong attention to detail
Ability to interact professionally and appropriately with clients, attorneys, and others
Must be energetic, well organized, and have the ability to multi-task
Must possess and demonstrate exceptional customer service skills, and the ability to handle situations with tact and diplomacy
Ability to work in a high intensity, high stress environment
Ability to work effectively in a fast-paced environment while accomplishing short-term goals without losing sight and commitment to the longer-term needs of the firm
Excellent verbal and written communication skills
Excellent problem-solving, analytical, and evaluative skills
Schedule
Remote
Monday - Friday
8:30am - 5:00pm (EST)
Benefits
Health, Dental, and Vision Insurance
401(k) Plan with Profit Sharing
Flexible Spending Account
Paid Time Off
Paid Holidays
Basic Life Insurance
Long Term Disability
Employee Referral Bonuses
The anticipated salary range for this position, which we in good faith expect to pay at the time of posting, is $38,000.00 - $41,000.00 annually. This range allows us to make an offer that reflects multiple factors, including experience, education, qualifications, and job-related knowledge and skills, as well as internal pay equity. It's not typical for an individual to be hired at or near the top of the range, as we strive to provide room for future and continued salary growth. Base pay is just one component of our Total Rewards package, which may also include discretionary bonuses, commissions, or other incentives depending on the role.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to talk or hear. This is largely a sedentary role, however the employee may at times be required to sit; stand; walk; use hands to handle or feel; and reach with hands and arms. The employee must occasionally lift or move office products and supplies, up to 20 pounds.
AAP/EEO Statement
Keches Law Group is an equal opportunity employer. Keches Law Group does not discriminate based on race, ancestry, national origin, color, religion, gender, age, marital status, sexual orientation, disability, veteran status, or any other protected classification under the law.
Land Management Coordinator
Case specialist job in Columbus, OH
Purpose PLEASE NOTE - THIS IS A JOB DESCRIPTION ONLY. THIS IS NOT A POSTING FOR A VACANCY To see a list of job postings, please click HERE Assists with the development and implementation of the resource management program at assigned Park(s). May assist with resource management activities throughout Metro Parks.
Example of Duties
Coordinates, maintains, evaluates, and provides recommendations directly related to the implementation of resource management plans at assigned park(s).
May assist with the Bison Reintroduction Project including daily care, health evaluations, structure and facility inspections, and other related services if assigned to Battelle Darby Creek Metro Park.
Implements resource management plans to achieve the goals of prairie, wetland, reforestation restoration, and steam restoration projects.
Operates and maintains equipment (e.g., tractor and brush hog, chainsaw, wood chipper) utilized in the implementation of prairie restoration, controlled succession and other land management projects.
Performs controlled succession mowing and clearing.
Assists with prescribed burns throughout Metro Parks.
Coordinates plot preparation, seed picking, planting and management of restored prairies, wetlands, reforestation areas, and other habitat restoration areas.
Evaluates, identifies, and manages non-native invasive species throughout park areas.
Assists with the Deer Management Program.
Prepares periodic reports of work accomplished.
May oversee small contracts for succession mowing, farm agreements, and non-native invasive species removal at assigned park(s).
May train Interns and others involved in land management projects such as controlled succession and prairie restoration, in the proper methods and techniques, and safe use of equipment, etc.
Promotes Park District through contact with other conservation agencies, general public and programs.
May coordinate aspects of the Hazardous Tree Program.
Performs special projects and related duties as required or assigned.
Qualifications
Education/Experience: Associate degree in biology, natural resources, environmental science or related field and two (2) years land management experience, or an equivalent combination of education and experience.
Attendance: Being present at work is an essential function of the position.
Language Skills: Ability to communicate verbally and in writing with coworkers, supervisors, volunteers, neighbors and the general public; ability to prepare and maintain accurate records. Ability to read, interpret and convey directions and instructions from plans and sketches.
Mathematical Skills: Ability to add, subtract, multiply and divide.
Reasoning Ability: Ability to interpret a variety of instructions; define problems, collect data, establish facts and draw valid conclusions.
Licenses, Registrations: Possession of a valid Ohio commercial driver's license, insurable by the Park District's insurance carrier, and ability to conform to Metro Parks' driving standards policy. Possession of valid standard first aid and CPR cards within six (6) months of employment; possession of valid pesticide applicator's license. May be required to have or obtain Ohio Certified Burn Manager certification.
Physical Demands: While performing the regular duties of this position, employee is required to sit on equipment for prolonged periods of time, stand, walk, operate power equipment and tools, bend, lift, and talk and hear. Employee uses hands and fingers to pick seeds, plant, use hand held power tools, use equipment/gear associated with prescribed burns, etc.
Work Environment: While performing the regular duties of this job, the employee regularly works in outside weather conditions. The employee spends a portion of their time working in the shop. The employee frequently works near moving mechanical parts. The noise level in the work environment is usually moderate.
Technology Skills: Demonstrated experience using computers, web-based programs, e-mail, internet, intranet, Microsoft Office products, fax machines, office and personal printers, and basic office equipment. Experience with the use social media desired.
Any Additional Information: Knowledge of safety practices and procedures, supervision, proper use of herbicides; land management practices and principles; ability to use equipment and tools utilized in land management projects. Ability to establish effective working relationships with coworkers, supervisors, volunteers and the general public.
Other Information
The above Description represents the essential and most significant duties of this position. It is not intended to exclude other work duties, assignments and responsibilities not mentioned herein.
Supervision
Received: Varies depending on park assignment(s). Position may be supervised by a Park Manager with functional guidance provided by the Resource Manager or position may be supervised by the Resource Manager with functional guidance from a Park Manager. Supervisor will be established upon appointment to the position.
Given: May direct work of Park Technicians 1s, part-time Park Technicians, seasonals, and/or Interns
FLSA Status
Given the nature of this classification's duties/responsibilities, it has been designated as Non-Exempt under the governing Fair Labor Standards Act and, therefore, is entitled to formal overtime compensation and/or formal compensatory time.
Core Values
Attendance: Is at work as scheduled; reports to work on time; follows proper procedures for requesting leave or calling off.
Policies & Procedures: Follows established policies and procedures; inquires of supervisor if unclear on policy/procedure, includes following safety policies, procedures and protocols.
Professionalism: Handles the responsibilities of the position in an effective manner; maintains integrity and appropriate behavior in dealing with conflicts and challenges with the public, co-workers, and managers; offers differing points of view in an acceptable manner.
Team Player: Supports other members of the organization in accomplishing their goals and projects; recognizes and credits others for their contribution in achieving goals.
Positive Attitude: Supports Metro Parks established priorities at all times; cultivates team environment; exhibits enthusiasm while carrying out responsibilities; looks for solutions to work conflicts and challenges.
Productivity: Thoroughly completes work in a timely manner; organizes and plans assignments well or follows supervisory instructions well with little explanation; follows-up as needed.
Quality: Demonstrates technical competence, meets job expectations; completes assignments with few errors.
Initiative: Does not wait to be told what to do; appropriately makes suggestions for improvements; does not hesitate when things do not go according to routine and quickly adjust to meet exceptions.
Interpersonal Communication: Interacts with others with tact and courtesy; communicates clearly and effectively; shares information with supervisor or coworkers to achieve goals; responsive to the public.
V105 - Legal Case Status Coordinator
Remote case specialist job
For ambitious, culturally diverse, curious minds seeking booming careers, Job Duck unlocks and nurtures your potential. We connect you with rewarding, remote job opportunities with US-based employers who recognize and appreciate your skills, allowing you to not just survive but thrive.
As a lifestyle company, we ensure that everybody working here has a fantastic time, which is why we've earned the Great Place to Work Certification every year since 2022!
Job Description:
Step into a role where your communication skills and calm demeanor make a real difference every day. As a Legal Case Status Coordinator with Job Duck, you'll be the steady point of contact for clients, helping them feel supported and informed while attorneys focus on their cases. You'll coordinate court dates, manage case statuses, and ensure attorneys have the right documents and instructions before heading to court. This position is perfect for someone who enjoys solving problems independently, thrives in fast-paced environments, and brings empathy and professionalism to every interaction. If you're resourceful, tech-savvy, and comfortable working with clients in distress, you'll find this role both rewarding and impactful.
• Monthly Salary Range: 1,150 to 1,220 USD
Responsibilities include, but are not limited to:
Respond to inquiries with professionalism and care
Organize and confirm court dates for attorneys
Act as a buffer between clients and attorneys, managing expectations and flow of information
Serve as the primary contact for clients, offering clear and compassionate communication
Check case statuses with courts and filing services
Share instructions and necessary documents for court appearances
Manage daily call volume as needed
Requirements:
1-2 years of experience in customer support inside a law firm
Excellent communication skills in both English and Spanish
Strong customer service or client-facing background required
Familiarity with assisting clients with legal cases is preferred
Ability to work independently and manage tasks without constant supervision
Solid writing and organizational abilities
Key Skills
Clear and confident communication
Strong customer service instincts are a must
Ability to follow detailed instructions is a must
Proactivity is a must
Independent thinking and problem-solving
Calm and composed under pressure
Professional presence and reliability
Common sense and attention to detail
Tech-savvy
Patient and empathetic
Self-directed and resourceful
Software: CRM familiarity is a plus, OpenPhone, Slack, Google Suite, Dropbox
Expected call volume: Some calls involved
Working Schedule: Monday to Friday
Location: Remote || PST (Pacific Standard Time)
Work Shift:
8:00 AM - 5:00 PM [PST][PDT] (United States of America)
Languages:
English, Spanish
Ready to dive in? Apply now and make sure to follow all the instructions!
Our application process involves multiple stages, and submitting your application is just the first step. Every candidate must successfully pass each stage to move forward in the process.
Please keep an eye on your email and WhatsApp for the next steps. A recruiter will be assigned to guide you through the application process. Be sure to check your spam folder as well.
Auto-ApplyCase Management Extender (Part Time Casual, As Needed)
Remote case specialist job
We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities.
Summary:
The Case Manager extender works collaboratively with all interdisciplinary staff internal to OhioHealth and also external organizations to achieve timely, cost efficient and effective management of patient care. Primary responsibilities include but are not limited to: insurance verification, obtaining pre-authorization and data entry of patient information, triaging phone calls, and directing calls appropriately, status changes, entering initial and correcting inpatient room and bed charges and performing charge reconciliation. The case manager extender is well organized, highly motivated, customer service oriented and expresses good communication skills. May require weekends and holiday rotations.
Responsibilities And Duties:
60%
ASSURING APPROPRIATE PAYER AUTHORIZATION AND/OR PAYER REQUIREMENTS ARE IN PLACE FOR HOSPITAL PAYMENT. 1. Responsible for insurance verification. When necessary, obtains pre-authorization from insurance companies. Interacts with physician offices and other third parties to obtain all necessary paperwork. 2. Triage incoming calls within the phone processing benchmarks. Answers multi line phone system, screens calls for office/hospital associates, directing to appropriate office/hospital associate, and ensures appropriate phone coverage. 3. Communicate and document accurate and appropriate information to internal and external customers. Communicates with third party payers and sends appropriate clinical information for authorization of hospital stay. 4. Perform authorization data entry and coordination of services through proactive collaboration and communications with utilization management and care coordination team. 5. Monitor commercial payers accounts, to include but not limited to: attachment of requested dictation to claims, addition of diagnosis allowances and authorization numbers 6. Refer utilization management/clinical decisions beyond level of authority to care coordination/UM team and Manager/Director of UM team for review and decision. 7. Provides general office and clerical support for office as assigned by Office Supervisor and or Manager, to include but not limited to: faxing dictation to referring physician offices, completion of disability forms, FMLA forms, Attorney request letters for reports, patient record releases, Industrial C-9s, C-84s, C-86s, Medco 17s, Industrial appeal paperwork and retroactive C-9s. 8. Researching, obtaining and completing required documents for the team. 9. Coordinating ancillary services according to policies 10. Facilitate communication between community agencies, care coordination and utilization management team. 1 1. Facilitates transfers of patients to alternative facilities 12. Attends staff meetings 13. Attends continuing in-house education seminars for further education as needed
30%
PATIENT STATUS AND CHARGE RECONCILIATION 1. Responsibility for updating/correcting patient status for appropriate claim drop. 2. Perform charge entry to match appropriate patient status. 3. Review the charge reconciliation report daily to ensure that all room and bed charges are entered correctly on a patient. 4. Work in conjunction with the clinical, revenue and observation billers to correct or adjust any claims as directed by payer discussions.
10%
ORGANIZATIONAL/OFFICE RESPONSIBILITIES 1. Sorts, distributes, and mails transcription as assigned 2. Orders and stocks office supplies. 3. Ensure office equipment, are clean and well-maintained. 4. Provides support to appropriate staff members as assigned
Minimum Qualifications:
High School or GED (Required)
Additional Job Description:
Associates degree, or three to five years related Experience and/or training, or equivalent combination of and Experience . Computer competency in Microsoft Word, Excel, and Outlook, with a strong aptitude to learn other programs as needed. Ability to manage multiple priorities.
Work Shift:
Day
Scheduled Weekly Hours :
1
Department
Transfer Center
Join us!
... if your passion is to work in a caring environment
... if you believe that learning is a life-long process
... if you strive for excellence and want to be among the best in the healthcare industry
Equal Employment Opportunity
OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment
Remote Work Disclaimer:
Positions marked as remote are only eligible for work from Ohio.
Auto-ApplyIntake Specialist (Client Service Sales) - Remote
Remote case specialist job
Intake Specialist (Client Service - Sales) Heard and Smith, LLP was founded on the principles of compassion, humility and the relentless desire to pursue financial assistance for our clients. Our law firm has been helping the disabled for over 30 years and has a proven record. Do you have a heart for those in need? We are seeking individuals with excellent customer relations, strong work ethic, and a true desire to help others. Being part of the Heard and Smith team is more than a job; each day provides you with opportunities to change someone's life!
Fast-paced, professional environment;
Fulfilling, challenging, and rewarding;
Great team environment;
Paid Holidays, Accrued Paid Time Off (FT only);
Great Medical Benefits Package (FT only);
Wellness Program (FT only);
Competitive Salary $14.50-$16.50 per hour DOE
401k with Annual Employer Profit-Sharing contributions (historically 5% annual salary - employee contributions not required!)
As the Intake Specialist you are the first point of contact for potential clients who are seeking Social Security Disability (SSD) and/or Social Security Income (SSI) assistance. In a call center environment, you will guide potential clients through a screening process (triage) to determine eligibility for SSD/SSI and if eligible, invite them to become a client. You will assist clients in the completion of initial applications as well as addendums and updates for submission to the Social Security Administration.
In this role you will:
Build the initial client relationship and confidence in our firm with every prospective client interaction
Take 150 - 200 calls per day in a professional inbound/outbound call center environment
Sign up 4 new cases per day to the firm
Be expected to meet occupancy and adherence goals
Be expected to maintain a minimum call quality score of 90%
Consistently build the client relationship and confidence in our firm with every client interaction while proactively contacting clients to ensure the relationship is maintained
Solve problems and maintain confidentiality
Keep updated records and detailed documentation of client interactions, concerns, and complaints in a paperless database system
Use good judgment to discern what issues may be urgent and need a manager's or director's attention immediately
To be successful as an Intake Specialist you will need:
High School Diploma; Degree preferred; or equivalent combination
Call center and customer service experience
Strong people skills
Excellent telephone, communication, and active listening skills
Ability to meet performance standards whether in office or working remotely from home
Knowledge in computer technology and the Internet (MS Office, Outlook). Including the ability to learn new programs easily
Minimum 40 WPM typing speed
Multi-tasking skills and the ability to work well under pressure
Detail oriented
Excellent spelling and grammar
Problem analysis and problem-solving
Self-motivated, self-disciplined, able to work with little supervision
Reliability and dependability
Ability to work in fast paced environment
Ability to work in a confidential environment always maintaining client confidentiality
Has professional manner and high energy level, exhibits a positive attitude
Strong organizational skills
Good time management skills
Accepts new ideas and challenges and is highly motivated
Ability to work well with others as a team
Ability to work remotely from home as needed per business needs (see remote requirements)
Sales experience a plus
Fluent Spanish a plus
Minimum Requirements for a Remote Home Office Intake Specialist:
Computer with up-to-date operating system (No Macs, Chromebooks, Tablets)
Camera - internal to computer or external
Fast internet connection (20MB+)
Wired Ethernet cable Internet connection in your home office
Land line telephone or good cell phone signal in home office
Quiet, private home office with no distractions during business hours
Reside in Texas
Auto-ApplyRN Case Management Coordinator - Renal
Remote case specialist job
We are currently hiring for a Case Management Coordinator to join BlueCross BlueShield of South Carolina. In this role as a Case Management Coordinator, care management interventions focus on improving care coordination and reducing the fragmentation of the services the recipients of care often experience, especially when multiple health care providers and different care settings are involved. Taken collectively, care management interventions are intended to enhance client safety, well-being, and quality of life. These interventions carefully consider health care costs through the professional care manager's recommendations of cost-effective and efficient alternatives for care. Thus, effective care management directly and positively impacts the health care delivery system, especially in realizing the goals of the "Triple Aim," which include improving the health outcomes of individuals and populations, enhancing the experience of health care, and reducing the cost of care. The professional care manager performs the primary functions of assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy. Integral to these functions is collaboration and ongoing communication with the client, client's family or family caregiver, and other health care professionals involved in the client's care.
Description
Job Description
Location
This position is full-time (40 hours/week) Monday-Friday from 8:00am-4:30pm or 8:30am - 5:00pm EST and will be fully remote.
What You'll Do:
Provides active care management, assesses service needs, develops and coordinates action plans in cooperation with members, monitors services and implements plans, to include member goals. Evaluates outcomes of plans, eligibility, level of benefits, place of service, length of stay, and medical necessity regarding requested services and benefit exceptions. Ensures accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits. Provides telephonic support for members with chronic conditions, high-risk pregnancy or other at-risk conditions that consist of: intensive assessment/evaluation of condition, at-risk education based on members' identified needs, provides member-centered coaching utilizing motivational interviewing techniques in combination with reflective listening and readiness to change assessment to elicit behavior change and increase member program engagement.
Participates in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks and benefit plans. May identify, initiate, and participate in on-site reviews. Serves as member advocate through continued communication and education. Promotes enrollment in care management programs and/or health and disease management programs.
Provides appropriate communications (written, telephone) regarding requested services to both health care providers and members.
Performs medical or behavioral review/authorization process. Ensures coverage for appropriate services within benefit and medical necessity guidelines. Utilizes allocated resources to back up review determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). Participates in data collection/input into system for clinical information flow and proper claims adjudication. Demonstrates compliance with all applicable legislation and guidelines for all regulatory bodies, which may include but is not limited to ERISA, NCQA, URAC, DOI (State), and DOL (Federal).
Maintains current knowledge of contracts and network status of all service providers and applies appropriately. Assists with claims information, discussion, and/or resolution and refers to appropriate internal support areas to ensure proper processing of authorized or unauthorized services.
To Qualify for This Position, You'll Need the Following:
Required Education: Associates in a job-related field.
Degree Equivalency: Graduate of Accredited School of Nursing or 2 years job related work experience.
Required Experience: 4 years recent clinical in defined specialty area. Specialty areas include: oncology, cardiology, neonatology, maternity, rehabilitation services, mental health/chemical dependency, orthopedics, general medicine/surgery. Or, 4 years utilization review/case management/clinical/or combination; 2 of the 4 years must be clinical.
Required Skills and Abilities: Working knowledge of word processing software.
Knowledge of quality improvement processes and demonstrated ability with these activities.
Knowledge of contract language and application.
Ability to work independently, prioritize effectively, and make sound decisions.
Good judgment skills.
Demonstrated customer service, organizational, and presentation skills.
Demonstrated proficiency in spelling, punctuation, and grammar skills.
Demonstrated oral and written communication skills.
Ability to persuade, negotiate, or influence others.
Analytical or critical thinking skills.
Ability to handle confidential or sensitive information with discretion.
Required Software and Tools: Microsoft Office.
Required License/Certificate: An active, unrestricted RN license from the United States and in the state of hire OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) OR, active, unrestricted licensure as counselor, or psychologist from the United States and in the state of hire (in Div. 75 only). For Div. 75 and Div. 6B, except for CC 426: URAC recognized Case Management Certification must be obtained within 4 years of hire as a Case Manager.
We Prefer That You Have the Following:
Preferred Work Experience: At least 4 years of renal nursing experience.
Prior hemodialysis, peritoneal dialysis, nephrology nursing, and/or access management experience.
7 years-healthcare program management.
Preferred Education: Bachelor's degree- Nursing
Preferred Skills and Abilities: Working knowledge of spreadsheet, database software. Thorough knowledge/understanding of claims/coding analysis, requirements, and processes.
Preferred Licenses and Certificates: Case Manager certification, clinical certification in specialty area.
Our Comprehensive Benefits Package Includes the Following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.
Subsidized health plans, dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What To Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.
Pay Range Information:
Range Minimum
$53,462.00
Range Midpoint
$77,860.00
Range Maximum
$102,258.00
Pay Transparency Statement:
Please note that this range represents the pay range for this and other positions that fall into this pay grade. Compensation decisions within the range will be dependent upon a variety of factors, including experience, geographic location, and internal equity.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
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Auto-ApplyHousing Case Aide (Homebase Suprise)
Remote case specialist job
Join Our Team at Native American Connections! Who We Are: Native American Connections (NAC) is a nonprofit organization dedicated to improving the lives of individuals and families through affordable housing, behavioral health, and community development services. For over 50 years, we have proudly served Native American and underserved communities in the Phoenix area with culturally competent, trauma-informed care
grounded in respect and tradition. Our Mission: Our mission, grounded in traditional Native American culture, is to reduce health disparities by delivering high-quality, comprehensive integrated healthcare and providing stable housing throughout the communities we serve. Why Work With Us?
When you join NAC, you're not just taking a job - you're becoming part of a movement. A movement that values cultural identity, honors resilience, and believes in the power of community. You'll work alongside passionate professionals who are committed to healing generational trauma, strengthening families, and building vibrant futures. What We Do:
Behavioral Health Services: Culturally responsive treatment for mental health and substance use disorders including outpatient therapy, residential programs, and youth services.
Affordable Housing: Safe, stable, and supportive housing options - from transitional housing to permanent low-income housing.
Community Development: Revitalizing neighborhoods and preserving Native heritage through community-based projects and education.
Our Values:
Cultural Integrity | Community Wellness | Holistic Healing | Equity & Inclusion | Sustainability Now Hiring:
We are seeking compassionate, mission-driven individuals to join our growing team across various departments including clinical services, housing support, youth engagement, and administrative leadership. If you're passionate about social change, cultural advocacy, and serving diverse communities with dignity and care - NAC is the place for you. Based in Phoenix, Arizona | ️ 501(c)(3) Nonprofit Organization Apply Today & Make a Difference Tomorrow:
Visit ************************************************* to view open positions and join our circle of care. Housing Case Aide Location: Homebase Surprise, 12215 W Bell Rd, Surprise, AZ 85378 Hours: Saturday -Wednesday 7am-3:30 pm
POSITION SUMMARY:
The Home Base Youth Services Case Aide provides the necessary stability to the residents of the property through enforcement of community and program rules, life skills education, some case management services, and enforcement of all property rules and state and federal laws for residents residing at Native American Connections properties.
RESPONSIBILITIES:
Case management at these communities relies on the collaboration and communication of this case aide, case manager, property manager and any other outside support systems.
Initiate contact with hard to engage resident.
Maintain the daily shift report and document all resident communications.
Complete job readiness tasks, such as assisting residents with online job applications and resume writing.
Organize and facilitate social activities, including creating flyers and promoting events.
Complete daily shift tasks, such as property safety walks and cleaning duties
Assist Maintenance in removing trash from a vacated unit. Clean/replenish soft goods when a unit is ready for move in.
Manage inventory of soft goods. Notify Property Manager when goods need to be ordered.
Collaborate on the monthly community meetings and work to improve the payment history, health and safety issues, and resident conduct through the community through one-on-one education of the residents as needed.
Other duties as assigned.
EDUCATIONAL/WORK EXPERIENCE REQUIREMENT:
High School Diploma or GED required.
WORK EXPERIENCE / SKILLS REQUIREMENT:
One year experience in service delivery or any combination of related education, professional training or work experience which demonstrates the ability to successfully perform duties.
Knowledge of the economic, educational, and social problems of Native Americans and referral services
Must be able to work well with others in a team approach.
Excellent communication skills - written and oral
Experience in working with the Native American population preferred.
Possess and maintain a valid Arizona driver license and reliable transportation.
MS Office skills
NATIVE AMERICAN PREFERENCE: Preference is given to qualified Native American Applicants in accordance with the Indian Preference Act. If claiming a preference, a copy of valid documentation will be necessary.
DRUG FREE WORKPLACE: Native American Connections is a drug-free workplace with safety-sensitive jobs. Use of alcohol and legal or illegal drugs may impair and alter employees' judgement resulting in increased safety risks, workplace injuries, and faulty decision making. Reporting to work at NAC after use of alcohol, a controlled substance, or abuse of any other substance is absolutely prohibited.
FAIR LABOR STANDARDS ACT:
This position is considered to be Exempt for overtime pay provisions as provided by the Federal Fair Labor Standards Act (FLSA) and any applicable state laws.
Outreach & Engagement Specialist
Case specialist job in Lancaster, OH
Requirements
QUALIFICATIONS:
Ohio driver's license, proof of automobile liability insurance (minimum $100,000), Bachelor's degree preferred. Preference given to holders of Ohio Counselors and Social/Work Board licensure. Experience in working with adults with SMD, exhibits respect, compassion, warmth, caring and friendliness, non-judgmental of varying cultural beliefs, ability to assess, teach and model skill development techniques in home maintenance, interpersonal-social and pre-vocational interests, ability to set limits, confront behaviors and redirect.
Salary Description Starting at $16.50