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Workers Compensation Administrator
Surge Staffing 4.0
Computer recycling worker job in Columbus, OH
Effectively manage claims execution and cost containment. Responsible for assisting the administration of the workers' compensation program including injury intake, processing claims, determining appropriateness of claims, coordinating return to work and maintaining and updating case records.
Production Responsibilities
1. Email time- process incoming email in accordance with company policy and procedures, using HTDs as guides and determinants.
2. Receive and triage injury reporting calls from the injury intake line throughout the day and after hours on a rotating basis.
3. Provide immediate assistance to all field and TPA staff in response to injury notification.
4. Provide treatment authorization for initial treatment.
5. Property damage liability assessment.
6. Document Escalation- working with leaders to obtain information for completion of the file.
7. Complete company reports as required.
8. Follow company policies and procedures.
9. Maintain records to ensure completeness.
10. Answer telephone to provide desired information for branch associates, customers and temporaries.
11. Assist WC Manager with reporting.
12. Administration and enforcement of the drug testing programs.
Legal
1. Attorney Assignment
2. Settlement Review, Evaluation & Recommendation (authorization is the purview of department Senior Vice President ONLY)
3. Litigation Management (R1, sending files, attorney interaction, docket)
Claim Execution and Cost Containment
1. Relay information to TPA and Carrier
2. Collaborate with claims examiners and TPAs for effective claims management.
3. Oversee return to work program and handle disability cases to determine the availability of modified work.
4. Review light duty payroll and approve or reject the time.
5. All other duties that may arise to ensure successful operation of the company.
6. Assist field offices with resolving questions and issues pertaining to incidents and claims of injury.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
$30k-37k yearly est. 3d ago
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Client Management - Workers' Comp
Reliant 4.0
Remote computer recycling worker 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 Account Manager, you will play a critical role in managing and expanding relationships within our Workers' Compensation division. In this role, you will serve as a strategic partner to our clients - acting as their primary point of contact, delivering reporting and insights, reviewing performance, identifying new business opportunities, and ensuring all service expectations are being met or exceeded.
Primary Responsibilities
Serve as the primary point of contact for assigned clients within the workers' compensation division, ensuring consistent, timely communication, strong account stewardship, and high client satisfaction.
Lead and manage end-to-end client implementations, including onboarding, timeline management, milestone tracking, and successful go-live delivery.
Conduct regular business reviews to assess performance, savings results, trends, and program effectiveness while presenting actionable insights and strategic recommendations.
Deliver reporting and analytics, including savings analyses, performance summaries, trend identification, and insights tailored to client goals.
Identify opportunities for growth and expansion, including additional products, program enhancements, and cross-sell/upsell opportunities aligned with client needs.
Collaborate with internal teams (Operations, IT, Finance and Sales) to resolve issues, support client requests, and ensure seamless service delivery.
Monitor and manage client satisfaction, proactively identify risks to retention, escalating issues when necessary, and ensuring timely resolution.
Support process and product improvement initiatives by gathering client feedback, identifying pain points, and recommending enhancements to internal teams.
Maintain detailed documentation of client activity, issues, renewal timelines, project milestones, and service-level commitments to ensure visibility and adherence to SLAs.
Maintain a strong understanding of workers' compensation, including bills/claims workflows, fee schedules, repricing methodologies, and relevant regulatory requirements.
Qualifications
3-5+ years of experience in account management, client services, or customer success, preferably in workers' compensation, medical claims, healthcare services, or insurance.
Strong understanding of workers' compensation bills/claims workflows, fee schedules, medical billing, and/or repricing methodologies (or the ability to learn quickly).
Demonstrated experience managing client relationships, including presenting data, conducting business reviews, and leading cross-functional initiatives.
Proven ability to lead implementations or onboarding projects, including managing timelines, milestones, and client expectations.
Excellent communication skills with the ability to translate technical or operational topics into clear client-facing language.
Strong analytical abilities, including comfort with reports, metrics, trend identification, and savings/financial outcomes.
High level of organization with the ability to manage multiple accounts, priorities, and deadlines simultaneously.
Experience collaborating with internal teams such as Operations, IT, and Sales to support client needs.
Proficiency with common tools such as Excel, PowerPoint, CRM systems, and project management tools.
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-$70,000 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.
$50k-70k yearly Auto-Apply 39d ago
Worker's Comp Attorney (Fully Remote)
JBA International 4.1
Remote computer recycling worker job
A plaintiff's law firm looking for a Workers' Comp Attorney to join their team in Sacramento, CA. This firm represents the rights of wronged employees throughout California. We pursue class actions, PAGA cases, Wage and Hour, FEHA violations, Discrimination, and Harassment cases. In this position, your responsibilities include communicating with relevant parties involved in a case, obtaining, preparing, and filing legal documents, and performing research relevant to each request for workers' compensation The ideal candidate will handle all aspects of a case, from pre-litigation to discovery, deposition, trial, or settlement. This firm has an excellent team of support staff will help you along the way. Our firm closely monitors caseloads so that no attorney is overworked.
Qualifications
Experience: At least two (2) years' experience in Workers' Compensation
Ability to manage a high volume of cases and hearings
Excellent written/verbal communication skills with attention to detail
Excellent hands-on computer skills
Strong research and analytical skills
Ability to multi-task and utilize critical thinking skills
Benefits
We offer a professional work environment and a competitive compensation package
Compensation commensurate with experience
We offer a benefits package that includes a 401(k) plan with generous employer match, health, dental, and vision insurance, paid holidays, flexible schedule, free parking, and paid vacation
$58k-88k yearly est. 60d+ ago
Workers Compensation Applicant Attorneys (Onsite or Remote)
Viper Staffing Services
Remote computer recycling worker job
(Hiring) Workers Compensation Applicant Attorneys (Onsite or Remote) $150,000 - $250,000 + Benefits (Pay may varies depending on experience) (3-10+ years of experience) We are seeking Workers Compensation Applicant Attorneys (Onsite or Remote) to become a part of our team! You will represent clients in legal proceedings, draw up legal documents and advise clients on legal transactions.
Responsibilities:
Represent clients in court or before government agencies
Prepare and draft legal documents on behalf of clients
Advise clients on business and legal transactions
Negotiate settlements for legal disputes
Comply with all legal standards and regulations
Perform administrative and management functions related to the practice of law
Qualifications:
Previous experience in law
Familiarity with various legal documents
Strong analytical and problem-solving skills
Ability to build rapport with clients
Excellent written and verbal communication skills
Email Resumes To: Admin@viperstaffing.com
Workers' Compensation Defense Attorney
California | WCAB Litigation Focus | Stable Defense Platform
A respected California defense practice with deep roots in workers' compensation litigation is seeking a Workers' Compensation Defense Attorney to join a collaborative, trial-oriented team. This opportunity is ideal for an attorney who enjoys hands-on case ownership, consistent appearances before the WCAB, and working within a firm built for long-term success rather than short-term volume.
This role offers the chance to step into a well-supported practice where attorneys are trusted to manage their cases independently while still benefiting from a collegial environment and a broader civil defense platform.
Mission Recruiting represents this opportunity exclusively.
Why This Role Stands Out
Consistent litigation exposure before the WCAB
Autonomy over a full workers' compensation defense caseload
Supportive, team-driven culture with a strong emphasis on client service
Long-standing California defense firm with decades of stability
Opportunity to collaborate across multiple civil defense practice areas
Attorneys here are valued for sound judgment, strong advocacy, and the ability to build lasting client relationships.
Position Overview
Workers' Compensation Defense Attorney
California-based practice
Full-time role with regular WCAB appearances
Defense representation for employers, insurance carriers, and third-party administrators
What You'll Be Doing
Managing workers' compensation defense matters from inception through resolution
Appearing at WCAB hearings, depositions, and trials
Drafting pleadings, motions, discovery, and settlement documents
Evaluating exposure and advising clients on litigation and settlement strategy
Developing and executing a case strategy independently
Communicating with clients, claims professionals, opposing counsel, and internal teams
Ensuring compliance with WCAB procedures and EAMS requirements
The Ideal Background
Active membership in the California State Bar
Meaningful experience handling workers' compensation defense matters
Comfort managing a full caseload with minimal oversight
Regular involvement in WCAB appearances
Working knowledge of EAMS filings and WCAB compliance
Strong written advocacy and professional communication skills
Compensation & Benefits
Base salary range of $150,000 to $190,000
Compensation reflective of experience and portable book, if applicable
Medical, dental, and vision insurance
401(k) plan
Continuing legal education and professional development support
Culture & Platform
Collaborative and team-oriented environment
Client-focused practice philosophy
Emphasis on quality work, consistency, and long-term relationships
Broad civil defense platform beyond workers' compensation, offering professional depth and stability
About Mission Recruiting
Mission Recruiting is one of the nation's leading legal recruiting firms, connecting attorneys with law firms that value career longevity, professional growth, and meaningful work.
Salary Range: $150,000 to $190,000
Reference: 148328
#IND1 #ZR
$45k-75k yearly est. 16d ago
MD/DO (Patient Care) **Must have multiple State Licenses and DEA's**
Mindful 4.2
Remote computer recycling worker job
We are seeking a Compassionate and Adult ADHD Experienced Provider to Join our Team at Mindful. Mindful is a digital health company that is making high-quality psychiatric chronic care management more accessible and affordable for patients.Our mission is to empower everyone living with ADHD to reach their fullest potential. We meet that mission by providing a patient-first, technology-powered ADHD treatment platform that keeps costs down and reduces patient wait times. With guidance from the most advanced clinical leadership and board-certified psychiatrists, we have created a platform that provides a patient-first healthcare experience and the highest quality of ADHD care for our patients.
What to Expect:
Flexible and Sustainable Work Schedule: Manage your own schedule; at times weekend or off-hours may be needed. Our clinicians manage patients online, allowing the autonomy to set their own schedules. We value happy team members and a sustainable, balanced career.
Dedicated Clinical Admin Team Just for You: We help you take care of patient scheduling, patient management, pharmacy communications and all other administration work. Our dedicated care team will help you focus your time on the most important thing - providing care to the patients.
Comfortable & Fun Remote Work Environment: Work from anywhere you like alongside our enthusiastic, tight-knit team of medical doctors, other clinicians, engineers, and care team staff.
On-site Training: Get medical help and advice for complex patient cases from our expert psychiatrists and mental health clinicians.
Disrupting Mental Healthcare: A healthy mind can be life-changing, but for 1 in 5 Americans, it's not easy or affordable to see a psychiatrist. Done. is disrupting the traditional mental healthcare industry, using our web-based technology to bring personalized attention to hundreds of thousands of people around the world at an incredibly affordable price point. Join us to be part of this tele-health innovation.
Malpractice liability insurance policy
What we are looking for:
Excitement and passion about Mindful vision; recognition of the impact on the healthcare industry
Comfort working independently as well as with the Done team
Comfort operating in a fast-moving, high-growth environment
Experience diagnosing and treating patients with ADHD
What you will do:
Conduct psychiatric evaluations
Manage your patient's medication regimens you prescribe and adjust medication and dosages as needed
Respond to EHR messages, refill requests, and conduct occasional remote follow-up appointments with your patient panel
Willing to review complex cases and possible discharges cases
What you will need:
Willingness to put patients first
Board Certified/Eligible in Psych or related field
Valid DEA / License in ME, CT, NM, RI, VT, GA, and NV, preferably
Proficiency with word processing and computer skills; comfortable adapting to new software and workflow updates
Excellent written and verbal communication skills
$47k-149k yearly est. Auto-Apply 60d+ ago
MD/DE/NJ/NYC - Prospects for Future Openings
Marketplace Chaplains 4.2
Remote computer recycling worker job
It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business.
Please Note: While assigned hours are generally consistent from week to week, there are no guaranteed minimal hours and positional needs will vary depending on Chaplain availability and Client requirements.
Position Summary
Chaplains are the frontline staff fulfilling the mission and Christian ministry of MCHAP, by using their gifts and talents to serve company employees and their immediate families.
FUTURE OPENINGS FOR PT TIME CHAPLAINS
Essential Functions and Responsibilities
• Serves as a messenger and conveyor of faith, mission, and purpose.
• Interacts with companies, their employees, and the community in a manner that exhibits character through personal and spiritual disciplines.
Ministry
• Makes regular visits to company worksites (usually weekly) to interact with employees and build relationships of trust and friendship motivated by Christian faith.
• Visits employees or immediate family members wherever care can be expressed and help given: hospitals, nursing homes, funeral homes, family residences, or other sites.
• May provide confidential pastoral discussions for problem issues of employees and their immediate family members including, but not limited to family matters, divorce, serious illness, care of aging parents, death and grief recovery, parenting, financial situations that may include debt discussions, budgeting, and other life issues related to financial stress, as well as any other personal issues. Provides referral service and acts as coordinator for specialized assistance to employees and/or immediate family members with specific needs.
• May assist in the planning, conduct or attend funerals for employees or immediate family members, including follow-up support and encouragement to immediate family members during the grief period.
• May make jail visits to employees and immediate family members.
• Works with companies to serve notifications of death and serious injuries to families and other employees, encouraging those impacted by various tragedies.
• May provide post-termination care for laid-off or terminated employees in order to foster a smooth transition to another work environment.
• May facilitate, but not lead, spiritual enrichment activities, as an employee-sponsored and led activity will usually be more fruitful than a chaplain led event.
• Provides, as appropriate/requested, literature and other resources to assist company employees with life issues.
• Represents companies to clients/customers where it would be appropriate to ministry services involved (i.e., serious illness, accidents, traumatic events, and funerals).
• Participates in new employee orientation to explain the Employee Care Service and the role of the Chaplain Team.
• With Executive Director of Operations (EDO) permission, responds positively and assertively to other duties and services requested by executive leadership of companies, within the scope of the Letter of Agreement between MCHAP Chaplains and the company.
Requirements
1. Has ability to work as member of interdisciplinary group and in an interfaith setting. Possesses ability to accept different lifestyles, cultures, beliefs, and values.
2. Skills to effectively listen and interact with clients, employees, and their families. Skills to deliver community presentations. Skills to deal effectively with family members and staff under stressful circumstances. High regard for the dignity and worth of clients, employees and their families. Skills to cope with stressful situations and able to document accurately according to standards.
3. Spiritual maturity and commitment to a Christian lifestyle and to MCHAPs Ministry values. Incorporates Christian values and beliefs in day-to-day activities and in the performance of job duties. Has a fundamental understanding of the Holy Bible and its proper application. Attests to a saving faith in Jesus Christ and actively participates in a biblically based church.
4. Demonstrated ability to interact professionally with diplomacy, patience, and courtesy with diverse groups; ability to establish and maintain effective and cooperative working relationships while providing exceptional customer service. Ability to make administrative and procedural decisions and judgments on sensitive, confidential issues.
5. Demonstrated excellent oral and written communication skills to communicate and interact effectively with leadership, colleagues, employees, and families. Ability to maintain emotional stability to cope with human suffering, emergencies, and other stresses.
6. Demonstrated skill in analyzing information to define and follow up on problems or objectives. Ability to identify solutions and solve problems. Demonstrated skill in interpreting policy and procedures related to the position and keeping others informed.
7. Demonstrated computer proficiency using Google Suites, Microsoft Office, or other equivalent software, internet, email messaging, and web-based software applications. Ability to understand and learn new technology programs.
8. Must have active state driver's license and state minimum auto insurance (state(s) where servicing clients).
Conditions of Employment
Must pass a pre-employment background check.
Work Environment
This is a remote position in the field, and the work environment is dependent upon the clients' worksite. Work environments can include manufacturing, hospitals, office buildings, and funeral homes with differing levels of temperature, noise, and light exposure.
$46k-148k yearly est. Auto-Apply 60d+ ago
MD, Addiction Medicine (Part-Time, Remote)
Pelago
Remote computer recycling worker job
Pelago is the world's leading virtual clinic for Substance Use Management. Our program provides guidance, support and treatment for members seeking to overcome their tobacco, alcohol and opioid use. From unhealthy habits to active substance use disorders, Pelago delivers a personalized solution based on individual health, habits, genetics, and goals, providing care for members wherever they might be on the substance use spectrum. Pelago's suite of virtual services ranges from education, to cognitive behavioral therapy (CBT) to comprehensive medication-assisted treatment (MAT). Pelago enables employers and health plans to deliver accessible, affordable, and effective treatment for substance misuse. Pelago has scaled to helping hundreds of employers and health plans and has already helped more than 750,000 members manage their substance use better. We have recently closed our Series C and raised over $151m from leading global investors. If you are passionate about making an impact on the health of others, join us and make it happen!About the Role:
Pelago Health is seeking a mission-driven MD in Addiction Medicine to join our clinical team. This role involves providing specialized, evidence-based care to individuals seeking addiction treatment through telehealth services. As an Addiction Medicine specialist, you will offer clinical assessments, treatment plans, and Medication Assisted Treatment (MAT) to support members in their recovery.
This is a unique opportunity to make a profound impact on addiction treatment delivery, utilizing cutting-edge telemedicine technology to reach individuals in need of specialized care. You will collaborate with an interdisciplinary team to provide accessible, high-quality treatment and contribute to the innovation of addiction recovery services.
This is a remote and part-time role, averaging approximately 10 hours per week, open to candidates located in the United States. Multi-state licensure is strongly preferred.
In this role you will...
Provide specialized care through live, interactive clinical assessments, diagnosis, and treatment via telehealth for individuals with Substance Use Disorder (SUD) and co-occurring conditions.
Prescribe and monitor Medication Assisted Treatment (MAT), including naltrexone, Suboxone, and other evidence-based pharmacotherapies, working closely with the member operations team.
Address mental health issues commonly found alongside SUD, such as anxiety, depression, and sleep disorders.
Develop individualized treatment plans and make appropriate referrals based on thorough clinical assessments.
Collaborate with counselors, coaches, and member operations teams to provide integrated, patient-centered care that fosters recovery.
Contribute to clinical excellence initiatives such as case reviews, peer reviews, journal clubs, and grand rounds.
Maintain accurate and up-to-date clinical documentation, adhering to compliance and quality assurance standards.
Educate patients about their treatment plans, focusing on their individual needs and recovery goals.
Collaborate with cross-functional teams to optimize care delivery and improve treatment outcomes.
Assist in the development and refinement of clinical protocols, treatment standards, and policies to enhance overall care quality.
The background we are looking for...
MD with board certification in Addiction Medicine or a related field.
Active licensure in at least one U.S. state; multi-state licensure strongly preferred. Must be willing to obtain additional licensure as needed (Pelago will sponsor this).
DEA registration (or in process) and current state-controlled substance license (or in process).
Previous experience in digital health or telemedicine environments, with comfort using digital platforms and electronic health records (EHRs).
A passion for patient-centered care, innovation in addiction medicine, and continuous quality improvement.
Strong communication skills, with the ability to collaborate effectively across teams and organizations.
Bonus: Participation in the Interstate Medical Licensure Compact (IMLC).
The provided range reflects our US target hourly range for this part-time position. Individual pay within the range will vary based on a variety of factors like role-related experience and education, internal pay equity, and other relevant business factors.
Pay Range$175-$215 USD
$42k-133k yearly est. Auto-Apply 15d ago
Telehealth MD with Multi-state Licensure (contract)
Everly Health
Remote computer recycling worker job
Everlywell's mission is to transform lives with modern, diagnostics-driven care, and we believe that the future of healthcare is meeting people where they are. Headquartered in Austin, Texas, Everly Health is the parent company to Everlywell, Everly Health Solutions, Everly Diagnostics, PWN Health, and Natalist. We've set a new standard of people-focused, diagnostic-driven care that puts patients at the center of their own health journey.
Our infrastructure guides the full testing experience with the support of a national clinician network that's composed of hundreds of physicians, nurses, genetic counselors, PharmDs, and member care specialists. Our solutions make world-class virtual care more attainable with rigorous clinical protocols and best-in-class science to tackle some of the healthcare industry's biggest problems.
We are a digital health company pioneering the next generation of biomarker intelligence-combining technology with human insight to deliver personalized, actionable health answers. We transform complex data into life-changing awareness -seamlessly integrating advanced diagnostics, virtual care, and patient engagement to reshape how and where health happens. Over the past decade, Everlywell has delivered close to 1 billion personalized health results, transforming care for 60 million people and powering hundreds of enterprise partners.
PWN Remote Care Services, P.A. (PWN) is a telehealth practice facilitating access to high-quality, diagnostic-driven patient care. PWN is part of a provider network affiliated with Everlywell, a leading remote-based healthcare company. At PWN our mission is to enable access to diagnostic testing, treatment, and professional guidance that empowers individuals to improve their health. Our suite of services enables a broad spectrum of health industry clients to provide seamless access to diagnostic testing and related care interventions. We are a 50-state physician, registered nurse, and genetic counselor network with a strong care coordination and patient support team and technology infrastructure.
We are looking for a board-certified physician licensed in multiple states, who is passionate about expanding access to care by providing focused telehealth consultations to our patients.Specific Needs:
The physician will use their expertise and clinical judgment to provide telehealth sessions to patients via phone and/or video for prescriptive and/or informational sessions.
The physician will adhere to the required state telemedicine regulatory guidelines.
The physician will use their expertise and clinical judgment to conduct comprehensive health assessments on patients as they deem appropriate.
The physician will use their expertise and clinical judgment to develop and implement treatment plans as they deem appropriate.
The physician will use their expertise and clinical judgment to educate patients and their families on health promotion, disease prevention, and self-care techniques.
Position Credential Requirements:
Medical licensure is in good standing in all active states.
Board Certified in internal medicine or family medicine.
Must be a physician in good standing in their medical practice (if applicable).
Physician must be enrolled and in good standing with Medicaid in the states in which the physician is physically located, multiple medicaid state enrollments a plus.
Physician must be enrolled and in good standing with Medicare.
Must be in compliance with HIPAA regulations and our privacy policies.
Participating providers must be board certified by an ABMS-recognized board.
Exceptional webside manner and ability to deliver high-quality patient care.
Ability to provide result interpretation, in addition to education, information and guidance on appropriate next steps in their care.
1+ year of telehealth experience.
Must be tech savvy.
Able and willing to learn/adjust to changes in protocols and/or workflows
Medical Specialities:
Internal Medicine
Family Medicine
Benefits:
Flexible schedule
Professional Liability Insurance
Work Setting:
Remote
Telehealth
$42k-133k yearly est. Auto-Apply 60d+ ago
Workers' Compensation Underwriter
Magmutual 3.3
Remote computer recycling worker job
We are seeking a Senior Workers' Compensation Healthcare Underwriter with a minimum of 7 years of experience to join our underwriting team. This role requires deep technical expertise in evaluating and pricing workers' compensation risk, combined with a strong working knowledge of regulatory requirements across jurisdictions. The underwriter will be expected to independently manage a complex book of business, maintain strict compliance with rating bureau rules and filings, and collaborate cross-functionally with internal stakeholders on underwriting, business development, operations, claims, and compliance matters.
SPECIFIC DUTIES:
Manage new and renewal accounts for assigned agents and producers.
Apply solid risk analysis, pricing strategies, and compliance with state filings and corporate guidelines.
Build and maintain strong agency relationships in partnership with our Business Development Team.
Contribute to strategic business planning and organizational projects.
Monitor portfolio performance, loss ratios, and mod trends across regions and industry segments.
Identify opportunities to improve underwriting guidelines, appetite, or pricing strategies in coordination with underwriting leadership.
QUALIFICATIONS, EXPERIENCE REQUIRED:
Experience: Minimum 7 years of workers' compensation underwriting experience with a carrier
Retail relationships with workers compensation brokers
Prior experience underwriting Umbrella and GL policies are a plus.
Bachelor's degree required.
Comfortable working with underwriting platforms, rating tools, policy admin systems, Salesforce, and Excel.
Proven ability to analyze risk, negotiate effectively, and make sound underwriting decisions.
PREFERRED QUALIFICATIONS:
Exposure to compliance functions, internal audit processes, or statutory reporting requirements.
Proven ability to underwrite within strict compliance boundaries and interpret rules across jurisdictions.
Confident decision-maker with strong risk appetite alignment and escalation instincts.
Communication: Clear, professional, and persuasive communicator with internal teams and external agents.
Precision in rating, documentation, and classification.
Works effectively with business development, compliance and claims
Takes ownership of outcomes and supports peer development.
LOCATION: Hybrid (Atlanta) or Remote
Location:
Atlanta Office
$39k-64k yearly est. Auto-Apply 4d ago
Field Reimbursement Specialist
ANI Pharmaceuticals 4.4
Remote computer recycling worker job
About Us
Welcome to ANI Pharmaceuticals, where we are dedicated to improving and enhancing patients' lives through the manufacturing and distribution of high-quality pharmaceutical products.
With a diverse portfolio of generic and branded pharmaceuticals, ANI is a trusted partner to healthcare providers, pharmacists, and patients alike. We understand the importance of accessibility, and our products are available across a wide range of therapeutic areas, contributing to the well-being of communities globally.
At ANI Pharmaceuticals, there are opportunities to contribute to our purpose every day. We value authenticity, knowledge, and hard work, and we strive to celebrate our employees in a positive environment. Our culture empowers everyone to be successful and apply our full potential.
About the Role
The Field Reimbursement Specialist (FRS) is a key contributor to the overall patient support program for Purified Cortrophin Gel. The Field Reimbursement Specialist serves as a resource in support of product access. This individual will work closely with their matrix team to identify health plan access pull through opportunities, resolve patient access barriers, and provide HCP education. The FRS is an extension of the overlapping reimbursement manager and assists with facilitating treatment access for patients. This work would include communicating with the case management team conducting benefit investigations, educating health care providers on the prior authorization and appeal process, and coordinating other patient services.
Responsibilities
Reports to a director on the Reimbursement team for development and mentoring
The FRS will act as a main point of contact at designated accounts providing support to HCPs on behalf of patients prescribed ANI medications
The FRS provides proactive education to health care provider on the insurance requirements for a patient's prescription
Works with Hub case manager and in-network Specialty Pharmacies on prior authorization requirements and communication with HCP and patients
Coordinates communication and activities with Nurse Access Specialist colleagues
Facilitates patient assistance when applicable, such as copay and free goods
Partners with managed care colleagues to understand policies and highlight new trends
Collaborates with sales colleagues when appropriate and as directed by Compliance policies
Skills/Competencies
Strong collaboration with Hub partners and cross-functional colleagues
Familiarity with OIG guidance, HIPAA guidelines and FDA protocols
Possesses a sense of urgency to address critical access issues for patients
Problem-solver who navigates challenging access scenarios and identifies solutions
Takes initiative to move a patient case forward at all times
Strong interpersonal and communication skills
Qualifications/Requirements
Relevant post-secondary education or applicable certifications
2+ years of experience working with specialty medications - either in specialty pharmacy, Hub services, at a provider's office or with an insurance payer
Demonstrated expertise with both pharmacy and medical benefits in a specialty disease market
Ability to travel up to 25% with some evening and weekend commitments
The base salary range for this position is $70,000-$90,000; the exact salary depends on various factors such as experience, skills, education, location, competencies and industry-specific knowledge.
ANI Pharmaceuticals offers a variety of benefits to eligible employees, including health insurance coverage, life and disability insurance, retirement savings plans, paid leave programs, paid holidays and paid time off. Many of these benefits are subsidized or fully paid for by the company.
$70k-90k yearly Auto-Apply 8d ago
Reimbursement Specialist - Ambulatory - Days - Remote
Vcu Health
Remote computer recycling worker job
Remote: To the Virginia area only. The Reimbursement Specialist improves revenue collection pertaining to high cost medications that require prior authorization. This job will initiate, follow-up, and proceed with approval and/or denials of prior authorizations efficiently via phone, fax, or electronically.
The Reimbursement Specialist carries out benefit investigation and coordinates Patient Assistance Programs and/or copay cards for patients with high co-pays or those without insurance coverage. This role works closely with nursing and physicians in order to obtain required documentation for prior authorization and billing.
The Reimbursement Specialist arranges refills, transfers, and delivery of medications. Updates patient case management system regularly. Ideally, this role is familiar with disease state terminology or willingness to research. This role also works as a Pharmacy Technician when deemed necessary.Licensure, Certification, or Registration Requirements for Hire: Current certification by the Pharmacy Technician Certification Board (PTCB) Current licensure with the Virginia State Board of Pharmacy By virtue of societal trust and security explicitly imparted to pharmacies for the control of drugs, candidate/incumbent must have a clean criminal record (i.e. no felony conviction; no drug or pharmacy related convictions, including misdemeanors); no denial, suspension, revocation, or restriction of registration or licensure by any State Board of Pharmacy Licensure, Certification, or Registration Requirements for continued employment: Current certification by the Pharmacy Technician Certification Board (PTCB) Current licensure with the Virginia State Board of Pharmacy Experience REQUIRED: Minimum of one (1) year previous pharmacy practice experience in a similar setting Minimum of three (3) years prior experience with Manufacturers Patient Assistance Programs and prior experience with prescription on-line adjudication Previous work experience using a personal computer and various billing software applications as well as e-mail, spreadsheets, word processing, databases, etc. Experience PREFERRED: N/A Education/training REQUIRED: High School Diploma or equivalent Education/training PREFERRED: Associates Degree in Business or related field from an accredited program Independent action(s) required: Identifies equipment problems; various aspects of assisting the pharmacist that don't require a pharmacist's supervision or check. Supervisory responsibilities (if applicable): N/A Additional position requirements: Able to work all shifts, weekends, holidays, emergency coverage Age Specific groups served: N/A Physical Requirements (includes use of assistance devices as appropriate): Physical: Lifting less than 20 lbs. Activities: Prolonged standing, Prolonged sitting, Frequent bending, Walking (distance), Climbing (steps, ladder, other), Reaching (overhead, extensive, repetitive), Repetitive motion Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking Emotional: Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Noisy environment, Able to adapt to frequent change Days
EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.
Castle Biosciences Earns "Top Workplaces USA Award" for Phoenix, Pittsburgh, and Friendswood! You won't find a work culture and benefits package like ours every day. Come join our team and a group of colleagues who love working at Castle! Learn more at *************************
Castle Biosciences Inc. is growing, and we are looking to hire a Reimbursement Specialist (Claim Denial & Appeal Focus) working remotely from your home office based in the USA, with a start date on or before January 15, 2026.
Why Castle Biosciences?
Total Compensation Package:
* Salary Range: $46,000.00 - $47,277.00. Final salary is based on Experience and Education levels.
* Excellent Annual Salary + 20% Bonus Potential
* 20 Accrued PTO Days Annually
* 10 Paid Holidays
* 401K with 100% Company Match up to 6%
* 3 Health Care Plan Options + Company HSA Contribution
* Company Stock Grant Upon Hire
* $75/month reimbursement for internet service
A DAY IN THE LIFE OF A Reimbursement Specialist (Claim Denial & Appeal Focus)
This individual is responsible for resolving denied insurance claims for laboratory services by providing payers with requested documentation, initiating the appeal process on behalf of the patient, following up on outstanding transactions, and delivering the highest level of customer service to internal and external customers. This role spends most of its time reviewing and resolving front-end claim issues to ensure timely, accurate submission; reviewing Explanation of Benefits (EOBs), electronic remittance advice, and denial letters; assigning ANSI codes; and taking appropriate action in the billing system. Responsibilities include contacting insurance companies for missing information or claim status, using payer portals for follow-up, and supplying additional documentation needed to adjudicate claims. The role also involves creating custom appeals with appropriate arguments to overturn denials based on payer medical policy or state laws and submitting both standard and custom appeal letters for insurance companies including Medicare, Medicare Advantage, and commercial plans.
REQUIREMENTS
* High School Diploma or equivalent GED or equivalent work experience.
* Two years of health insurance billing with experience in identifying and resolving claim issues for laboratory tests
* Must have a working knowledge of various payers' designations of authorized representative forms
* Experience handling a high volume of claims work on a daily basis (35 plus claims per day)
* Must demonstrate the ability to type 35 WPM with 90% or higher accuracy.
TRAVEL REQUIREMENTS
*
SCHEDULE
* Monday - Friday, 8:00 AM to 5:00 PM, non-exempt position, working remotely from your home office based in the USA.
READY TO JOIN OUR BIOTECH TEAM?
We truly appreciate your time. If this feels like the right opportunity for you, we'd love for you to complete our mobile-friendly application. We're excited to learn more about you and look forward to connecting soon!
Castle Biosciences Awards and Research Developments!
WORK AUTHORIZATION
All candidates must be legally authorized to work in the United States. Currently, Castle Biosciences does not sponsor H-1B visas, OPT, or employment-related visas.
ABOUT CASTLE BIOSCIENCES INC.
At Castle Biosciences, people are at the heart of everything we do. Our mission is to improve health through innovative tests that guide patient care. We empower patients and clinicians to make more confident, personalized treatment decisions through rigorous science and clinically actionable solutions that help improve disease management and patient outcomes.
Our impact starts with our team. Every individual at Castle plays a meaningful role in advancing patient care. We value integrity, trust and collaboration in all we do and are committed to fostering an environment where people can grow, thrive and make a lasting impact. Here, your work has purpose, your voice matters and together, we're shaping the future of precision medicine.
Castle Biosciences is an equal opportunity employer as to all protected groups, including protected veterans and individuals with disabilities.
If you have a disability and you believe you need a reasonable accommodation in order to search for a job opening or to submit an online application, please e-mail ReasonableAccommodationsRequest@castlebiosciences.com.
This email was created exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only messages left for this purpose will be returned. Messages left for other purposes, such as following up on an application or technical issues not related to a disability, will not receive a response.
No third-party recruiters, please
$46k-47.3k yearly 23d ago
Perm - Gastroenterology - MD/DO
Mount Carmel Grove City 3.6
Computer recycling worker job in Columbus, OH
Job Title: Permanent Physician - Gastroenterology
Join a Growing Gastroenterology Practice in Columbus, OH We are excited to announce an opportunity to join a thriving Gastroenterology practice just 15 minutes from downtown Columbus, Ohio. This practice operates within a beautiful healing environment at a state-of-the-art hospital that opened in 2019. You will have the chance to create a lasting impact on patient care in a team-oriented atmosphere.
Job Responsibilities:
Practice on one hospital campus, providing a blend of outpatient office visits, endoscopy, and inpatient coverage.
Utilize an established referral base within the medical group and community partners.
Provide consultative hospital services and patient-centered care.
Engage in a team-based environment utilizing Epic EMR.
Support patients through onsite lab and X-ray services.
Participate in a 1:4 call rotation, including some weekends.
Advanced Endoscopy training is preferred but not necessary.
Embrace a supportive environment with dedicated Advanced Practice Provider (APP) assistance.
Qualifications:
Board Certified in Gastroenterology (TRULY Board Eligible candidates with plans to test may also apply).
3-5 years of outpatient Gastroenterology experience preferred; GI fellows encouraged to apply.
Ohio medical license (or willingness to obtain).
BLS and ACLS certifications are required.
Recent NPDB Self Query report (within 30 days active) required.
Advanced Endoscopy training is highly preferred.
License and Certification Requirements:
Active Ohio medical license or the ability to obtain one.
BLS and ACLS certifications are mandatory.
All candidates must provide a recent NPDB report.
Explore Columbus, Ohio!
Columbus is a vibrant city with a rich cultural scene, diverse neighborhoods, and beautiful parks. Enjoy a wide range of dining options, arts experiences, and sports events. The city's friendly community and strong economy make it an ideal place to live and grow both personally and professionally. Come be a part of this dynamic city while furthering your career in Gastroenterology!
$90k-186k yearly est. 60d+ ago
Reimbursement Specialist (PST Time Zone)
Veracyte 4.6
Remote computer recycling worker job
The successful candidate will be a rockstar at identifying, analyzing, and resolving insurance company denials. While working with our Reimbursement, Commercial, and Finance teams this role will provide on-going insight and analytics on all medical insurance claims. This is an U.S. remote position.
*This is a full time, non-exempt role with a schedule of Monday through Friday 8:30am-5pm PST
Responsibilities include:
Verifying insurance/recipient eligibility, billing and follow-up on claims to Medicare, Medicaid and Private Insurer Payers.
Researching and responding to Medicare, Medicaid and other Payer inquiries regarding billing issues and insurance updates.
Reviewing unpaid and/or denied claims, appeals and follow-up on accounts to zero status.
Organizing and distribute comprehensive appeal packages to the insurance provider.
Ability to review and interpret explanation of benefits to determine contractual allowance.
Researching accounts and resolving deficiencies.
Calling insurance companies regarding outstanding accounts. Utilize payor websites to check claim status.
Reviewing and submitting accurate claims, re-submissions and claim review forms.
Researching and monitoring specific billing issues, trends and potential risks based on current research and customer feedback.
Answering all patient/doctor/hospital/lab/insurance company phone calls regarding accounts, and takes appropriate action.
Providing administrative support (when requested) including performing data entry, updating various record keeping systems, upholding company policies and Client requirements, and participating in projects, duties, and other administrative tasks.
Knowledge, understanding, and compliance with all applicable Federal and Local laws and regulations relating to job duties.
Knowledge, understanding, and compliance with Company policies and procedures.
Other duties as assigned.
Who You Are:
Bachelor's Degree or Associates Degree
1-2 Years of direct appeals and billing experience
Enthusiasm and an entrepreneurial spirit
Familiarity with ICD and HCPC/CPT coding preferred
Familiarity with CMS 1500 claim form preferred
Familiarity with Claim Adjustment Reason Codes (NUCC) preferred
Ability to create and maintain spreadsheets
Ability to use analytical, interpersonal, communication, organizational, numerical, and time management skills.
Experience handling and expediting escalated issues, with follow up to the customer.
Ability to quickly assess a situation and take appropriate actions to address customer needs and requests in a timely and efficient manner. Self-starter with the ability to work independently and effectively in a team environment.
Ability to organize and prioritize multiple projects/tasks and meet deadlines in a constantly evolving and fast-paced environment.
Strong, consistent work ethic with a keen attention to details and ability to focus on the big picture.
Excellent written and verbal communication skills.
Must be able to communicate with confidence and tact across all levels within the company.
#LI-Remote
$38k-53k yearly est. Auto-Apply 60d+ ago
Reimbursement Specialist
Zoll Medical Corporation
Remote computer recycling worker job
CMS At ZOLL, we're passionate about improving patient outcomes and helping save lives. We provide innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and treat patients suffering from serious cardiopulmonary and respiratory conditions.
ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed to deliver better insights and better outcomes. On any given day, clinicians utilize these ZOLL products for tens of thousands of cardiac patients around the world:
* LifeVest, the world's first wearable defibrillator, has been trusted to protect more than 1M patients at risk of sudden cardiac death.
* HFMS (Heart Failure Management system) is a non-invasive, patch-based device that monitors pulmonary fluid levels and has been shown to reduce heart failure readmissions rates by 38 percent.
* TherOx Super Saturated Oxygen (SSO2) Therapy is the first FDA-approved therapy since the stent 20+ years ago to reduce infarct size in patients with the most severe heart attacks.
Heart disease is the leading cause of death for both men and women in the U.S. At ZOLL, your work will help to ensure cardiac patients get the life-saving therapy they need.
ZOLL has been Pittsburgh's Manufacturer of the Year, one of Western PA's Healthiest Employers, and even one of Pittsburgh's Coolest Offices. But it's our unique opportunity to impact people's lives that makes ZOLL the ideal place to build your career.
Job Summary
The Reimbursement Specialist is an integral member of the reimbursement team and has
primary responsibility for the timely initiation of authorizations with insurance carriers for new
and established patients. The representative will also be in contact with the physician office and
sales staff for additional clinical information, progress notes and additional testing when required
Essential Functions
* Communicates medical need and educates case manager on LifeVest system to obtain authorization for services. Works with insurance carriers to authorize service for new and existing patients.
* Obtains necessary documentation for continued authorization as dictated by payer, including updated clinical information or forms.
* Contacts the client, physician office and sales representative to relay or obtain pertinent information and documentation to ensure continued coverage.
* Completes weekly follow up with insurance companies, physicians or sales team to obtain updated clinical and/or authorization decisions for new and existing patients.
* Interacts with sales staff as needed to obtain required documentation.
* Responsible for generation of all authorization requests.
* Performs other duties as assigned by Management.
Required/Preferred Education and Experience
* High School Diploma required
* 3+ years' experience in medical insurance verification preferred
* experience working with all payer types to include Medicare, Medicaid and third-party
commercial insurance companies preferred
Knowledge, Skills and Abilities
* Superior communication and customer service skills, and
ability to handle multiple tasks simultaneously under strict deadlines.
* Strong negotiation skills.
* Superior communication, customer service skills and strong phone presence
* Ability to handle multiple tasks simultaneously under strict deadlines
* Proficiency in MS Excel, MS Teams, email programs and Online data systems.
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.
* Standing - Occasionally
* Walking - Occasionally
* Sitting - Constantly
* Talking - Occasionally
* Hearing - Occasionally
* Repetitive Motions - Frequently
ZOLL is a fast-growing company that operates in more than 140 countries around the world. Our employees are inspired by a commitment to make a difference in patients' lives, and our culture values innovation, self-motivation and an entrepreneurial spirit. Join us in our efforts to improve outcomes for underserved patients suffering from critical cardiopulmonary conditions and help save more lives.
#LI-KH1
The hourly pay rate for this position is:
$18.50 to $21.50
Factors which may affect this rate include shift, geography, skills, education, experience, and other qualifications of the successful candidate. Details of ZOLL's comprehensive benefits plans can be found at *********************
Applications will be accepted on an ongoing basis until this position is filled. For fully remote positions, compensation will comply with all applicable federal, state, and local wage laws, including minimum wage requirements, based on the employee's primary work location.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, disability, or status as a protected veteran.
ADA: The employer will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990.
$18.5-21.5 hourly Auto-Apply 15d ago
Reimbursement Specialist II (Remote)
Three Oaks Hospice
Remote computer recycling worker job
Come join our team at Three Oaks Hospice and our sister companies- Agape Hospice Care, Sage Hospice, Primary and Palliative Care, Elevation Hospice of Colorado, Elevation Hospice, and Primary and Palliative Care of Utah. We are growing and looking for compassionate professionals who want to make a meaningful impact while building a rewarding career in hospice and palliative care.
Together, we share a unified mission to deliver best-in-class care to patients and families. While each organization maintains its own identity and local culture, we operate as one connected network-using shared systems and support to create a smooth, consistent, and candidate-friendly hiring experience.
Why Work for Us: We are committed to being an employer of choice, offering a supportive culture centered on patient care, clinical excellence, and employee success. If you're looking for purpose, stability, and growth, this is the place to be. Join our team!
We are looking for a passionate Reimbursement Specialist II to join our leading team of hospice care professionals and make a difference, by listening, caring, and serving.
POSITION SUMMARY : Responsible for the billing and collections for assigned hospice agencies within the company. Additionally, this position will be instrumental in analyzing and following up on billed medical claims to determine the appropriate course of action to resolve the claims in accordance with state and federal guidelines.
QUALIFICATIONS:
High school diploma or equivalent is required; Undergraduate degree is preferred
Two years medical billing experience; physician practice billing experience is a plus
Understanding and knowledge of requirements of Medicare, Medicaid, and Insurance billing
Experience verifying benefits through various insurance systems
Ability to read and understand claims to effectively review and process billing requirements
Ability to exercise discretion and independent judgment
Excellent oral and written communication skills
Ability to work with high volume of work while maintaining attention to detail
Computer proficiency in MS Office and Web enabled applications
$32k-45k yearly est. Auto-Apply 8d ago
Reimbursement Specialists
Mercalis
Remote computer recycling worker job
*** THE SHIFTS FOR THESE ROLES ARE M-F (3)9A-6P AND (3)11A-8P EST ONLY ***
** TRAINING FOR THESE ROLES WILL BE ON SITE (Morrisville, NC) M-F 8A-5P EST **
Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris™ revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana. To learn more about Valeris, please visit ****************
As a Reimbursement Case Manager, you provide inbound and outbound phone support and serve as the primary contact for patients, caregivers, and providers. You will facilitate a collaborative process that gauges, coordinates, and monitors patient needs and appropriately facilitate a patient's journey utilizing services offered through the Patient Support Program on behalf of a manufacturer. The primary function is to provide unparalleled customer service to patients, caregivers and providers as a dedicated contact by coordinating resources, exchanging information and ensuring appropriate delivery of services. These services include handling the day-to-day activities within reimbursement services, such as daily interactions with healthcare insurance companies to verify the financial aspects of healthcare services to ensure patients have access to life saving treatments they need.
Responsibilities
Reimbursement Case Managers may be regionally aligned and will serve as an expert on reimbursement, co-pay, foundation assistance, PAP issues, and other forms of available support and will be responsible for handling patient and healthcare provider interactions
Serve as an advocate to patients regarding eligibility requirements, program enrollment, reimbursement process, affordability support, and general access for prescribed therapy
Establish relationships, develop trust, and maintain rapport with patients, payers and healthcare providers
Serve as direct point of contact to health care providers for ongoing support and relationship development by acquiring and delivering detailed information regarding a program and/or a patient
Serve as a resource for patients and healthcare professionals to verify insurance coverage, medical billing, reimbursement process, and general access for complex pharmaceuticals
Evaluate program enrollment forms for data integrity
Responsible for insurance benefit investigations, and triage cases according to program standard operating procedures
Follow program guidelines and escalate complex cases according to program policy, SOPs, Call Guides, and other program materials.
Working case management system, documenting status/background in case notes, communicating patient benefits, assisting in the PA/Appeals process and like responsibilities
· Ability to understand and explain benefits offered by all payer types including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD)
· Act as an assigned liaison to client contacts (e.g., regional contact for sales representatives), Program Management, other internal stakeholders and Healthcare Providers
Maintain records in accordance with applicable standards and regulations to the programs/promotions
· Provide unparalleled customer service while serving as a brand advocate and program representative; understands the importance of achieving quality outcomes and commit to the appropriate use of resources
Works with the Program Manager, on a day-to-day basis to maintain open lines of communication and share awareness regarding patient status, prescriber feedback/satisfaction and program effectiveness
Understand health and disease states of patients of the programs
Maintains a high level of ethical conduct regarding confidentiality and privacy
Help maintain team morale by consistently demonstrating positive attitude
· On time adherence to training deadlines for all corporate policies and procedures governing access to confidential data
· Ensure all SOPs are followed with consistency
· Conducts miscellaneous tasks or projects as assigned Identify and report pharmacovigilance information as required by client(s) (i.e., Adverse Events) - (specific to program/client requirements)
Qualifications
Associate or Bachelor's degree preferred; or a minimum of 4 years of call center or customer service experience with progressive levels of responsibility within a service driven environment
Ability to communicate effectively both orally and in writing
Knowledge of medical insurance terminology and reimbursement/insurance, healthcare billing, physician office, health insurance processing or related experience
Excellent problem-solving and decision-making skills required
Attention to detail and committed follow through in communication with patients, providers and internal stakeholders
Strong organizational skills
Willing to work in a dynamic, fast paced environment and have the ability to multi-task and adapt to change while adhering to Program Standards
Strong interpersonal skills, ability to work both independently and as part of a team,ability to jump in and help others as needed
Empathetic listening skills in order to interact effectively with patients and providers
Punctual, reliable with strong attendance record
Proficient with Microsoft products
Physical Demands & Work Environment
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.
Although very minimal, flexibility to travel as needed is preferred.
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
Why Work for Valeris?
We're committed to supporting the well-being and success of our team members. As part of our organization, full-time employees can expect:
Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
Additional health support, including telehealth and Employee Assistance Program (EAP) services
Company match on Health Savings Account contributions
Free Basic Life and AD&D coverage equal to your annual earnings, with a minimum of $50,000 and a maximum of $300,000
Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability
401(k) Retirement Savings Plan with 100% match on the first 5% you contribute, with immediate vesting
Paid Time Off (PTO) and Sick Leave to support work-life balance
Team members receive nine paid holidays plus two floating holidays
Opportunities for advancement in a company that supports personal and professional growth
A challenging, stimulating work environment that encourages new ideas
Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
A mission-driven, inclusive culture where your work makes a meaningful impact
Any offer of employment is contingent upon the successful completion of a background check and, depending on the position, a drug screen in accordance with company standards. Please note that this job description is not intended to be an exhaustive list of all duties, responsibilities, or activities associated with the position. Responsibilities and tasks may be modified at any time, with or without notice.
Our Commitment to Equal Opportunity
At Valeris, we don't just accept difference - we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.
$33k-43k yearly est. Auto-Apply 3d ago
Reimbursement Specialist
Ossur North America
Remote computer recycling worker job
About Us
At Embla Medical, we are a purpose-driven company dedicated to improving people's mobility through the delivery of Prosthetics, Neuro Orthotics, Bracing & Supports and Patient Care. We do this with compassion and innovation, from how we design our award-winning mobility solutions to how we operate our network of patient care clinics.
We are dedicated to providing the best possible care to our patients to help them live Life Without Limitations.
About the Role
Monitor, assess, and report on provider, payor, and legislative trends and developments. Manage day-to-day reimbursement activities to achieve key business objectives. Maintain existing reimbursement services and develop new ones. Work cross-functionally with Ossur's Chronic Solutions (Ossur/College Park/Fior & Gentz) Business Area to develop new reimbursement services and training to targeted customers. Increase customer recognition of our companies as providers of industry-leading reimbursement resources.
This is a remote-eligible position in the following states: CA, CT, FL, GA, NY, OH, OR, RI, VI, WV.
What You'll Do
External Customer Reimbursement Responsibilities
Provide appropriate support to external customers with reimbursement questions about Ӧssur products.
Develop appropriate reimbursement materials regarding our companies' products for customers.
Assess and implement new reimbursement programs/resources/services that support our companies' customers.
Assist customers in obtaining authorization and writing appeals
Internal Customer Reimbursement Responsibilities
Update Ӧssur, College Park, and Fior & Gentz Sales & Marketing staff re. changes in payor policies affecting our customers' access to our products.
Work cross-functionally with our companies' product management re. reimbursement issues / submissions to government contractors (e.g., PDAC).
Other Responsibilities
Participate in DME MAC Advisory Council meetings.
Attend DME MAC educational meetings.
Company Responsibilities:
Exercise good use of company funds and property within the set guidelines. Maintain an honest and professional attitude as the company's representative at all times.
All employees must be aware, have knowledge and shall have received general training in Ӧssur's Quality requirements. Training takes place in the Onboarding process and in New Employee Orientation. More specific Quality training is job specific.
All training related to the quality management system is done in accordance with the Training Management Process (QM1681).
Contribute to a safe working environment by maintaining own workspace and reporting any potential hazards.
Adhere to Company's safety rules
Adhere to Company Values - Honesty - Frugality - Courage
Who You Are
5+ years of experience in medical device reimbursement, market access, reimbursement policy, healthcare provider, and/or healthcare payer
BS/BA degree
Strong understanding and working knowledge of private, federal, and state healthcare coverage
Prior experience with O&P facilities and/or physician practices preferred
Ability to review medical records and assess their compliance with payer coverage requirements
Proven ability to work cross-functionally in a large organization
Demonstrated ability to take initiative and seek guidance when appropriate
Demonstrated strong written and oral communication skills in group and one-on-one settings
Strong analytical skills required
Computer skills required, including Outlook, Word, Excel, and PowerPoint
Ability to travel: 20%
Remote work arrangement negotiable
Why You'll Feel Good Working Here
Join our team if you want to make a lasting impact; we will support you along the way.
Global organization with a network of employees around the world
We believe in the importance of people's growth and development
At Embla Medical we celebrate different ideas, perspectives and backgrounds
Joining Embla Medical is not just taking a job, patients we care for depend on us to help them get back their freedom and livelihood
Competitive Compensation Packages
Medical, Dental, and Vision Benefits
401(k) Retirement Plan with employer matching contribution
9 paid holidays
13 vacation days, birthday and two (2) volunteer day
8 sick days within your first year of employment
Paid Parental Bonding
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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to sit. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel; and reach with hands and arms. The employee must frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, color vision, and ability to adjust focus.
The US base pay range for this full-time position is $68,518 - $101,557 + bonus + benefits. Our pay ranges are determined by role, level, and location. The range displayed on each job posting reflects the minimum and maximum target for new hire pay rates. Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training. Your recruiter can share more about the specific salary range for your preferred location during the hiring process.
Please note that the compensation details listed in US role postings reflect the base salary only, and do not include bonus, equity, or benefits.
Embla Medical is committed to sustainable business practices and renowned for positively impacting people‘s health and well-being
Embla Medical is an equal opportunity employer and makes employment decisions on the basis of merit. We want to have the best available individual in every job.
Embla Medical's equal opportunity policy prohibits all discrimination (based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical disability, mental disability, military service, pregnancy, child birth or related medical condition, actual or perceived sexual orientation, or any other consideration made unlawful by local laws around the world).
Embla Medical is committed to complying with all applicable laws providing equal employment opportunities. This commitment applies to all individuals involved in the operations of Embla Medical and prohibits discrimination by any emplo yee of Embla Medical, including supervisors and co-workers.
Important Warning: Beware of fraudulent recruiters impersonating our company. Please take extra caution when asked for any sensitive personal information, such as social security numbers or bank account details. We will never ask you for any form of payment during the recruitment process. Please make sure you refer to our official website.
$33k-43k yearly est. Auto-Apply 9d ago
Reimbursement Specialist
Zoll Data Systems 4.3
Remote computer recycling worker job
CMS
At ZOLL, we're passionate about improving patient outcomes and helping save lives. We provide innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and treat patients suffering from serious cardiopulmonary and respiratory conditions.
ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed to deliver better insights and better outcomes. On any given day, clinicians utilize these ZOLL products for tens of thousands of cardiac patients around the world:
LifeVest, the world's first wearable defibrillator, has been trusted to protect more than 1M patients at risk of sudden cardiac death.
HFMS (Heart Failure Management system) is a non-invasive, patch-based device that monitors pulmonary fluid levels and has been shown to reduce heart failure readmissions rates by 38 percent.
TherOx Super Saturated Oxygen (SSO2) Therapy is the first FDA-approved therapy since the stent 20+ years ago to reduce infarct size in patients with the most severe heart attacks.
Heart disease is the leading cause of death for both men and women in the U.S. At ZOLL, your work will help to ensure cardiac patients get the life-saving therapy they need.
ZOLL has been Pittsburgh's Manufacturer of the Year, one of Western PA's Healthiest Employers, and even one of Pittsburgh's Coolest Offices. But it's our unique opportunity to impact people's lives that makes ZOLL the ideal place to build your career.
Job Summary
The Reimbursement Specialist is an integral member of the reimbursement team and has
primary responsibility for the timely initiation of authorizations with insurance carriers for new
and established patients. The representative will also be in contact with the physician office and
sales staff for additional clinical information, progress notes and additional testing when required
Essential Functions
Communicates medical need and educates case manager on LifeVest system to obtain authorization for services. Works with insurance carriers to authorize service for new and existing patients.
Obtains necessary documentation for continued authorization as dictated by payer, including updated clinical information or forms.
Contacts the client, physician office and sales representative to relay or obtain pertinent information and documentation to ensure continued coverage.
Completes weekly follow up with insurance companies, physicians or sales team to obtain updated clinical and/or authorization decisions for new and existing patients.
Interacts with sales staff as needed to obtain required documentation.
Responsible for generation of all authorization requests.
Performs other duties as assigned by Management.
Required/Preferred Education and Experience
High School Diploma required
3+ years' experience in medical insurance verification preferred
experience working with all payer types to include Medicare, Medicaid and third-party
commercial insurance companies preferred
Knowledge, Skills and Abilities
Superior communication and customer service skills, and
ability to handle multiple tasks simultaneously under strict deadlines.
Strong negotiation skills.
Superior communication, customer service skills and strong phone presence
Ability to handle multiple tasks simultaneously under strict deadlines
Proficiency in MS Excel, MS Teams, email programs and Online data systems.
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.
Standing - Occasionally
Walking - Occasionally
Sitting - Constantly
Talking - Occasionally
Hearing - Occasionally
Repetitive Motions - Frequently
ZOLL is a fast-growing company that operates in more than 140 countries around the world. Our employees are inspired by a commitment to make a difference in patients' lives, and our culture values innovation, self-motivation and an entrepreneurial spirit. Join us in our efforts to improve outcomes for underserved patients suffering from critical cardiopulmonary conditions and help save more lives.
#LI-KH1
The hourly pay rate for this position is:
$18.50 to $21.50
Factors which may affect this rate include shift, geography, skills, education, experience, and other qualifications of the successful candidate. Details of ZOLL's comprehensive benefits plans can be found at *********************
Applications will be accepted on an ongoing basis until this position is filled. For fully remote positions, compensation will comply with all applicable federal, state, and local wage laws, including minimum wage requirements, based on the employee's primary work location.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, disability, or status as a protected veteran.
ADA: The employer will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990.