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  • Healthcare Customer Service Specialist II (SCA)

    Performant Financial 4.7company rating

    Remote or San Angelo, TX job

    ABOUT PERFORMANT: At Performant, we're focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission: To offer innovative payment accuracy solutions that allow our clients to focus on what matter most - quality of care and healthier lives for all . If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture - then Performant is the place for you! ABOUT THE OPPORTUNITY: Hiring Range: $19.02/Hour As a Healthcare Customer Service Specialist II (SCA) you will work within a team and be the primary point of contact for all providers, Medicare contractors, etc. This position provides professional, accurate and timely responses to CMS (Medicare) and provider inquiries. This includes responding to written, telephonic, and electronic inquiries within the appropriate timeframes. Candidates for this job will be recruited exclusively from Tom Green County, TX (San Angleo, TX) and the surrounding area. Key Responsibilities: Maintain a current knowledge of all contract requirements and objectives. Develop professional working relationships with colleagues, healthcare providers and other Medicare contractors. Take inbound calls from providers to answer questions and resolve complex issues. Make outbound calls to healthcare providers as a courtesy to confirm if letters requesting records for review have been received. Respond to assigned written communications from providers timely and accurately. Educate providers on proper process protocols and their appeal rights. Establish appropriate contacts and perform necessary research to validate provider contact information. Conduct critical due diligence follow-ups if additional research or action is required to resolve an inquiry. Enter and update all contact and activity information into tracking logs and the audit platform where not automatically completed by the system, e.g., a telephone call, correspondence responses, special notes, etc. Research and route internal/external communications to the appropriate person or department Notify management of: all escalated displeasure with the audit program legal action government intervention escalated concerns regarding audit issues and edit parameters. suggestions to improve or correct processes or documents. Perform miscellaneous duties as assigned in a highly professional manner. Knowledge, Skills, and Abilities Needed: Excellent verbal and written communication skills Skilled in data entry and knowledge of computers Working knowledge of Excel Courteous, professional, and respectful attitude Strong understanding of customer service policies and processes Ability to learn CMS rules and regulations and understand the CMS Recovery Audit Contractor program. Healthcare and insurance terminology knowledge preferred but not required. Flexibility to prioritize and handle non-standard situations that may arise. Must be detailed, organized and able to manage various job duties as required. Maintain a strong work ethic and attendance. Required and Preferred Qualifications: At least two years' experience in a call center or customer service position required. At least one year claims processing/billing experience preferred. High School diploma or GED is required. Must maintain HIPAA Certification. WHAT WE OFFER: Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee's responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). Regularly sit/stand 8 or more hours per day. Occasionally lift/carry/push/pull up to 10lbs. Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. Other requirements may apply. All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Performant is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performant's Human Resources team to discuss further. Our diversity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED
    $19 hourly Auto-Apply 7d ago
  • EDI Software Tester

    Firstsource Solutions 4.3company rating

    Remote job

    Software Tester EDI This is a new role within the EDI department supporting the CUBS platform. The addition is intended to enhance our internal QA capabilities, with a focus on testing changes to data imports/exports and supporting new feature development across our RCM solutions. The tester will work closely with developers, business analysts, file technicians, and QA oversight. Work Environment: * Remote Position: 100% work-from-home * Core Hours: 8:00 AM - 4:30 PM EST (with flexibility based on time zone and team alignment) * Team Culture: Mix of independent work and team collaboration, especially during QA cycles or cross-functional meetings Responsibilities: * Test Change Requests: Validate all programming modifications affecting import/export of data files (837, 835, 277, etc.). Review scope documentation and requirements provided by BSAs and developers. * Support Feature Testing: Execute structured testing of new system features to confirm functionality and adherence to requirements. * QA Documentation: Write clear, step-by-step test cases for current and future regression testing. Log and track defects in a shared system, ensuring timely resolution and retesting. * Regression Support: Contribute to the design and execution of regression testing across clients, especially after high-risk deployments. * Client-Specific Testing: Understand client-specific rules and validation processes that may affect how files are handled or interpreted. * Continuous QA Improvement: Help document testing checklists and reusable scripts for future test cases. Suggest process improvements where appropriate. Key Characteristics We're Looking For: * Strong Communicator: Able to clearly document test steps, explain findings, and ask clarifying questions when requirements are unclear. * Detail-Oriented: Accuracy is key-this person should naturally spot inconsistencies and outliers in data or functionality. * Organized: Able to manage multiple testing assignments at once and document results cleanly and consistently. * Accountable and Self-Directed: Capable of managing time effectively and working independently when needed, but willing to engage with the team when issues arise or clarification is needed. * Curious and Analytical: Seeks to understand why changes were made and how they affect downstream processes. * Process-Minded: Comfortable following SOPs and structured testing protocols but also contributes ideas to improve QA standards. Required Qualifications: * At least 2 years of QA or software testing experience, ideally in a data-focused or transactional system environment. * Solid understanding of functional and regression testing principles. * Familiarity with file-based data processing, especially related to structured data (e.g., CSV, flat files, or EDI). * Comfortable with Excel, basic data review tools, and test documentation. Additional Preferred Qualifications: * Exposure to healthcare billing or RCM processes, including common transaction types like 837s (claims), 835s (remits), and 277s (status). * Experience with HIPAA EDI file standards or similar structured data protocols. * Understanding of data mapping or transformation logic used in healthcare file processing. * Familiarity with basic QA tools such as test case managers or issue trackers (e.g., Jira, TestRail, Azure DevOps). * Working knowledge of database queries (e.g., basic SQL) is a plus but not required. * Prior experience working with development teams or in Agile or Waterfall environments is a bonus. Benefits including but not limited to: Medical, Vision, Dental, 401K, Paid Time Off. We are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law.
    $71k-94k yearly est. 7d ago
  • Field Marketing Associate

    Array Services Group 3.5company rating

    Remote job

    Array is a financial innovation platform that helps digital brands, financial institutions, and fintechs get compelling consumer products to market faster. We deliver a suite of credit and identity monitoring tools, privacy protection, and a financial ads marketplace via embeddable widgets or a clean, modern API. Our private label offerings help drive revenue and increase engagement for our customers while empowering millions of consumers to achieve their financial goals. As a remote-first company, we're focused on providing opportunities for high performing individuals to have deep impact in the fast growing fintech space. A clear mission, a commitment to continuous improvement and a willingness to experiment empower us individually and together deliver the best products for our clients and users. We are seeking a Field Marketing Associate who is excited to drive top-of-funnel growth and work closely with our Marketing Leader for Demand Generation. This role will play a hands-on part in bringing our marketing programs to life by supporting our lead nurturing, event execution, and outbound campaign efforts that build pipeline and brand visibility. You will: Manage outreach before, during, and after events to engage prospects, support the sales team, and drive conversions. Travel: Represent Array at conferences and events including staffing the booth (expect to travel to 25 events annually). Execute integrated inbound and outbound campaigns tied to webinars, dinners, and other marketing-led events to drive engagement and lead conversion. Assist in multi-channel promotion by working on supporting digital components (email, social media, event landing pages) that complement field efforts. Gather and share insights by collecting feedback from field events and customer interactions to inform future marketing programs and provide valuable input to the demand generation team. Manage marketing materials by ensuring field teams are equipped with relevant assets, signage, collateral, and swag that reflect current campaigns and messaging. Participate in cross-functional efforts by aligning with Sales, Product Marketing, and Brand teams to ensure cohesive messaging and consistent customer experience across all touchpoints. Maintain a habit of using AI tools to think, build, and ship faster-it's your default, not an afterthought. You have: 1+ years of experience in field marketing, marketing, or sales roles, or ideally within a fast-paced or growth-focused environment. Strong communication skills, both written and verbal, with the ability to engage prospects and collaborate across teams. Strong organizational skills and time management skills, with a track record of managing multiple projects simultaneously. A passion for connecting with customers and communities through meaningful brand experiences and events. Comfort interacting with customers and prospects, both digitally and in person. Familiarity with marketing and sales tools like HubSpot, Apollo, Salesforce, or Gong. A hands-on, resourceful approach to solving problems, with a willingness to roll up your sleeves to get things done. Experience writing outbound messages or working closely with a BDR/SDR team. A belief that AI is reshaping work, you instinctively use it to accelerate everything you do. Pay Transparency: Salary Range: $75,000+ depending on experience. Expected interviews: Recruiter conversation - Hiring Manager Interview - Loop round: How We Work, Meet other members of the Marketing and Sales teams. Array Offers All Full Time Employees the following Benefits and Perks: Full medical, dental, and vision, premiums covered at 100% for full-time employees and 70% for dependents Unlimited PTO and sick leave + 14 company holidays to encourage a healthy work-life blend 100% 401k match up to 4% with immediate vesting Generous and competitive parental leave for all parents $1,000 desk setup subsidy to set-up your unique remote office $100/month to subsidize wifi/cell phone expenses Summer Fridays (half-day Fridays) typically from late May to the end of August AnniversArray Kits for work anniversaries Not sure if you meet the Qualifications? We know that folks tend to only apply if they check every box. If you think you have the appropriate qualifications, but don't meet every single one, we encourage you to still apply. We'd love to hear from you. We are proud to be an equal opportunity workplace; we are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. Array will provide reasonable accommodations to qualified applicants-if you need an accommodation to participate in the application or interview process, please email **************** to make your request.
    $75k yearly Auto-Apply 12d ago
  • Account Executive

    Array Services Group 3.5company rating

    Remote job

    Array is a financial innovation platform that helps digital brands, financial institutions, and fintechs get compelling consumer products to market faster. We deliver a suite of credit and identity monitoring tools, privacy protection, and a financial ads marketplace via embeddable widgets or a clean, modern API. Our private label offerings help drive revenue and increase engagement for our customers while empowering millions of consumers to achieve their financial goals. As a remote-first company, we're focused on providing opportunities for high performing individuals to have deep impact in the fast growing fintech space. A clear mission, a commitment to continuous improvement and a willingness to experiment empower us individually and together deliver the best products for our clients and users. We are seeking experienced Account Executives with a proven track record in B2B SaaS sales. Array provides an industry-leading suite of consumer credit solutions designed to strengthen financial relationships between institutions and their customers. We are particularly interested in AEs with experience selling to financial institutions and fintechs to drive growth and deliver tailored solutions for their needs. You Will: Collaborate with leadership to develop a growth strategy focused on financial gain and client satisfaction within the FinTech, Banking, Financial Services, and Direct-to-Consumer spaces. Build and maintain relationships with clients, serving as the face of the company and promoting growth through strategic sales activities. Consult with prospective clients to understand their needs and recommend products or services that align with their business goals, particularly in credit services and debt settlement. Research and analyze prospect companies, markets, and client needs to create tailored sales discussions that demonstrate the value of Array's solutions. Present compelling sales proposals that showcase Array's industry-leading suite of consumer credit solutions to potential banking and credit union clients. Attend trade association meetings and industry conferences to build networks, identify opportunities, and represent Array as a leader in consumer credit solutions. Travel to meet clients or to attend conferences; expect to travel once a month. Maintain a habit of using AI tools to think, build, and ship faster-it's your default, not an afterthought. You Have: 4+ years of SaaS and B2B sales experience, specifically targeting digital banking, credit services, or debt settlement industries. Proven expertise in selling to banks, credit unions, or other financial institutions, with a history of developing strategic partnerships in these markets. Excellent verbal and written communication skills, with the ability to effectively convey technical concepts to a non-technical audience. Demonstrated success in prospecting new clients, generating leads, and closing sales to meet or exceed revenue targets. Creativity and resourcefulness in approaching sales and building long-term customer relationships in innovative ways. Proficiency in CRM software, such as Salesforce, to manage sales processes and client relationships effectively. The willingness to travel to meet clients or to attend conferences. A belief that AI is reshaping work, you instinctively use it to accelerate everything you do. Pay Transparency: Salary Range: $100,000+ depending on experience (base salary), w/uncapped commission. Expected interviews: Recruiter conversation - Hiring Manager Interview - How We Work in Sales - Pitch / Business Case. Array Offers All Full Time Employees the following Benefits and Perks: Full medical, dental, and vision, premiums covered at 100% for full-time employees and 70% for dependents Unlimited PTO and sick leave + 14 company holidays to encourage a healthy work-life blend 100% 401k match up to 4% with immediate vesting Generous and competitive parental leave for all parents $1,000 desk setup subsidy to set-up your unique remote office $100/month to subsidize wifi/cell phone expenses Summer Fridays (half-day Fridays) typically from late May to the end of August AnniversArray Kits for work anniversaries Not sure if you meet the Qualifications? We know that folks tend to only apply if they check every box. If you think you have the appropriate qualifications, but don't meet every single one, we encourage you to still apply. We'd love to hear from you. We are proud to be an equal opportunity workplace; we are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. Array will provide reasonable accommodations to qualified applicants-if you need an accommodation to participate in the application or interview process, please email **************** to make your request.
    $100k yearly Auto-Apply 7d ago
  • Technical Writer

    Firstsource Solutions 4.3company rating

    Remote job

    We are seeking a detail-oriented and experienced Technical Writer to join our team. The ideal candidate will have a strong background in creating and maintaining business operations policies and procedures, including desktop-level procedures. This role is essential for ensuring that our operational documentation is clear, accurate, and accessible to all stakeholders. Key Responsibilities: * Develop, write, and maintain comprehensive business operations policies and procedures, including desktop-level procedures. * Collaborate with business units, subject matter experts, and stakeholders to gather information and ensure documentation accuracy. * Create clear, concise, and user-friendly documentation that meets organizational standards and regulatory requirements. * Review and update existing documentation to reflect changes in business processes, technology, and regulations. * Ensure consistency and standardization of documentation across all business units. * Utilize various tools and software to create and manage documentation, including word processors, content management systems, and graphic design tools. * Conduct regular reviews and audits of documentation to ensure ongoing accuracy and relevance. * Provide training and support to staff on the use and interpretation of policies and procedures. * Stay up to date with industry trends and best practices in technical writing and documentation. Qualifications: * Bachelor's degree in English, Communications, Technical Writing, Business Administration, or a related field. * Minimum of 3 years of experience in technical writing, with a focus on business operations policies and procedures. * Experience in the Healthcare Payer industry or US Health insurance business processes. * Strong understanding of business operations and business process documentation. * Excellent writing, editing, and proofreading skills. * Proficiency in using documentation tools such as Microsoft Word, Adobe Acrobat, and content management systems. Preferred Skills: * Knowledge of desktop publishing and graphic design tools. * Strong communication and interpersonal skills, with the ability to work effectively with cross-functional teams. * Detail-oriented with a strong focus on accuracy and clarity. * Ability to manage multiple projects and meet deadlines.
    $51k-72k yearly est. 29d ago
  • Medical Review Coding Appeals Auditor (Outpatient)

    Performant Financial 4.7company rating

    Remote job

    ABOUT PERFORMANT: At Performant, we're focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission: To offer innovative payment accuracy solutions that allow our clients to focus on what matter most - quality of care and healthier lives for all . If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture - then Performant is the place for you! ABOUT THE OPPORTUNITY: Hiring Range:$65,000 - $73,000 The Medical Review Coding Appeals Auditor (Outpatient) is responsible for conducting Appeals reviews of new evidence presented by auditee's, disputing all or part of the findings from medical review audit work completed by the medical review coding audit team members, Communicates and supports the identification of potential training opportunities or enhancements to training and/or concept review guideline materials and tools. Responsible for performing some audit activity and consistently achieves or exceeds productivity goals and quality standards. Serves as subject matter expert, provides supplemental escalation support, and may perform special project activity as needed. Key Responsibilities Performs limited volume of outpatient coding reviews on medical records to maintain subject matter expertise, and additionally as needed to support business needs. Conducts Appeals reviews on medical review audit work completed by the medical review coding audit team members, as new evidence is presented by auditees Objectively and accurately documents Appeals results in accordance with department quality policies and procedures, scoring and reporting all Appeals results and routes record appropriately within audit platform based upon how the Appeal review resulted in concurrence with audit finding or identified corrections required. Reviews audit documentation and conducts research, analyzes claims data, applies knowledge of client SOW, applicable concept guidelines, policies, and regulations as necessary to determine if audit result is accurate and includes complete details to support findings. Provides correction to narrative rationale to correspond with audit determination and flags patterns of concern to audit leadership for real-time intervention, preventing an accumulation of improper findings Contributes to the continuous improvement feedback process and suggests or makes any edits, documentation, next steps, and reporting as may be necessary in accordance with department process and audit leadership direction. May perform primary audit activity as assigned by management Monitors, tracks, and reports on all work conducted in accordance with Appeals process and management direction. May prepare reports for management that includes a variety of data and trends at the individual, department, and client program level, as well as date range or concept based/trended, or other characteristic that will provide valuable business insights. Consults with internal resources as necessary. Become subject matter expert for assigned business segment(s). Maintain current knowledge and changes that affect our industry and clients as it pertains to medical practice, technology, regulations, legislation, and business trends. Participates in and contributes to applicable department meetings. Successfully completes, retains, applies, and adheres to content in required training as assigned that includes but not limited to information security, anti-harassment and other compliance and policy/procedures training applicable for position. Proactively contributes to continuous improvement of activities and sets positive example Contributes collaboratively to identifying opportunities for improvement of audit results and continuous improvement initiatives. May support training material/tools and best practices development. May identify/make recommendations to management for supplemental team/concept type training. May support training activities for new audit staff or provide supplemental training for existing staff as needed. Contributes to positive team environment that fosters open communication, sharing of information, continuous improvement, and optimized business results. Receives feedback and adjusts work priority as necessary. Serves as positive role model and example for other audit staff and conducts work in accordance with company policies, government regulations and law. Performs job duties with high level of professionalism and maintains confidentiality Perform other incidental and related duties as required and assigned to meet business needs. Knowledge, Skills and Abilities Needed Demonstrated ability to perform claim payment audits with high quality and production results, as well as successful application of skills to conduct quality assurance review of audit work completed by others. Must be able to manage multiple assignments effectively, create documentation outlining findings, Appeals review results and/or documenting suggestions, organize and prioritize workload, problem solve, work independently and with team members. Thorough working knowledge of CPT/HCPCs/ICD-9/ICD-10. Proficiency with MCS 1500/UB 04 forms Strong knowledge of medical documentation requirements and an understanding CMS, Medicaid and/or Commercial insurance programs, particularly the coverage and payment rules and regulations. Working knowledge of encoder Proven ability to review, analyze, and research coding issues Reimbursement policy and/or claims software analyst experience Familiarity with interpreting electronic medical records (EHR) Basic understanding of accounting principles for accounts payable and receivable as it relates to medical billing. Independent, out-of-the-box thinker; Performs successfully against work given in the form of objectives and projects; leads by example. Understands processes, procedures, and workflow; and demonstrated ability to identify areas of opportunity Demonstrated ability to consistently apply sound judgment and good effective decision making. Understands Medical Review Audit and Quality Assurance objectives, activities, and key drivers in achieving operational goals. Ability to efficiently and effectively run reports, analyze information, identify meaningful trends, and identify potential solutions. Strong communication skills, both verbal and written; ability to communicate effectively and professionally at all levels within the organization, both internal external. Demonstrated ability to collaborate effectively in a variety of settings and topics. Excellent editing and proofreading skills. Ability to independently organization, prioritize and plan work activities effectively for self and others; develops realistic action plans with the ability to multi-task effectively. Excellent time management and delivers results balancing multiple priorities. Strong analytical skills; synthesizes complex or diverse information; collects and researches data; uses experience to compliment data. Leverages strong critical thinking, questioning, and listening skills to research and effectively resolve complex issues. Demonstrated ability to identify areas of opportunity and create efficiencies in workflows and procedures. Demonstrated ability to be proactive; identifies and resolves problems in a timely manner; develops alternative solutions. Ability to create documentation outlining findings and/or documenting suggestions. Strong general computer skills, including, but not limited to Desktop and MS Office applications (Intermediate Excel Skills), application reporting tools, and case management system/tools to review and document findings. Solid technical aptitude with demonstrated ability to quickly learn and adapt to new systems and tools. Ability to be flexible and thrive in a high pace environment with changing priorities. Adaptable to applying skills to diverse operational activities to support business needs. Self-starter with the ability to work independently in remote setting with minimum supervision and direction in the form of objectives. Serves as a positive role model; and demonstrates characteristics that align and contribute to a collaborative culture of continuous improvement and high performing teams. Capability of working in a fast-paced environment, flexibility with assignments and the ability to adapt in a changing environment Ability to obtain and maintain client required clearances, if applicable, as well as pass company regular background and/or drug screening. Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to, : able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours. Required and Preferred Qualifications Current certification as a CPC, CPC-H, CPC-P, RHIA, RHIT, CCS, or CCS-P Not currently sanctioned or excluded from the Medicare program by OIG 3+ years of direct experience in medical chart review for all provider/claim types for outpatient 5+ years relevant auditing experience in a provider or payer environment demonstrating breadth and depth of knowledge/skills for the position. (less than 5 yrs. may be considered for internal candidates based upon demonstrated skills and results). Prior experience in role with responsibility for conducting primary audit, utilization management or prior-authorization work, or review of audit work performed by others (QA function, appeals function, lead, supervisory role, etc.) Prior experience in payer edit development and/or reimbursement policy a plus. Prior experience working in remote setting preferred. WHAT WE OFFER: Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee's responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). Regularly sit/stand 8 or more hours per day. Occasionally lift/carry/push/pull up to 10lbs. Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. Other requirements may apply. All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Performant is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performant's Human Resources team to discuss further. Our diversity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED
    $65k-73k yearly Auto-Apply 50d ago
  • Manager-HRBP

    Firstsource Solutions 4.3company rating

    Remote or Palm Bay, FL job

    The Manager - HRBP is responsible for serving as a strategic partner to business units, driving the execution of HR initiatives, covering areas like talent management, employee relations, performance management, and workforce planning, to ensure alignment with organizational goals, enhance employee engagement, and nurtures a positive workplace culture Roles & Responsibilities * Business Partnership: Build strong relationships with business units and serve as a strategic HR partner, understanding their goals and needs. * Talent Management: Collaborate with business leaders to identify, attract, develop, and retain top talent to meet organizational objectives. * Performance Management: Implement performance management processes, including goal setting, performance evaluations, and feedback, to improve individual and team performance. * Employee Relations: Address and resolve complex employee relations issues, ensuring fair and consistent treatment of employees. * Workforce Planning: Assist in workforce planning, including staffing needs, succession planning, and skills development. * Change Management: Support and lead change management efforts within business units, ensuring smooth transitions during organizational changes. * Workplace Culture: Promote a positive workplace culture by championing diversity and inclusion initiatives, employee engagement, and a values-driven environment. * HR Compliance: Ensure compliance with employment laws, regulations, and company policies, and provide guidance to business units on HR compliance matters. * Data Analysis: Utilize HR data and metrics to make data-driven decisions and recommendations for improving HR strategies. * Employee Engagement: Implement employee engagement initiatives, gather employee feedback, and measure employee sentiment. * HR Reporting: Generate HR reports and analyses to provide insights on workforce trends, HR performance, and areas for improvement. * Collaboration: Collaborate with other HR team members and departments to align HR strategies and initiatives with organizational goals. * Project Management: Manage HR projects and initiatives, ensuring they are completed on time and within budget. * Uphold a strong commitment to business ethics, including confidentiality and data privacy. * Maintain consistent performance to achieve predefined performance metrics. * Strictly adhere to compliance regulations and security policies. * Ensure compliance with all federal, state and local laws. Expected/Key Results * Enhancing Employee Engagement and Ensuring Timely Communication * Elevating Employee Satisfaction * Managing the Performance Management Process and Promoting Career Progression for Employees * Improving Employee Retention * Ensure 100% compliance * Adherence to SLA, quality and KPI targets Qualifications The qualifications listed below are representative of the background, knowledge, skill, and/or ability required to perform their duties and responsibilities satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. * High school diploma or equivalent required * Bachelor's Degree preferred or equivalent combination of education and work experience * 4+ years of experience in human resources * Relevant years of experience in human resources, with a focus on HRBP or CoE roles * Experience in strategic business partnership and talent management, including performance management and workforce planning. Competencies & Skills * Ability to cultivate strong partnerships with stakeholders and employees. * Exceptional communication skills, both written and verbal. * Skill in implementing effective performance management processes, setting clear goals, and providing feedback. * Proficiency in using HR data to make data-driven decisions and provide insights. * Capable to address complex employee relations issues fairly and equitably. * Skill in managing HR projects and initiatives efficiently and within budget. * Possesses a consultative approach, seeking input and feedback from others. * Understanding of the organization's industry, operations, and competitive landscape. * Understanding of employment laws, regulations, and HR compliance standards. * Proficiency in Microsoft Office products, particularly Outlook and Word * Working knowledge of MS Teams and willingness to appear on-camera, when needed * Strong verbal and written communication skills, with the ability to maintain professionalism in interactions with employees * Strong work ethic with high standards of reliability and dependability * Commitment to protecting data privacy in maintaining, disclosing and transmitting employee confidential, private and sensitive information * Self-disciplined and capable of maintaining focus with minimal supervision Additional Qualifications * Ability to occasionally work flexible hours to address business demands and employee needs * Ability to occasionally travel out-of-town, including nationwide and international * Possession of a valid driver's license and ability to meet insurability standards for any work-related driving * Ability to download 2-factor authentication application(s) on personal device, in accordance with company and/or client requirements * Ability to pass a pre-employment background investigation based on client requirements, including but not limited to, criminal history, motor vehicle report, work authorization verification, and credit report . Work Environment * The work environment characteristics described here are representative of those an employee encounters while performing this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * This position may work remotely from home or onsite, exposed to outdoor weather conditions during travel, if applicable. 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Must be able to regularly or frequently talk and hear, sit for prolonged periods, use hands and fingers to type, and use close vision to view and read from a computer screen and/or electronic device. Must be able to occasionally stand and walk, climb stairs, and lift equipment up to 25 pounds. * Firstsource is an Equal Employment Opportunity employer. All employment decisions are based on valid job requirements, without regard to race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, age, disability, genetic information, veteran status, or any other characteristic protected under federal, state or local law. * Firstsource also takes Affirmative Action to ensure that protected veterans and qualified disabled persons are introduced into our workforce and considered for employment and advancement opportunities.
    $67k-106k yearly est. 25d ago
  • Client Services Operations Support Representative I (SCA) - Lathrop Office On-site

    Performant Financial 4.7company rating

    Remote or Lathrop, CA job

    ABOUT PERFORMANT: At Performant, we're focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission: To offer innovative payment accuracy solutions that allow our clients to focus on what matter most - quality of care and healthier lives for all . If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture - then Performant is the place for you! ABOUT THE OPPORTUNITY: Hiring Range: $19.14 The Client Services Operations Support Representative I (SCA) is, responsible for providing clerical support and efficient processing of high-volume transaction-oriented assignments for Performant's Healthcare Eligibility and Recovery Services business operations located in Lathrop, CA. Please note this opportunity is a full-time, on-site position. Key Responsibilities: Provides clerical support including, but not limited to, copying, filing, processing documents and mail, performing basic data entry, phone calls, and operating general office equipment. Processing incoming correspondence, including posting payments (checks, EFT and debit/credit card). Some phone work is required contacting insurance carriers and healthcare providers to gather payment information. Data entry into various applications/systems as may be required for applicable workflows. Accurately and efficiently performs assigned tasks ensuring adherence to all company, departmental and client policies, procedures, federal & state regulations, contractual compliance, and other requirements/standards. Achieves or exceeds quality and productivity expectations and other assigned goals/objectives. Obtain and maintain any client clearances for system/record access as may be required for position based upon client and work assignments. Completes assigned training on time and with acceptable scores. Demonstrates understanding of training materials and applies knowledge in appropriate situations. Completes other tasks and duties as assigned to meet business needs. Knowledge, Skills and Abilities Needed: Ability to perform basic tasks in Microsoft Excel and Word programs with occasional assistance Basic use of general office equipment and easily adapts to new office equipment and tools. Basic problem-solving skills and good communication, both written and oral, skills. Ability to quickly learn internal and client applications easily. Fast and accurate typing and 10-key skills Basic math skills to calculate numbers and percentages Demonstrated timely follow-up skills, ability to multi-task and prioritize workload. Very detailed oriented and highly organized Ability to prioritize daily workloads and meet daily deadlines Able to work efficiently independently and collaboratively promoting a positive team environment Strong customer service skills Must be responsible, dependable, and reliable Required and Preferred Qualifications: Some experience working in a customer service or clerical job is required. One (1) year or more of related office clerical support experience is preferred. High school diploma or equivalent is required and proof of such will be sought prior to hire. WHAT WE OFFER: Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee's responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). Regularly sit/stand 8 or more hours per day. Occasionally lift/carry/push/pull up to 10lbs. Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. Other requirements may apply. All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Performant is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performant's Human Resources team to discuss further. Our diversity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED
    $19.1 hourly Auto-Apply 9d ago
  • Correspondence Clerk I (SCA) - in Office

    Performant Financial 4.7company rating

    Remote or San Angelo, TX job

    ABOUT PERFORMANT: At Performant, we're focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission: To offer innovative payment accuracy solutions that allow our clients to focus on what matter most - quality of care and healthier lives for all . If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture - then Performant is the place for you! ABOUT THE OPPORTUNITY: Hiring Range: $17.75hr. In office position The focus of the Correspondence Clerk I (SCA) is to accurately receive, review, electronically scan, and forward correspondence, ensuring that all federal and state regulations, contractual compliance and company guidelines and standards are met in the process. Key Responsibilities: Ensure that all deadlines are met, as dictated by client contracts, department & company policies and any/all regulatory or compliance requirements. Review all incoming mail, prioritizing by urgency and importance as per department & client guidelines. Process and scan all correspondence efficiently and accurately. Upload media to accounts and ensure uploads are successful. Enter appropriate status codes in the system, updates current account information, and generates letters. Distributes designated media to other departments as appropriate. Counts and logs daily production. Performs other duties as assigned. Knowledge, Skills, and Abilities Needed: High level of ability in multi-tasking and prioritizing workload. Must have flexibility and be able to adapt to ever changing needs and requirements. MS Excel & Word skills. Able to meet or exceed deadlines. Able to work efficiently independently and complete any/all workload as assigned by department management. Strong communication in both verbal and written business language skills. Responsible, dependable, conscientious, detail-oriented, and reliable. Required and Preferred Qualifications: High School Diploma or GED is required. At least two years of general office work experience is required. WHAT WE OFFER: Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee's responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). Regularly sit/stand 8 or more hours per day. Occasionally lift/carry/push/pull up to 10lbs. Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. Other requirements may apply. All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Performant is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performant's Human Resources team to discuss further. Our diversity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED
    $17.8 hourly Auto-Apply 51d ago
  • Team Lead

    Firstsource Solutions 4.3company rating

    Remote job

    Job Title: Team Leader Job Type: Full Time Grade: G Function/Department: Revenue Cycle Reporting to: Manager- Operations Role Description: The Team Lead for the Revenue Cycle is responsible to assist department Manager in supervising on-site employees, whether they are located in a hospital or office. This role involves assisting the Department Manager in various responsibilities, including assessing the performance of Account Resolution Specialists, Customer Service Representatives, and Early-Out Representatives, as well as managing employee records and ensuring quality assurance. Roles & Responsibilities * Lead, mentor, and cultivate departmental teams. * Supervise and manage the day-to-day operations of the Receivables staff, whether onsite or in an office setting. * Coordinate account inventories and provide regular reports to the Department Manager. * Design and deliver staff training programs. * Maintain accurate time and attendance records for the staff. * Resolve operational issues through problem-solving. * Delegate and oversee workflow processes. * Assume responsibilities for employees during absences or high workloads. * Achieve assigned management goals and objectives. * Conduct quality audits on staff performance. * Handle account reconciliations and returns to clients. * Report and document any employee disciplinary issues to the Manager. * Adhere to the policies and procedures outlined in the Employee Handbook and the Employee Code of Conduct. * Actively participate in the Corporate Compliance Program to ensure adherence to regulations. * Assist in various projects assigned by management. * Exhibit excellent judgment, professionalism, and leadership qualities. * Demonstrate strong verbal communication skills, delivering feedback effectively and expressing thoughts concisely. * Possess robust analytical and PC skills. * Display flexibility with work hours and adaptability to change. Preferred Educational Qualifications * Bachelor's degree or equivalent experience is required Preferred Work Experience * Experience with medical claims billing and/or patient accounting processes is required Competencies & Skills * Proficiency in collaborating and communicating effectively with colleagues, staff, and clients. * Consistent display of professionalism and courtesy. * Competent with personal computer operations. * Show initiative and creativity in carrying out job duties. * Exceptional written and verbal communication skills. * Capable of prioritizing multiple tasks in a fast-paced work environment. * Exhibit strong leadership qualities. Benefits including but not limited to: Medical, Vision, Dental, 401K, Paid Time Off. We are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law.
    $40k-82k yearly est. 7d ago
  • Manager - Revenue Cycle

    Firstsource Solutions 4.3company rating

    Remote job

    Job Title: Manager - Early Out Reports To: Operations Director Shift: M-F 8am-5pm EST Position Overview: The Early Out Manager is responsible for leading and supervising a team of Early-Out Representatives, both remote and onsite. This role ensures operational efficiency, employee performance, and quality assurance across the department. The Manager will maintain accurate employee records, monitor productivity, and collaborate closely with internal and client-facing teams to meet performance expectations. Key Responsibilities: * Provide daily oversight and direction for departmental operations * Manage account inventory and deliver daily/weekly reports to the Operations Director * Monitor and support staff training initiatives * Step in to cover responsibilities during staff absences or periods of high call volume * Coordinate overtime schedules as needed to meet workload demands * Document and report disciplinary issues to the Operations Director and Human Resources * Conduct quality assurance activities including account audits, productivity reviews, and performance evaluations * Collaborate with the Client Services Manager to ensure service delivery aligns with client expectations and inventory flows efficiently through the revenue cycle * Uphold company policies and procedures as outlined in the Employee Handbook and Code of Conduct * Actively participate in the Corporate Compliance Program * Support additional projects and initiatives as assigned by leadership Required Qualifications: * Bachelor's degree or equivalent professional experience * Proven experience with Epic Systems * Strong understanding of patient accounting processes * Background in Early-Out and Healthcare Collections * Exceptional interpersonal and communication skills across all levels of staff and clients * Professional demeanor with a commitment to courteous and respectful conduct * Proficiency in personal computer use and related software * Demonstrated initiative, problem-solving ability, and creativity in task execution * Ability to manage multiple priorities in a fast-paced environment * Strong leadership and team management capabilities * Willingness to travel as needed Benefits including but not limited to: Medical, Vision, Dental, 401K, Paid Time Off. We are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law.
    $74k-108k yearly est. 41d ago
  • MEdical Review Nurse II - SNF/MDS

    Performant Financial 4.7company rating

    Remote job

    ABOUT PERFORMANT: At Performant, we're focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission: To offer innovative payment accuracy solutions that allow our clients to focus on what matter most - quality of care and healthier lives for all . If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture - then Performant is the place for you! ABOUT THE OPPORTUNITY: Hiring Range: $75,000 - $84,000 The Medical Review Nurse II - SNF/MDS primarily performs medical claims audit reviews. As a MR Nurse, you will join a team of experienced medical auditors and coders performing retrospective and prepayment audits on claims for Government and Commercial Payers. You will work remotely in a fast paced and dynamic environment and be part of a multi-location team. Key Responsibilities: Auditing claims for medically appropriate services provided in both inpatient and outpatient settings while applying appropriate medical review guidelines, policies and rules. Document all findings referencing the appropriate policies and rules. Generate letters articulating audit findings. Supporting your findings during the appeals process if requested. Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse. Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits. Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients. Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows; Assist with QA functions and training team members. Participate in establishing edit parameters, new issue packets and development of Medical Review Guidelines. Interface with and support the Medical Director and cross train in all clinical departments/areas. Other duties as required to meet business needs. Knowledge, Skills and Abilities Needed: Experience with utilization management systems or clinical decision-making tools such as Medical Coverage Guidelines (MCG) or InterQual. Experience with and deep knowledge of ICD-9, ICD-10, CPT-4 or HCPCS coding. Knowledge of insurance programs program, particularly the coverage and payment rules. Ability to maintain high quality work while meeting strict deadlines. Excellent written and verbal communication skills. Ability to manage multiple tasks including desk audits and claims review. Must be able to independently use standard office computer technology (e.g. email telephone, copier, etc.) and have experience using a case management system/tools to review and document findings. Must be able to manage multiple assignments effectively, create documentation outlining findings and/or documenting suggestions, organize and prioritize workload Effectively work independently and as a team, in a remote setting. Required and Preferred Qualifications: Active unrestricted RN license in good standing, is required. Must not be currently sanctioned or excluded from the Medicare program by the OIG. Minimum of five (5) years diversified nursing experience providing direct care in an inpatient or outpatient setting. One (1) or more years' experience performing medical records review. One (1) or more years' experience in health care claims that demonstrates expertise in, ICD-9/ICD-10 coding, HCPS/CPT coding, DRG and medical billing experience for an Insurance Company or hospital required. Strong preference for experience performing utilization review for an insurance company, Tricare, MAC, or organizations performing similar functions. WHAT WE OFFER: Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee's responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). Regularly sit/stand 8 or more hours per day. Occasionally lift/carry/push/pull up to 10lbs. Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. Other requirements may apply. All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Performant is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performant's Human Resources team to discuss further. Our diversity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED
    $75k-84k yearly Auto-Apply 50d ago
  • Complex Claims Administrator

    Harris & Harris, Ltd. 4.3company rating

    Remote or Chicago, IL job

    Harris & Harris has over 50 years of experience in the customer service and revenue recovery field, specializing in the utilities, government, and healthcare markets. We're looking for friendly, professional, and motivated Complex Claims Administrator join our Legal Compliance team. If you're looking for a company that embraces the principles of respect, compassion, and trust, apply today! Complex Claims Administrator The Complex Claims Administrator will work as a patient advocate, and ensure proper research, billing, and filing of all complex claims. Schedule: 8:00am to 5:00pm Monday through Friday are regular business hours. Location: Can work remotely, candidates local to Chicagoland preferred Salary: $20.00/hour Additional Compensation and Benefits: At Harris & Harris, we truly care about each employee's health, wellness, financial stability, and education. We are proud to offer each employee the following benefits: Medical and Dental insurances from premium providers 401K with matching Company paid Accident and Disability Insurance, Long Term Disability Insurance, EAP, and Travel Assistance Tuition Reimbursement Paid Time Off Additional benefits such as identity theft protection, flexible spending accounts, pre-tax commuter benefits, and more. DAY TO DAY Work in the clients EMR, Patient Account System, and Software Platforms to identify Liability Claims and correctly bill both hospital, and professional claims. Review police reports, medical records, and all available information to assist in correctly billing liability claims. Perform duties as a patient advocate by speaking with a patient that was seen at the hospital as a result of an accident Making outbound/inbound calls to the patient to assist in obtaining liability information, and assisting in opening a claim when deemed necessary Complete daily billing activities for new accounts. Updating the clients Patient Accounting System with proper notation. Completing weekly reports needed to resolve accounts (i.e. rebill reports, reject reports). Electronic filing of incoming documents Develop a relationship with payers to encourage timely request and prompt payment. WHAT YOU MUST POSSESS Must Have: High School Diploma or GED required, some college a plus' Medical Billing experience Experience Working in Multiple systems at the same time Experience with Healthcare systems like Epic General understanding of Workers Compensation laws Must be very detail oriented Experience with 10-key data entry Ability to type 35-40 wpm WHY HARRIS & HARRIS? Harris & Harris is a premier, full-service revenue recovery firm headquartered and founded in Chicago, IL. Founded in 1968, we have been in business for more than 50 years, and we specialize in the utilities, government, and healthcare markets. The family business Sam Harris started is now a firm of more than 500 hundred employees including collections professionals and customer care representatives who employ the latest technology and best ethical practices to help businesses recover revenue and provide world class customer service. We take pride in knowing what it takes to turn a call from "average" to "excellent." We have been delighting clients and customers for decades thanks to our outstanding employees. They make the difference every day, shift, and call and transform challenges into victories. At Harris & Harris, we're proud to be an organization where everyone is welcome and can be their authentic selves at work. We're passionate about celebrating the differences that make each of us unique. Our culture focuses on our employees and we look for opportunities to recognize and celebrate together. We are an organization that cares about our people. From monthly activities, bonuses and contests, to competitive wages and benefits, we foster an environment where we employees feel valued. We also are an organization that believes in the power of giving back. Our internal cross functional committee, Harris Cares, guides our philanthropic activities. We have partnered with organizations such as One Warm Coat, Greater Chicago Food Depository, American Cancer Society, Bright Pink, The Heat and Warmth Fund (THAW), and Operation Stars and Stripes. Most recently we have partnered with local schools and charitable organizations to give back to our communities including the American Heart Association, Habitat for Humanity, A Just Harvest, and R. Nathaniel Dett Elementary School. At Harris & Harris, everyone is important, and one person can make a difference for their colleagues, for our clients, and for our company. We look forward to hearing from you! Harris & Harris is an equal opportunity employer. Applicants will not be discriminated against based on race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, disability, ancestry, marital status, veteran status, medical condition or any protected category prohibited by local, state or federal laws.
    $20 hourly Auto-Apply 43d ago
  • AI Content Creator

    Firstsource Solutions 4.3company rating

    Remote job

    About Firstsource Firstsource Solutions is a leading provider of customized Business Process Management (BPM) services. Firstsource specializes in helping customers stay ahead of the curve through transformational solutions to reimagine business processes and deliver increased efficiency, deeper insights, and superior outcomes. About the Opportunity Firstsource is building a team of highly skilled AI Content Creators with specific domain knowledge (see below). This is contract (gig based) work only. However we will have some full-time opportunities in the future. If you're an expert in your field, we hope you'll join our team of high-performing people who will develop and optimize AI-generated content focused on one or more of the following areas: * Administrative Law * Algebra * Algorithmic Game Theory * Applied Mathematics * Applied Probability * Arithmetic * Artificial Intelligence (Computer Science) * Artificial Intelligence * Automata and Formal Languages * Automated Reasoning * Bayesian Statistics * Biology * Calculus & Advanced Math * Chemistry * Coding (Python, Javascript, SQL, HTML/CSS, PHP) * Cognitive Intelligence * Cognitive Science (AI) * Cognitive Science (Mathematics) * Cognitive Science (Psychology & AI) * Combinatorial Optimization * Computational Complexity * Computational Finance * Computational Learning Theory * Computational Logic * Computational Neuroscience * Computational Number Theory * Computational Statistics * Computer Science * Constructive Mathematics * Control Theory * Critical Thinking (Philosophy) * Decision Analysis * Decision Making (Critical Thinking) * Decision Theory * Differential Equations * Discrete Math & Logic * Dynamic Systems * Dynamical Systems * Earth Science * Epidemiology * Ethics (Moral Philosophy) * Finance * Financial Mathematics * Fuzzy Logic * Game Theory (Mathematics & Economics) * Geometric Analysis * Geometry & Trigonometry * Graph Theory * History * Humanities * Hybrid Systems * Information Theory * Interval Analysis * Knowledge Representation * Language Arts * Languages * Law (contract, evidence, statutory) * Linear Programming * Logic (Philosophy) * Mathematical Biology * Mathematical Economics * Mathematical Education * Mathematical Epidemiology * Mathematical Logic * Medicine & Health * Model Checking * Natural Sciences * Negotiation Theory * News * NLP (AI & ML) * Nonlinear Dynamics * Operations Research * Optimization Theory * Parallel Computing * Performing Arts * Philosophy * Physics * Physics (Engineering) * Probabilistic Reasoning * Probability & Statistics * Problem Solving (Root, Cause, Analysis) * Proof Theory * Quantum Information Theory * Reinforcement Learning * Religion * Retail Shopping * Risk Analysis * Risk Management * Science & Research Methodology * Scientific Methodology (Research Science) * Set Theory * Social Psychology * Statistical Learning Theory * STEM * Structural Equation Modeling * Symbolic Logic * System Identification * Systems Theory * Theoretical Computer Science * Theoretical Cryptography * Theory of Computation * Type Theory * Uncertainty Quantification * Verification and Validation * Visual Arts Qualifications * Bachelors, Masters, or Ph.D. * Expert/fluent written and verbal English language skills are required * Expertise in your field is required (one or more of the above mentioned) * Experience in AI content creation preferred
    $48k-80k yearly est. 60d+ ago
  • Accounting Manager

    Array Services Group 3.5company rating

    Remote job

    Array is a financial innovation platform that helps digital brands, financial institutions, and fintechs get compelling consumer products to market faster. We deliver a suite of credit and identity monitoring tools, privacy protection, and a financial ads marketplace via embeddable widgets or a clean, modern API. Our private label offerings help drive revenue and increase engagement for our customers while empowering millions of consumers to achieve their financial goals. As a remote-first company, we're focused on providing opportunities for high performing individuals to have deep impact in the fast growing fintech space. A clear mission, a commitment to continuous improvement and a willingness to experiment empower us individually and together deliver the best products for our clients and users. As an Accounting Manager at Array, you will join a team of 4 to ensure precision and clarity in financial reporting as we scale a multi-vertical fintech platform serving banks, credit unions, and integration partners. You'll own the books across a growing portfolio of entities, balancing detail-oriented bookkeeping with strategic visibility into the numbers that drive decisions. This role is critical as Array expands through M&A, requiring disciplined accounting hygiene, process automation, and integration of newly acquired entities. This role reports to our controller. You will: Oversee day-to-day accounting operations for two or three subsidiaries of the company, ensuring accuracy in journal entries, reconciliations, and financial statements. Lead monthly and quarterly closes, delivering timely and transparent reporting for all assigned subsidiaries in order for them to consolidate into the Parent company accurately. Partner with finance and operations teams to integrate acquired entities and align accounting systems and standards post-M&A. Implement scalable processes and tools that streamline reporting and enable real-time financial visibility. Support audits, compliance, and due diligence processes with clarity and rigor. Maintain a habit of using AI tools to think, build, and ship faster-it's your default, not an afterthought. You have: 7+ years of progressive accounting experience, ideally in fintech, SaaS, or multi-entity environments. Ideally starting in Public Accounting, with a few years of Corporate experience. US CPA license. Bachelors Degree in Accounting. Mastery of Technical Accounting; Examples: Taxes, ASC 606 & 805 Proven success in managing accounting during rapid scaling or M&A integration. High attention to detail with the ability to translate numbers into actionable insights. Strong work ethic in a remote environment; taking ownership of your tasks and looking for ways to make processes better. Proficiency with NetSuite, Microsoft Excel and Google Drive. Comfort with other accounting tools, such as Banking platforms, Ramp and Salesforce. Willing to work Central or Eastern time zone hours. A belief that AI is reshaping work, you instinctively use it to accelerate everything you do. Pay transparency: $115,000 + for base salary, depending on experience. Expected interview process: Recruiter Conversation - Hiring Manager Interview - Technical Assessment - Meet a team member - How We Work (w/CFO). Array Offers All Full Time Employees the following Benefits and Perks: Full medical, dental, and vision, premiums covered at 100% for full-time employees and 70% for dependents Unlimited PTO and sick leave + 14 company holidays to encourage a healthy work-life blend 100% 401k match up to 4% with immediate vesting Generous and competitive parental leave for all parents $1,000 desk setup subsidy to set-up your unique remote office $100/month to subsidize wifi/cell phone expenses Summer Fridays (half-day Fridays) typically from late May to the end of August AnniversArray Kits for work anniversaries Not sure if you meet the Qualifications? We know that folks tend to only apply if they check every box. If you think you have the appropriate qualifications, but don't meet every single one, we encourage you to still apply. We'd love to hear from you. We are proud to be an equal opportunity workplace; we are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. Array will provide reasonable accommodations to qualified applicants-if you need an accommodation to participate in the application or interview process, please email **************** to make your request.
    $115k yearly Auto-Apply 6d ago
  • Business Development Representative

    Array Services Group 3.5company rating

    Remote job

    Array is a financial innovation platform that helps digital brands, financial institutions, and fintechs get compelling consumer products to market faster. We deliver a suite of credit and identity monitoring tools, privacy protection, and a financial ads marketplace via embeddable widgets or a clean, modern API. Our private label offerings help drive revenue and increase engagement for our customers while empowering millions of consumers to achieve their financial goals. As a remote-first company, we're focused on providing opportunities for high performing individuals to have deep impact in the fast growing fintech space. A clear mission, a commitment to continuous improvement and a willingness to experiment empower us individually and together deliver the best products for our clients and users. We are looking for a Business Development Representative experienced in top-of-funnel sales in B2B SaaS products. Quality and execution oriented, this role will be responsible for outbound lead generation. You will: Develop top-of-funnel sales opportunities by generating new leads through a variety of channels, including cold calling, email, and social media. Focus on direct to consumer, fintech, and neobank verticals. Self-source prospects for outreach through research, networking, and other channels. Meet specific KPIs for cold calls and email outreach. Qualify leads and identify their needs and pain points. Collaborate with sales and marketing teams to develop and execute prospecting strategies. Manage, document and plan all activity with proficiency in Salesforce. Collaborate with sales leadership to share market feedback, set strategy, prioritize industry segmentation. Maintain a habit of using AI tools to think, build, and ship faster-it's your default, not an afterthought. You have: Experience shortening discovery for complex internal AEs and target prospects; enterprise and channel partnerships. Strong communication and interpersonal skills. Excellent phone and presentation skills. Proven ability to generate and qualify leads through relentless and thoughtful prospecting. Proficiency in customer relationship management (CRM) software, such as Salesforce. The ability to work both independently and as part of a team; especially with account executives. 1-3+ years of experience as an SDR/BDR with cold calling KPIs. Strong general work experience, strong sales acumen outside of fintech is welcome, strong management and work experience in a prior career is desired. Knowledge of the financial technology (Fintech) industry is a plus. A belief that AI is reshaping work, you instinctively use it to accelerate everything you do. Pay Transparency: $60,000+ for base salary, depending on experience. This role will offer commission. Expected interviews: Recruiter conversation - Interview with Hiring Manager - Loop round: How We Work, Pitch. Array Offers All Full Time Employees the following Benefits and Perks: Full medical, dental, and vision, premiums covered at 100% for full-time employees and 70% for dependents Unlimited PTO and sick leave + 14 company holidays to encourage a healthy work-life blend 100% 401k match up to 4% with immediate vesting Generous and competitive parental leave for all parents $1,000 desk setup subsidy to set-up your unique remote office $100/month to subsidize wifi/cell phone expenses Summer Fridays (half-day Fridays) typically from late May to the end of August AnniversArray Kits for work anniversaries Not sure if you meet the Qualifications? We know that folks tend to only apply if they check every box. If you think you have the appropriate qualifications, but don't meet every single one, we encourage you to still apply. We'd love to hear from you. We are proud to be an equal opportunity workplace; we are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. Array will provide reasonable accommodations to qualified applicants-if you need an accommodation to participate in the application or interview process, please email **************** to make your request.
    $60k yearly Auto-Apply 51d ago
  • Revenue Cycle Billing Specialist

    Firstsource Solutions 4.3company rating

    Remote job

    Schedule: 8am to 4:30pm Pay: 18/hr-22/hr DOE The goal of the Revenue Cycle Billing Specialist is to successfully collect on aging medical insurance claims. Essential Duties and Responsibilities: * File claims using all appropriate forms and attachments * Handle Outbound calls and Maneuver between several different software systems * Research account denials and file written appeals, when necessary. * Evaluate the information received from the client to determine which insurance to bill and attain necessary attachments or supporting documentation to send with each claim. * Ensure the integrity of each claim that is billed. * Document in detail all efforts in CUBS system and any other computer system necessary. * Verify patient information and benefits. Additional Duties and Responsibilities: * Meet specified goals and objectives as assigned by management. * Maintain good working relationships with state and Federal agencies. * Resolve accounts in a timely manner. * Always maintain confidentiality of account information. * Adhere to the prescribed policies & procedures as outlined in the Employee Handbook and Employee Code of Conduct. * Maintain awareness of and actively participate in the Corporate Compliance Program. * Maintain a confidential and orderly remote work area. * Assist with other projects as assigned by management. Educational/Vocational/Previous Experience Recommendations: * High school diploma or equivalent is required. * Formal training in the specialty of Insurance Billing preferred. * Knowledge of all insurance payers preferred. * Ability to effectively work and communicate with patients, co-workers, and management both in person and remote virtual chat environments * Ability to always present oneself in a courteous and professional manner * Ability to stay on task with little or no management supervision * Demonstrate initiative and creativity in fulfilling job responsibilities * Capacity to prioritize multiple tasks using time management and organizational skills. * Proficient PC knowledge and the ability to type 30-40 wpm. Working Conditions: * Remote work from home office, virtual Call Center environment. * Must be able to sit for extended periods of time. We are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law.
    $32k-42k yearly est. 7d ago
  • Configuration Analyst

    Firstsource Solutions 4.3company rating

    Remote job

    We are seeking a highly skilled and experienced Configuration Analyst to join our team. The ideal candidate will have extensive knowledge of Healthcare Payer operations and a strong experience in developing and delivering configuration on Claims platforms like Core Admin platforms. This role is essential for ensuring that our staff are well-trained and knowledgeable about industry standards, processes, and best practices. Key Responsibilities Configuration of Healthcare Payer (Health Plan) Core Administrative Platforms: Design and configure the benefits, system parameters, and pricing requirements on the Health Plan (Payer) core administrative platforms for various lines of business, including Medicare, Medicaid, Commercial, and Individual-Exchange, ensuring compliance with business requirements and regulatory standards. Requirements Gathering and Analysis: Collaborate with clients and internal stakeholders to gather and document configuration requirements, ensuring a clear understanding of client needs and project objectives. Configuration Design and Execution: Develop detailed configuration designs, incorporating feedback from clients and internal stakeholders, and obtain approval prior to implementation. Execute configuration activities as per the approved design, ensuring accuracy and alignment with client specifications. Testing and Quality Assurance: Partner with the testing team to conduct thorough testing of configurations, review results, and make necessary adjustments to ensure quality and performance standards are met. Required Skills and Qualifications * Minimum of 2+ years of experience in Configuration on either HealthRules Payer or Facets or QNXT is required (US Health insurance). * Proven experience with configuration for Medicare, Medicaid, Commercial, and Individual-Exchange lines of business. * Experience with HealthEdge HealthRules Payer (HRP) configuration would be preferred * Experience with HealthEdge Source (Burgess) or HealthEdge GuidingCare would be added advantage * Strong communication skills, with demonstrated ability to engage effectively with clients and internal stakeholders. Firstsource is an Equal Employment Opportunity/Affirmative Action Employer and maintains a Drug-Free Workplace. The company participates in E-Verify and we will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS), with information from each new employee's I-9 to confirm work authorization. It is the policy of this Company to seek and employ qualified individuals at all locations and facilities, and to provide equal employment opportunities for all applicants and employees in recruiting, hiring, placement, training, compensation, insurance, benefits, promotion, transfer, and termination. To achieve this, we are dedicated to taking affirmative action to employ and advance in employment qualified individuals with disabilities, disabled veterans, and other eligible veterans.
    $69k-101k yearly est. 29d ago
  • Healthcare Quality Assurance Specialist (SCA) in office

    Performant Financial Corporation 4.7company rating

    Remote or San Angelo, TX job

    ABOUT PERFORMANT: At Performant, we're focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission: To offer innovative payment accuracy solutions that allow our clients to focus on what matter most - quality of care and healthier lives for all. If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture - then Performant is the place for you! ABOUT THE OPPORTUNITY: Hiring Range: $19.00hr Under general supervision the Healthcare Quality Assurance Specialist (SCA) in office provides support to the departmental quality assurance program. This position is responsible for performing the full range of quality assurance duties, working independently, and exercising judgment and initiative. Positions at this level receive occasional instruction or assistance as new or unusual situations arise and are fully aware of the operating procedures and policies of the work unit. Exercises no direct supervision over staff. Key Responsibilities: The duties listed below are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to this position. * Quality reviews work assignment tasks related to specific departmental workflows. * Uses available tools to gather data and analyze trends or patterns affecting quality; highlights key successes and shares best practices with staff to ensure continued success in quality of tasks/service performance. * Responsible to identify areas of improvements and collaborate with departmental leadership team members to identify and streamline processes and implement processes that enhance the company's standards of work performance and the customer experience. * Provides structured and timely recommendations through verbal and/or written feedback to leadership team. * Provides direct individual coaching/feedback to team members using specific examples highlighting positive and negative trends which identify performance strengths as well as areas of improvement needed. * Develops and conducts targeted group coaching sessions that address quality deficiencies and/or improvement opportunities. * Assists with creation of training materials and performs related duties as assigned. * Assesses new hires after training has been completed to determine readiness for moving into support. * Observes and complies with all company and mandated rules, regulations, and protocols. * Selects a quality sample for assigned staff members, conducts timely QA reviews based on outlined criteria, enters QA results into tool. * Runs QA reports summarizing results of QA conducted by staff members, team and department. * Follows Quality standard operating procedures. * Performs other duties as assigned. Knowledge, Skills, and Abilities Needed: * Strong soft skills: ability to interact effectively and constructively with others * Outstanding written and verbal communication skills * Good critical thinking, questioning, and listening skills; excellent attention to detail * Problem-solving and task management skills * Time management skills for managing multiple tasks simultaneously, while completing work within allocated time frames * Ability to handle changing situations and work within a diverse group * Ability to work independently but also as a member of a team. * Ability to meet objectives with minimal supervision * Strong technical skills are desired Required and Preferred Qualifications: * Ability to obtain and maintain client required clearances as well as pass company regular background and/or drug screening. * Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety& ergonomics, confidentiality, and dedicated work focus without distractions during work hours. WHAT WE OFFER: Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee's responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. * Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. * Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). * Regularly sit/stand 8 or more hours per day. * Occasionally lift/carry/push/pull up to 10lbs. Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: * Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. * Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. * Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. * Other requirements may apply. All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Performant is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performant's Human Resources team to discuss further. Our diversity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED
    $19 hourly Auto-Apply 33d ago
  • Healthcare Collections Specialist

    Firstsource Solutions 4.3company rating

    Remote job

    SCHEDULE: Monday through Friday The Healthcare Collections Specialist performs specialized collection work. This task is performed on behalf of clients to help in reducing their outstanding accounts receivables. Foundation Knowledge, Skills, and/or Abilities Required: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Duties and Responsibilities: * Maneuver between several different software systems documenting accurate and up to date information in the account history while maintaining confidentiality of account information * Maintain a confidential and orderly remote work area. * Assist with obtaining and updating debtors contact information in client systems * Answer inbound calls from patients who are requesting assistance with making a payment on their outstanding medical/healthcare accounts. This assistance may include providing suggestions of ways that a patient can find the resources to pay their account(s) or negotiate payment arrangements that are within the payment guidelines specific to the hospital or physician's office. * Place outbound calls to patients who have yet to establish a payment or payment arrangements to resolve their outstanding medical/healthcare bills. Upon contact, provide assistance and suggestions of ways that a patient can find the resources to pay their account(s) or negotiate payment arrangements that are within the payment guidelines specific to the hospital or physician's office. * Work closely within a virtual team atmosphere to accomplish daily productivity goals primarily regarding the number of calls made/received and the dollars collected each day. * Work closely within a virtual team atmosphere to accomplish monthly dollars collected goals. * Work virtually in a highly incented environment; contests and incentives are run weekly to ensure that all Collectors are motivated to work closely with patients and collect available monies. * Daily commitment and agree to remain up to date with all aspects of the collection laws and company compliance requirements to ensure that all steps are taken while working with patients is in full compliance and within the regulations of the Fair Debt Collection Practices Act (FDCPA). * Understand and agree to follow federal laws on collection practices Additional Duties and Responsibilities: * Adhere to the prescribed policies and procedures as outlined in the Employee Handbook and the Employee Code of Conduct. * Maintain awareness of and actively participate in the Corporate Compliance Program. * Assist with other projects as assigned by management Educational/Vocational/Previous Experience Recommendations: * High school diploma or equivalent is required * Collection's experience is preferred * 6 months customer service experience * Ability to effectively work and communicate with patients, co-workers, and management both in person and remote virtual chat environments * Ability to always present oneself in a courteous and professional manner * Ability to stay on task with little or no management supervision * Demonstrate initiative and creativity in fulfilling job responsibilities * Capacity to prioritize multiple tasks using time management and organizational skills. * Proficient PC knowledge and the ability to type 30-40 wpm. Working Conditions: * Remote work from home office, virtual Call Center environment. * Must be able to sit for extended periods of time. We are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law.
    $31k-40k yearly est. 7d ago

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