Quality Analyst - Remote
Philadelphia, PA jobs
Description & Requirements Maximus is seeking a detail-oriented and experienced Quality Analyst. This role is responsible for conducting quality evaluations of staff performance, supporting calibration sessions, and ensuring alignment with client-defined quality standards. The ideal candidate will demonstrate strong analytical and communication skills, and a commitment to continuous improvement.
*Position is contingent upon contract award*
This is a fully remote role.
Must have the ability to pass a federal background check.
Equipment will be provided but must meet the remote position requirement provided below.
Remote Position Requirements:
- Hardwired internet (ethernet) connection
- Internet download speed of 25mbps and 5mbps (10 preferred) upload or higher required (you can test this by going to ******************
- Private work area and adequate power source
Essential Duties and Responsibilities:
- Conduct internal audits for the quality assurance program to ensure that quality metric requirements of the project are being met.
- Collaborate in developing new procedures and update existing procedures when changes occur.
- Analyze reports on operational performance and provide solutions to identified issues.
- Analyze and develop routine and ad hoc reports on project performance, and research and suggest solutions to identified issues.
- Conduct monitoring activities and audits for quality assurance purposes and to support the effective functioning of the project.
- Analyze quality program data to identify trends and to develop and implement corrective action plans as appropriate.
- Assist with monitoring performance and meeting contractual requirements using system applications.
- Assist in the production and update of staff resource materials including knowledge management system, quick reference guide, matrices, charts, and workflows.
- Assist with staff training for the purpose of achieving and maintaining quality program goals.
- Analyze effectiveness of key initiatives and quality improvement efforts.
- Perform other duties as assigned by management.
• Participate in calibration sessions to ensure consistency and alignment in quality evaluations across the team.
• Utilize AI tools and technologies to support quality assurance activities, data analysis, and reporting.
• Assist the center with taking calls as needed to support operations and maintain service levels.
Minimum Requirements
- Bachelor's degree in relevant field of study and 3+ years of relevant professional experience required, or equivalent combination of education and experience.
• Monitor agent interactions to ensure adherence to quality standards and provide timely, constructive feedback.
• Meet daily, weekly, and monthly monitoring goals by completing required evaluations, delivering timely feedback, and documenting results to support overall quality targets.
• Maintain strong organizational skills to effectively track monitors across different lines of business
• Collaborate in the development and revision of procedures in response to operational changes.
• Analyze operational and quality data to identify trends, gaps, and opportunities for improvement.
• Make recommendations based on data analysis to enhance performance and service delivery.
• Participate in and contribute to calibration sessions to ensure consistency in quality evaluations.
• Assist in training initiatives aimed at improving agent performance and overall quality scores.
• Support the creation and maintenance of staff resource materials, including guides, workflows, and reference documents.
• Utilize AI tools and technologies to enhance quality assurance processes, reporting, and decision-making.
• Take calls as needed to support center operations and maintain service levels.
• Participate in pilots and provide feedback from a quality assurance perspective to help inform improvements to quality metrics.
• Perform other duties as assigned by management.
EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************.
Minimum Salary
$
50,000.00
Maximum Salary
$
61,000.00
Easy ApplyElevate Patient Experiences as a Representative with Us!
Philadelphia, PA jobs
As our community evolves, so does the need for compassionate care. If your position was recently impacted, Greater Philadelphia Health Action, Inc., invites you to continue your mission of service with us.
GPHA,
a non-profit organization that was founded in 1970, is hiring Full-time Patient-Centered Representative Monday through Friday, 8:30 AM to 5:00 PM, at multiple locations:
Carl Moore Health Center, 1401 S. 31st St. Phila., PA 19146
Chinatown Medical Services, 432 N. 6th St. Phila., PA 19123
Frankford Ave Health Center, 4500 - 4510 Frankford Ave. Phila., PA 19124
Hunting Park Health Center, 1999 W. Hunting Park Ave. Phila., PA 19140
Southeast Health Center, 800 Washington Ave. Phila., PA 19147
Woodland Ave Health Ave, 5000 Woodland Ave. Phila., PA 19143
Candidates must obtain a high school diploma (or GED) and at least (2) years' experience in a health care setting or a combination of certificates relative to the Registration Assistant/Front Desk position. Comprehensive knowledge of insurance policies, medical terminology, and anatomy is preferred; knowledge of HMO/managed care practices is preferred; fundamental understanding of patient/provider scheduling modules is required; excellent typing and telephone skills are required. Able to interact with people compassionately and effectively while gathering necessary information, making independent decisions, and working well with others. Bilingual is desired but not required.
Specific Responsibilities and duties include Completing the patient registration and scheduling process accurately and promptly using the Electronic Practice Management (EPM) System. Ensure patients' demographic, financial, and insurance information is entered and updated accurately and swiftly. Manage daily appointment schedules efficiently and review them regularly. The Patient-Centered Representative also operates the paging/telephone system as needed; Greets and provides direction/information to patients, visitors, guests, and sales representatives professionally and cordially; Attends all mandatory staff development/training sessions and staff meetings; Enters and updates patient's demographic information accurately and timely; and perform other duties as assigned by the supervisor.
GPHA offers GREAT PAY, Performance BONUSES, Comprehensive Medical, Dental, Vision, Life, and LTD Insurance. We also offer 401k with a very lucrative company match, Employee Assistance and Self-Care, and Professional Activity, Educational, and Tuition Reimbursements, Paid Vacation, Paid Sick, Paid Personal Days, Paid Educational Days, Holiday Pay, Loan Forgiveness, and Free Malpractice Insurance...and many positions have Flexible, Hybrid or REMOTE WORK Schedules.
At Greater Philadelphia Health Action, Inc. (GPHA), we respect diversity and promote equity through action, advocacy, and policy through a dedicated team of representatives committed to listening, learning, and enacting systemic change. We create different channels, outlets, and programs to enhance safe spaces within GPHA, creating a shared understanding and language around justice, diversity, equity, and inclusion. GPHA is an Equal Opportunity Employer. GPHA does not and will not discriminate in employment and personnel practices to include hiring, transferring and promotion practices on the basis of race, color, sex, age, handicap, disability, religion, religious creed, ancestry, national origin, or any other basis prohibited by applicable law.
Join a network that values dedication, balance, and purpose. Visit us at ***************
Auto-ApplyIDN Key Account Executive II - Western PA/Northern OH
Pittsburgh, PA jobs
Dynavax is a commercial-stage biopharmaceutical company developing and commercializing novel vaccines to help protect the world against infectious diseases. We operate with the highest level of quality, integrity and safety for the betterment of public health. Our proprietary CpG 1018 adjuvant powers our diversified infectious vaccine portfolio, which includes HEPLISAV-B , our commercial product approved in the U.S. and the European Union, for prevention of hepatitis B virus in adults. We also supply CpG 1018 to research collaborations and partnerships globally. Currently, CpG 1018 is being used in development of COVID-19, plague, shingles, and Tdap vaccines. At Dynavax, our vision and work ethic are guided by the collective ideals underpinning our core values, and these form the basis of our dynamic company culture. We strive to maintain a culture where each employee is valued by the organization and where our organization is valued by each employee. We offer a highly flexible work environment for our headquarter employees where individuals work remotely and gather for in-person meetings when necessary. Dynavax is headquartered in the San Francisco Bay area, and our manufacturing facility is in Düsseldorf, Germany.
The IDN Key Account Executive II will have full account responsibility and business ownership for assigned Accounts to establish and grow HEPLISAV-B sales. Working with the Director, Vaccine Sales this position will serve as the primary account owner with assigned IDN, Independent and Group Practice accounts. The IDN Key Account Executive II will be responsible for full top down and bottom up ownership and execution in assigned accounts with a primary objective of expanding Adult Hepatitis B Vaccination and greater adoption of HEPLISAV-B. This role will be responsible for understanding sales strategies and execution plans that enable HEPLISAV-B to meet its full revenue potential in assigned accounts. The IDN Key Account Executive II position will be expected to execute all functions of the role independently with minimal supervision from the Director, Vaccine Sales and/or assigned mentor for executive level customer engagements. This position is field based and will require daily travel.
The ideal candidate should reside in or near Pittsburgh, PA or Cleveland, OH, but other locations in major metropolitan areas within the assigned territory will be considered.
Responsibilities
Responsible for achieving sales targets and owning/managing customer relationships for assigned Accounts. Assigned accounts will include large IDNs, independent customers and group practices.
Serves as sole owner for assigned accounts - responsible for successful execution at all levels of the customer organization to achieve declared goals/objectives.
Demonstrates a deep understanding of vaccine decision making, vaccine adoption and implementation process and key decision makers across all levels of assigned accounts.
Responsible for developing, communicating, and monitoring an account strategy for each assigned account. Conducts quarterly business reviews with Director, Vaccine Sales.
Execute all functions of the role independently with minimal supervision from the Director, Vaccine Sales and/or assigned mentor for executive level customer engagements.
Develop relationships with key stakeholders at each level of organization who are responsible for implementation of vaccines.
Partner with Director, Vaccine Sales to execute sales & marketing strategies to support HEPLISAV-B expansion within assigned accounts.
Responsible for understanding competitive positioning, market dynamics and customer business models to identify opportunities across assigned accounts.
Maintain accurate up-to-date customer records in the Account Management system.
Exercise sound judgement and oversight to ensure integrity and compliance with company policies in all activities and communications.
Foster Dynavax core values and leadership behaviors.
Other duties as assigned.
Qualifications
Bachelor's Degree required from an accredited institution; MBA preferred.
3+ years of life sciences sales experience required; IDN/Hospital experience preferred.
2 years of vaccine or buy & bill experience required.
2+ years of strategic account management experience preferred.
Knowledge of the IDN/Hospital landscape within assigned territory required.
Previous health system account management experience is highly preferred.
Strong proven strategic vision, business acumen and influencing skills to drive strategic and operational initiatives across the organization.
Documented track record of consistent sales and growth success along with superb account management skills.
Proven track record of financial/budget management experience.
Knowledge of large health systems, including immunization related quality initiatives.
Excellent oral and written communication skills, presentation and influencing skills.
Ability to drive business results and identify new opportunities and strategies through strategic thinking and business planning.
Experience in matrix management, change advocate.
Heavy travel required.
Key Competencies: Accountability, Customer Engagement, Customer Discovery, Business Acumen, Executional Effectiveness
Ability to operate a motor vehicle.
Ability to sit for prolonged periods; reach with arms and hands; lift and move small objects; and use hands to keyboard and perform other office related tasks including repetitive movement of the wrists, hands and/or fingers.
Must be able to obtain all industry credentials and certifications.
Additional Knowledge and Skills desired, but not required:
C-suite leadership and account management experience within IDNs and Hospitals is highly preferred.
California residents: for information on how we handle your personal information and your privacy rights as a job candidate, please see our Candidate Privacy Notice:
*********************************************************************************************
Dynavax is an equal opportunity employer & prohibits unlawful discrimination based on race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, disability, marital & veteran status.
Auto-ApplyDistrict Manager
Allentown, PA jobs
Description Biote Medical is the world leader in hormone optimization and we are adding to our team! We partner with providers to take a complete approach to healthier aging through patient-specific bioidentical hormone replacement therapy and the only nutraceutical line created specifically to support hormone health.This position will help support our Central PA territory. We're looking for someone with a passion for changing healthcare who wants to be in a hands-on and engaged position working within a dynamic and collaborative sales team.You must be located in the Central PA area to be considered.Position and Scope:We are looking for a driven candidate with the desire to recruit qualified physicians and practitioners into a partnership relationship with Biote; in order to provide cutting edge technology for bioidentical hormone replacement therapy (BHRT) and healthy aging options to their own patients and to the public at large. The ideal candidate is responsible for relationship development, practice development and sales of the Biote Method to practitioners. Sales activity includes prospecting, cold calling, practice development, tradeshows, sales events, and other methods for creating leads and closing sales for Biote within the approved price matrix. In addition, the Liaison provides technical, educational, and Provider Partner support. This is a field-based remote position.As a District Manager, your daily responsibilities will include:
Acquiring and retaining extensive knowledge of hormone replacement therapy through materials provided by Biote, as well as outside sources.
Effectively conducting physician, staff and patient training in the areas of Biote's business protocols; specifically, marketing, financial, therapy, forms, patient seminars, company online resources and other topics that may change from time to time.
Ability to read and understand medical and scientific studies.
Researching and evaluating physicians in assigned areas based on Biote's criteria for appropriateness and suitability.
Effectively presenting Biote's training and business program to physicians, Nurse Practitioners, Physician Assistants, office managers and office staff.
Recruiting suitable physicians and other practitioners through professional and effective prospecting, appointment setting and presentation skills.
Cultivating and maintaining mutually productive partnerships with practitioners to grow new and current practices and maintain patient retention levels of 60% or better.
Effectively conducting physician, staff and patient training in the areas of Biote's business protocols; specifically, marketing, financial, therapy, forms, patient seminars, company online resources and other topics that may change from time to time.
Securing all required contracts, paperwork and documentation as well as payments and fees as needed for attendees to participate in regular training and certification classes.
Conducting and facilitating patient educational seminars as needed for trained practitioners on a monthly basis.
Contributing to the development of the practice by assisting the Office Manager/Marketing position with email marketing, social media, referral cards and website information cards.
Prospecting for new leads and identifying quality sales prospects from active leads.
Attending marketing and sales events for prospects and current customers.
Working with customers for sales referrals with new prospects.
Updating all relevant sales activities in the Company's CRM system.
Closing sales accurately and effectively each month to meet or exceed targets.
Responding to all emails received from the customer and Biote employees and related vendors in a timely manner.
Performing other related duties as required or requested.
As a District Manager, your background should include:
Bachelor's degree
Strong teamwork, communication (written and oral), client management, and interpersonal skills.
Minimum of 3-5 years of sales experience in a business-to-business model, preferably medical device, diagnostics, and/or biotech.
Strong work ethic and time management skills
Ability to make effective and persuasive communications and technical presentations to physicians, management and/or large groups. Ability to thoroughly understand and communicate the attributes and qualities of Company products using professional selling and closing skills.
Proficient in Microsoft Office suite and customer relationship management software.
Ability to travel in order to do business, approximately 20% of the month.
Scheduled hours are 40 to 50 hours per week Monday through Friday but may be extended as required to execute the tasks assigned.
Valid driver's license issued by the state/province in which the individual resides and a good driving record is required.
Home office capability is required with reliable high-speed internet access
Company Perks:
Medical, Dental & Vision Insurance, Virtual Visits/Telemedicine
Company Paid Life and AD&D Insurance
15 days of Paid Time Off and Company Holidays
401k with a 3% employer contribution
Motus mileage program
Other excellent health and wellness benefits in line with our business
If you're interested in this awesome opportunity, please apply today!
Auto-ApplyMarketing & Communications Coordinator - Remote PA,
Yardley, PA jobs
This is a remote position working part time /20hrs per week, therefore the compensation range would be an hourly rate based on .5 /half of the anticipated base salary range listed below. Work schedule is: Monday through Friday 8:30AM-12:30PM EST. Flexibility is preferred for a few events and other requests throughout the year. Need to reside near/around the Yardley, PA area.
* Website design experience is preferred to manage weekly responsibilities for website design and updates.
This position works closely with and assists leadership in marketing, social and communications strategy, planning and execution to achieve agreed upon goals. Works across a wide range of internal and external constituents. Provides team coordination support.
* Provides support and assistance in planning, developing, producing, and delivering marketing programs and projects.
* Collaborates with other departments and engages with key vendors in the development, production, and distribution of promotional and collateral materials
* Participates in research on key topics, stakeholders and best practices and makes recommendations
* Develops clear, concise and compelling content targeting a variety of audiences through Magellan`s key channels.
* Proofreads content for accuracy, branding and compliance.
* Supports the coordination of team activities including management of the editorial calendar to help ensure appropriate amplification and timely execution of programs and initiatives
* Coordinates key team activities and provides support with scheduling meetings, calendars, travel arrangements and other general departmental administrative support as needed.
* Regularly communicates status updates to Marketing and Communications leadership.
* Completes special projects as assigned.
The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.
Other Job Requirements
Responsibilities
Bachelor's degree in marketing, communications or related field.
Creative, quick thinker with strong writing, verbal and interpersonal communication skills.
Excellent project management and organizational skills.
Ability to multitask and prioritize accordingly.
Proactive and flexible self-starter with impeccable attention to detail.
Willingness to jump in and assist where needed.
Comfortable with Microsoft Office software programs and tools.
General Job Information
Title
Marketing & Communications Coordinator - Remote PA,
Grade
21
Work Experience - Required
Communications, Public Relations or Related Field, Marketing
Work Experience - Preferred
Education - Required
A Combination of Education and Work Experience May Be Considered., Bachelor's
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Salary Range
Salary Minimum:
$45,655
Salary Maximum:
$68,485
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Auto-ApplyClinical Admissions Specialist - Remote
Coraopolis, PA jobs
Job DescriptionDescription:
ATTENTION! $5,000 SIGN-ON BONUS!
Gateway Rehab Center (GRC) is searching for a Clinical Admissions Specialist who is caring, compassionate & displays excellent customer service to individuals who are seeking residential treatment. This position guides prospective patients through the admissions process by taking initial calls, completing intake assessments, & scheduling/coordinating admissions.
This position is remote, but the ideal candidate must live in the Pittsburgh area or surrounding counties. This position receives frequent supervision and instruction. Available shifts are 5 day/8 hour shifts or 4 day/10 hour shifts, including consistent evenings and weekends.
Responsibilities
Acts as an initial point of contact to potential patients and referral sources.
Offers support to family members, potential patients and referral sources.
Completes clinical assessments to help determine level of care based on ASAM criteria.
Completes initial authorization requests to ensure coverage from respective funding sources.
Knowledge, Skills, and Abilities
Computer proficiency with working knowledge of Word, Excel, and use of email.
Excellent verbal and written communication skills and organizational skills.
Familiarity with drug and alcohol/mental health treatment and/or managed care processes required.
General understanding of ASAM criteria.
Ability to multi-task.
Excellent time management skills.
Embraces and thrives in a team environment while also operating with a high degree of autonomy.
Requirements:
Bachelor's Degree is required; Master's Degree is preferred.
Experience conducting assessments and evaluations.
Why Choose Gateway Rehab?
Make an impact through Gateway's mission
“to help all affected by addictive disease to be healthy in body, mind, and spirit.”
Be a part of an organization that has been leading the way in addiction treatment for over 50 years.
Enjoy the flexibility of a fully remote role while maintaining meaningful client connections.
Additional Requirements:
Pass PA Criminal Background Check.
Obtain Child Abuse and FBI Fingerprinting Clearances.
Pass Drug Screen.
2-Step TB Test.
Work Conditions
Consistent evenings and weekends as needed
Home-based
Minimal physical demands
Significant mental demands include those associated with working with patients with addictive disorders and managing multiple tasks.
GRC is an Equal Opportunity Employer committed to diversity, equity, inclusion, and belonging. We value diverse voices and lived experiences that strengthen our mission and impact.
Early Childhood Education Assistant Teacher
Philadelphia, PA jobs
Job Description
As our community evolves, so does the need for compassionate care. If your position was recently impacted, Greater Philadelphia Health Action, Inc., invites you to continue your mission of service with us.
About Us
Founded in 1970 as South Philadelphia Health Action and subsequently incorporated as Greater Philadelphia Health Action, GPHA is a non-profit healthcare organization with a commitment to provide compassionate and affordable healthcare services regardless of an individual's ability to pay. Since 1970, GPHA has expanded to become one of the premier providers of primary and behavioral healthcare in the Greater Philadelphia area.
GPHA offers GREAT PAY, Performance BONUSES, Comprehensive Medical, Dental, Vision, Life, and LTD Insurance. We also offer 401k with a very lucrative company match, Employee Assistance and Self-Care, and Professional Activity, Educational, and Tuition Reimbursements, Paid Vacation, Paid Sick, Paid Personal Days, Paid Educational Days, Holiday Pay, Loan Forgiveness, and many positions have Flexible, Hybrid or REMOTE WORK Schedules.
Job Position
We are presently seeking Assistant Teachers at GPHA's Keystone Star IV Woodland Academy Child Development Center.
The Assistant Teacher cares for children under the guidance and supervision of the Lead Teacher to meet their physical, emotional, social and cognitive needs. The Assistant Teacher assists the teacher in both planning and implementing a variety of learning and program activities to meet the needs of children.
Requirements
Assistant Teachers require a Child Development Associate (CDA) certificate and a High School Diploma (HSD) or General Education Development certificate (GED) with two (2) years' work experience related to care and development of children. An Associate Degree in Early Childhood Education is preferred. Applicants without a CDA must be willing to obtain one within 1 year of employment.
Local Candidates only.
Equal Opportunity Employer
At Greater Philadelphia Health Action, Inc. (GPHA), we respect diversity and promote equity through action, advocacy, and policy through a dedicated team of representatives committed to listening, learning, and enacting systemic change. We create different channels, outlets, and programs to enhance safe spaces within GPHA, creating a shared understanding and language around justice, diversity, equity, and inclusion. GPHA is an Equal Opportunity Employer. GPHA does not and will not discriminate in employment and personnel practices to include hiring, transferring and promotion practices on the basis of race, color, sex, age, handicap, disability, religion, religious creed, ancestry, national origin, or any other basis prohibited by applicable law
RN - Registered Nurse - Senior Clinical Documentation Improvement Specialist - CCDS Certification
Pennsylvania jobs
Shift:
Days (United States of America)
Scheduled Weekly Hours:
40
Worker Type:
Regular
Exemption Status:
Yes The Clinical Documentation Improvement Program (CDI) is designed to improve the physician's documentation in the patient's medical record, supporting the appropriate severity of illness, expected risk of mortality and complexity of care of the patient. The role of the Clinical Documentation Improvement Specialist (CDIS) is to assist the providers with accurately identifying and documenting the healthcare services provided to the patient. This is accomplished with the recognition of complete and accurate diagnoses, procedures performed, and the treatment provided. The core of the program uses highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to be coded post discharge in a timely and accurate manner. A highly successful CDI program is based on a highly interactive process between physicians, CDIS staff and other support services. The program does not challenge the provider's medical judgement, but rather provides a methodology in which to clarify existing documentation. Acts as a liaison between the clinical and coding functions. Provides education to the medical staff and other clinical professional on documentation relevant to the Revenue Management processes and Discharge Not Final Billed reduction. Provides daily interactions with physicians and clinical professionals regarding documentation clarification and optimization. It is expected that the CDIS have previous clinical skills, including an understanding of Anatomy and Physiology in order to appropriately discuss with the physician such issues as the underlying etiology, principal diagnosis, diagnostic studies, treatment modalities, to name a few. The essential focus of this position is to analyze the clinical information, using the documentation as the primary driver for overall System Case Mix Index.
Job Duties:
Applicants must currently hold the required CDI certification in order to be considered for this position. Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP).
This is a work from home position. The position is full-time, 40 hours weekly; Dayshift; Monday through Friday.
Candidates must hold a Registered Nurse license in Pennsylvania or a Multistate License. A minimum of 3 years RN work experience is required; BSN is strongly preferred.
Benefits at Geisinger:
We offer a comprehensive benefits package starting on day one, including:
Health, dental, and vision insurance
Three medical plan choices, including expanded network options
Pre-tax savings plans (FSA & HSA)
Company-paid life, short-term, and long-term disability insurance
401(k) with automatic Geisinger contributions
Generous PTO that accrues quickly
Up to $5,000 in tuition reimbursement per calendar year
MyHealth Rewards wellness program with financial incentives
Family-friendly support: adoption/fertility assistance, parental leave, military leave, and Care.com membership
Employee Assistance Program (EAP): mental health, legal guidance, childcare/eldercare referrals, and more
Voluntary benefits: accident, critical illness, hospital indemnity, identity theft protection, pet insurance, and more
The Senior CDI Specialist improves the physician's documentation in the patient's medical record, supporting the appropriate severity of illness, expected risk of mortality and complexity of care of the patient. Assists the providers with accurately identifying and documenting the healthcare services provided to the patient. The position will, through ongoing education, support the improvement and continue to sustain clinical documentation related to relative patient acuity, risk reduction, ad overall improvement and accuracy of Case Mix Index. Acts as documentation liaison to physician staff as a means of finalizing information in the medical record.
Job Duties:
Reviews inpatient medical records within 24-48 hours of admission for a specified patient population to: evaluate the documentation in order to assign the principal diagnosis, relevant secondary diagnoses, and procedures for accurate DRG assignment, risk of mortality, severity of illness Formulates queries when it is determined there is missing documentation, conflicting documentation or unclear documentation.
Attends physician rounds on assigned units, as well as interdisciplinary team meetings as appropriate to daily patient assignment.
Provides on-going education to physicians and essential healthcare providers regarding clinical documentation improvement and the need for accurate and complete documentation in the patient's record.
Collaborates with the nursing staff, clinical nutrition, pharmacist, along with the physicians on documentation in an attempt to resolve queries prior to the patient's discharge.
Identifies strategies for sustained work process changes that facilitate complete, accurate clinical documentation.
Maintains the confidentiality of all information acquired, pertaining to the patient, physician, associates, and visitors to Geisinger.
Promotes a partnership with the Inpatient Coding staff, to provide clinical education, to assure documentation of discharge diagnosis and any secondary diagnoses' to reflect the accuracy of the patient's clinical status and care.
Acts as a resource person for the interdisciplinary team in order to promote collaboration and coordination of patient care considering age specific, developmental, cultural, and spiritual needs of the patient.
Complies with established hospital and Department Policies, Procedures Assists the Director with daily organization of CDI work flow at all Geisinger facilities.
Communicates and partners with the CDI Director regarding issues in need of a coordinated resolution.
Position Details:
Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.
Education:
Bachelor's Degree-Healthcare Related Degree (Required)
Experience:
Minimum of 3 years-Nursing (Required)
Certification(s) and License(s):
Basic Life Support Certification - Default Issuing Body, Certified Clinical Documentation Specialist - Default Issuing Body, Clinical Documentation Improvement Practitioner - Default Issuing Body, Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania
Skills:
Communication, Computer Literacy, Medical Records Management, Medical Records Systems, Teamwork, Working Independently
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.
KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
EXCELLENCE: We treasure colleagues who humbly strive for excellence.
LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
SAFETY: We provide a safe environment for our patients and members and the Geisinger family.
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.
We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
Auto-ApplyProject Coordinator, Continuing Education
Plymouth, PA jobs
Requirements
EDUCATION/RELATED EXPERIENCE:
Bachelor's degree, preferably in project management, education, or communication or equivalent work experience
Experience in project management or medical copyediting management within a medical communications organization, non-profit health care organization, or post-secondary academic setting preferred
Knowledge of ACCME and OIG/PhRMA guidelines a plus
SKILLS AND ABILITIES:
Impeccable organization skills and attention to detail
Ability to work under pressure, manage multiple tasks simultaneously, and meet deadlines with shifting priorities
Ability to handle confidential information in a discreet, professional manner
Excellent verbal and written communication skills and ability to interact effectively with internal and external staff, physicians, and other health care providers
Ability to adhere to established procedures and processes to ensure consistent quality and compliance
Flexibility and adaptability in accommodating last-minute changes and requests
Strong analytical, research, and writing skills
Exceptional problem-solving skills
Outstanding customer service and follow-up
Strategic thinker
High level of professionalism and accountability
Technology savvy with proficiency in all MS Office products, especially PowerPoint
Zoom, Adobe Acrobat Pro, and EthosCE experience a plus
WORK ENVIRONMENT & PHYSICAL REQUIREMENTS:
This position operates in a professional office environment and is largely sedentary.
This role routinely requires the use of standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines
When applying for this role, please include a cover letter along with your resume to describe your interest in this opportunity and how you demonstrate the skills as outlined in the above job description.
This position represents a unique opportunity to build a career with a premier organization. We offer a competitive salary and excellent benefits.
EOE. No calls please.
This position is located in Plymouth Meeting, PA with the ability to work remotely up to 2 days per week.
Field Reimbursement Director
Wayne, PA jobs
At Novocure, we are pioneering Tumor Treating Fields (TTFields), a noninvasive cancer therapy designed to disrupt tumor cell division and extend survival in some of the most aggressive forms of cancer. Every role here contributes to improving the lives of people living with cancer.
Currently we are seeking a Field Reimbursement Director, Market Access in a high-impact, field-based role responsible for U.S. provider reimbursement and market access initiatives enable patient access to Novocure products. This role involves developing and executing strategies related to coverage, coding, and payment, securing broad formulary inclusion, and driving technology adoption across payers, providers, and channel partners for providers. The position plays a critical role in shaping a favorable provider reimbursement landscape while providing strategic guidance and collaboration with field teams. Success requires a proven track record in payer account management, reimbursement expertise, a proactive mindset, exceptional communication skills, launch experience, and the ability to thrive in a fast-paced, cross-functional environment.
This is a full-time, exempt position, remote but linked to the Chesterbrook, Pennsylvania office.
In this role, you will:
* Serve as a subject matter expert on U.S. payer, policy, and provider economics, including Medicare DME, state Medicaid, commercial payers, and coding/coverage/payment pathways. Leverage expertise to solve complex reimbursement challenges and improve patient access.
* Compliantly communicate reimbursement education, support, and resources effectively to customers, including healthcare administrators, physicians, and billing/coding staff on an as-needed basis to support field teams
* Develop coding and billing guides, customer education materials, and other reimbursement resources to enhance patient access and streamline service delivery.
* Build and maintain strong relationships with public and commercial payers, reimbursement/policy key opinion leaders (KOLs), and professional societies to support favorable reimbursement outcomes.
* Collaborate cross-functionally with Sales, Strategic Accounts, Marketing, Revenue Operations, Medical Education, Legal, Government Affairs, and Compliance to drive reimbursement-focused engagement and strategic alignment.
* Monitor and interpret evolving market dynamics, CMS policies, product usage, and commercial payer trends; translate insights into proactive strategies and clear field guidance.
* Maintain comprehensive knowledge of local, regional, and national coverage issues through payer research, stakeholder engagement, and participation in public forums.
* Coordinate and support presentations by KOLs to decision-makers such as CMS, medical directors, P&T committees, and HTA bodies to influence coverage, coding, and payment decisions.
* Conduct in-depth analysis of reimbursement policies impacting Novocure and competitor products.
* Promote a culture of compliance by ensuring all activities aligned with company policies, regulatory standards, and industry's best practices.
* This is a full-time, exempt, remote position requiring field travel to engage with providers, payers, customers, and attend industry conferences.
* Thrive in a dynamic, fast-paced environment and adapt to evolving organizational priorities and responsibilities.
* Contribute to initiatives that advance business logistical operational effectiveness and enhance the overall PEx experience.
What we're looking for:
* Bachelor's degree in Business, Economics, Basic Sciences, or a related field; equivalent experience accepted. Graduate-level coursework or degree in health policy, health economics, or a related field, or coding certification is preferred.
* 12+ years of U.S. market access experience within medtech, biotech, or pharma industries, with a strong preference for expertise in provider medical device reimbursement, coverage, coding, and payment.
* Deep understanding of the U.S. reimbursement landscape to guide customers through coverage pathways and facilitate access to Novocure technologies.
* Proficient in CPT, ICD-10, and HCPCS coding systems relevant to medical devices across diverse healthcare settings.
* Strong grasp of private and government payer methodologies, coverage development processes, and healthcare benefit structures (e.g., deductibles, out-of-pocket costs, exclusions).
* Exceptional communication and presentation skills, both in-person and virtual, with the ability to engage customers and collaborate effectively with cross-functional teams.
* Strong writing abilities, with a focus on integrating clinical arguments effectively into persuasive documents.
* High attention to detail with demonstrated ability to conduct in-depth analysis and resolve complex reimbursement issues.
* Strategic and analytical mindset with the ability to translate insights into actionable solutions.
* Radiation oncology experience is a plus.
* Proficient in Microsoft Word, Excel, PowerPoint, and Outlook.
* Ability to travel up to 60% of the time.
Why Join Us
At Novocure, you will lead a mission driven operations organization that directly supports patient access to innovative therapies. This is an opportunity to shape the future of North American operations while developing people, improving processes, and ensuring every patient receives their therapy on time.
Equal Opportunity Statement
Novocure is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, age, national origin, disability, protected veteran status or other characteristics protected by federal, state, or local law. We actively seek qualified candidates who are protected veteran and individuals with disabilities as defined under VEVRAA and Section 503 of the Rehabilitation Act.
Novocure is committed to providing an interview process that is inclusive of our applicant's needs. If you are an individual with a disability and would like to request an accommodation, please email **********************************.
Nearest Secondary Market: Portsmouth
Nearest Major Market: Philadelphia
Epicor CPQ Consultant
Media, PA jobs
Benefits:
401(k)
Dental insurance
Health insurance
ICM America is looking for Epicor consultants ICM America is looking for Epicor CPQ Consultants to support us in various implementation projects.
We are looking for someone who ideally has a background in manufacturing, six-sigma, lean and 5- years+ of Epicor experience (v9, v10, Kinetic). In essence, we are looking for a Continuous Improvement Specialist who can relate process improvement (in a manufacturing environment) back to the Epicor processes *and vice versa. This will also feed into a Centers of Excellence approach. This initiative will be spread among several locations and will require some travel.
Overview
Epicor CPQ (formerly KBMax) is a cloud solution that simplifies and automates sales, engineering, and manufacturing processes for complex, customizable products. Sales reps, partners, and online customers can configure products in 2D, 3D, and augmented reality (AR). The system then generates prices, quotes, proposals, sales drawings, CAD files, BOMs, and more for the unique configuration. Epicor CPQ streamlines an otherwise lengthy and laborious Engineer-to-Order process, driving speed, efficiency, and accuracy.
Job Description (Summary)
The successful candidate will build custom user interfaces and advanced product rules that automate the design/quote process using advanced configuration and pricing algorithms. You will use your enterprise software knowledge to dig deep into customers issues and goals, learn about their products and business processes, and then develop a fully integrated solution.
Requirements
Duration: Permanent, full-time
US Citizen, no sponsorships
Experience with KBMax/Epicor CPQ required.
Experience with Snap / Snaplogic
Experience automating CAD models with macros or any other CAD automation technology
Ability to use toolsets (BAQ, BPM, SSRS, Application Studio)
Strong communication skills
Working with manufacturing companies
Flexible work from home options available.
Admissions Navigator - Remote
Coraopolis, PA jobs
Job DescriptionDescription:
Gateway Rehab is searching for an Admissions Navigator who is caring, compassionate & displays excellent customer service to individuals who are seeking residential treatment. This position guides prospective patients through the admissions process by taking initial calls, completing screenings, and scheduling & coordinating admissions. This position is remote, but the ideal candidate must live in the Pittsburgh area or surrounding counties.
This position receives frequent supervision and instruction. Available shifts are 5 day/8 hour shifts or 4 day/10 hour shifts, including consistent evenings and weekends.
Responsibilities
Completes non-clinical evaluation components consisting of & not limited to: answering initial calls & completing pre-screening process, coordinating & scheduling admissions, coordinating transportation, completing non-clinical documentation.
Knowledge Skills and Abilities
Computer proficiency with working knowledge of Word, Excel, and use of email.
Excellent verbal and written communication skills and organizational skills.
Familiarity with drug and alcohol/mental health treatment and/or managed care processes required.
Ability to multi-task.
Excellent time management skills.
High school diploma.
Experience in drug and alcohol screening and assessment.
Requirements:
High school diploma.
Experience in drug and alcohol screening and assessment.
Why Choose Gateway Rehab?
Make an impact through Gateway's mission
“to help all affected by addictive disease to be healthy in body, mind, and spirit.”
Be a part of an organization that has been leading the way in addiction treatment for over 50 years.
Enjoy the flexibility of a fully remote role while maintaining meaningful client connections.
Additional Requirements
Pass PA Criminal Background Check.
Obtain Child Abuse and FBI Fingerprinting Clearances.
Pass Drug Screen.
2-Step TB Test.
Work Conditions
Consistent evenings and weekends as needed
Home-based
Minimal physical demands
Significant mental demands include those associated with working with patients with addictive disorders and managing multiple tasks.
GRC is an Equal Opportunity Employer committed to diversity, equity, inclusion, and belonging. We value diverse voices and lived experiences that strengthen our mission and impact.
INTERN, FINANCE & ACCOUNTING-FULL-TIME TEMPORARY (HYBRID)
Greensburg, PA jobs
Hours:, Monday-Friday, daylight hours, Hybrid work schedule is available. Days and hours are subject to change. Candidate will assist finance with data compilation, analysis, customer service, and administrative support. Candidate will gain experience with accounting, finance, budgeting, cost reporting, and treasury concepts including special projects, audit work paper preparation, monthly account reconciliations, clerical functions, and other areas of interest .
TECHNICAL STANDARDS
Essential Functions: Defined as duties specific to the job, that, if removed, would change the entire purpose of the job; to include the Essential Physical Demands and Essential Working Conditions of this position.
* Core Essential Functions:
* Regular, consistent, on-site, and timely attendance.
Ability to perform the Essential Functions listed on the Physical Conditions and ability to perform the Essential Functions on the Working Condition chart (see attached chart).
* Specialty Essential Functions:.
* Finance and Billing
* Assist Accounting team with various account analysis, preparation of spreadsheets, journal entry posting, accounts payable processing and other related duties as assigned.
* Consistently demonstrates exemplary customer service skills and communications at all levels.
* Builds customer confidence in information services delivered by responding to customer needs in a timely, delightful and empathetic manner.
* Support Services Administration
* Ensures that all data delivered, regardless of the delivery method, e.g. electronic, digital, hardcopy, etc., is 100% accurate, concise and reliable.
* Accountability
* Assumes responsibility for all facets of individual job performance and the subsequent impact on the delivery of information services.
* Initiates corrective action and communications to rectify performance or delivery issues.
* Marginal Functions: Defined as duties that are not essential in nature and do not take a considerable amount of time to complete (less than 10%).
* Performs other duties as required.
* Required Skills and Knowledge: Minimum level of education, skills and abilities necessary in performing the job.
Education:
* Currently enrolled in an accredited accounting/finance program or recent graduate.
Certification / Licensure / Regulation:
* Act 34-PA Criminal Record Check from the PA State Police system
Prior Experience:
* None
Other Skills and Abilities:
* Proficient use of Microsoft products
* Excellent communication, interpersonal and organizational skills
* Ability to communicate with all members of the health care team
* Independent thinking and decision-making ability
Preferred Factor:
These are job related enhancements that are preferred or would benefit the performance outcome of the job but are not essential or required for the job to exist.
* None
The above job descriptive information is intended to describe the general nature and level of work being performed by individuals assigned to this job. This is not intended to be an exhaustive list of all duties and responsibilities, as an employee may be assigned other duties other than described in this document.
* Essential Working Conditions:
Constantly = (5 1/2 to 8 hours or more) or 200 reps/shift
Occasionally = (1/4 to 2 1/2 hours) or 2 - 32 reps/shift
Frequently = (2 1/2 to 5 1/2 hours or more) or 32 - 200 reps/shift
Rarely = (Less than 1/4 hours) or < 2 reps/shift
Sedentary Work -
Exerting up to 10 pounds of force occasionally.
Light Work -
Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly.
Medium Work -
Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force occasionally.
Heavy Work -
Exerting 50 to 100 pounds of force occasionally, and/or 25 to 50 pounds of force frequently, and/or 10 to 20 pounds of force constantly.
Very Heavy Work -
Exerting in excess of 100 pounds of force occasionally, and/or in excess of 50 pounds or force frequently, and/or in excess of 20 pounds of force constantly to move objects.
Working Conditions:
Never
Extreme Cold
Extreme Heat
Heights
Confined Spaces-Cramped Quarters (Labeled)
Extreme Noise (> 85 dB)
Mechanical Hazards
Use of Vibrating Tools
Operates Vehicle
Operates Heavy Equipment
Use of Lifting/Transfer Devices
Rotates all shifts
10 - 12 hour shifts
On Call
Rarely
Overtime (more than 8 hrs. /shift, 40 hours/week)
Constantly
8 hour shifts
Protective Equipment:
Never
Respirator-Breathing Equipment
Eye
Head (hard hat)
Hearing
Hands
Feet, Toes
Body
Occupational Exposures:
Never
Solvents
Paints (direct use of)
Dust (Sanding)
Ethylene Oxide
Cytotoxic Drugs (Chemo)
Blood and Body Fluids
Chemicals (direct use of)
Mists
Wax Stripper (direct use of)
Radiation
Ionizing Radiation
Lasers
Rarely
Latex (Rubber, erasers, balloons, gloves, rubber bands, etc.)
VII. Essential Physical Conditions:
Marginal
Frequently = (2 1/2 to 5 1/2 hours or more) or 32 - 200 reps/shift
Essential
Occasionally = (1/4 to 2 1/2 hours) or 2 - 32 reps/shift
Constantly = (5 1/2 to 8 hours or more) or 200 reps/shift
Rarely = (Less than 1/4 hours) or < 2 reps/shift
Physical Demands:
Never
Climbing Ladders
Use of Forceful Hand Grasp
Fine Finger Manipulation
Rarely
Kneeling
Squatting (Crouching)
Pushing / Pulling
Occasionally
Climbing Stairs
Hand / Arm Coordination
Bending (Stooping)
Frequently
Sitting
Walking
Standing
Keyboard/Computer Operation
Sensory Requirements:
Rarely
Feeling (Sensation)
Occasionally
Seeing Near-with Acuity
Frequently
Color Vision
Constantly
Hearing Clearly
Over Shoulder Work:
Rarely
Pulling or Pushing Objects Overhead
Reaching Above Shoulder Level
Lifting: floor to standing position:
Never
30 - 49 pounds
50 pounds
> 50 pounds
Rarely
20 - 29 pounds
Occasionally
10 - 19 pounds
Lifting: waist to shoulder level:
Never
30 - 49 pounds
50 pounds
> 50 pounds
Rarely
20 - 29 pounds
Occasionally
10 - 19 pounds
Lifting: shoulder to overhead:
Never
30 - 49 pounds
50 pounds
> 50 pounds
Rarely
20 - 29 pounds
Occasionally
10 - 19 pounds
Patient Education Consultant
Bethel Park, PA jobs
The Patient Education Consultant is responsible for conducting demonstrations and trainings with current and potential Tactile Medical patients on our products in their assigned area. This position will build strong rapport with the patient through introduction to our product, discussion of financial options and closing the sale to delivering the patient's training and ensuring the patient is able to use their product as prescribed. Demonstrations are completed in-person with patients at a pre-determined location while trainings may be delivered in-person or via telehealth. Both patient facing interactions require documentation standards which vary based on the patient's insurance as well as Tactile's requirements.
Responsibilities
* Educate the patient and/or caregiver in all aspects of device use, including donning and doffing of garments, use of controller, following prescribed protocol and initiating a therapy session
* Contact patients within service levels expectations to schedule and complete trainings and demonstrations
* Responsible for direct sales to patients which includes providing a clear and thorough explanation of the patient's financial responsibility for the product, insurance coverage and finalizing the sale
* Provide clear verbal instruction while conducting the demonstration or training with patients and caregivers; modifying the interaction to their specific situation to ensure the training/demonstration approach meets the patient's individual needs (utilize adaptive technique when needed)
* Manage and respond appropriately to any patient feedback or objection, both positive and negative, regarding the product, their financial responsibility and required paperwork
* Ensure appropriate preparation for all trainings and demonstrations including finalizing and confirming appointment details with the patient, ensuring that you have all equipment, supplies, documentation, and accessories necessary to effectively complete the training or demonstration
* Review, complete and submit required paperwork with patient and answer questions
* Work collaboratively with territory partners to facilitate completing of orders, which may include but not limited to collection of a signature on a prescription or other documents required for insurance requirements
* Identify, escalate, and communicate problems, questions, or additional patient support needs to appropriate department for follow up
* Effectively use translation tools for patients where English is not their first language
* Meet or exceed established performance expectations
* Maintain compliance with all appropriate regulatory requirements including HIPAA
* Travel up to 80% within assigned territory
* Other duties as assigned
Qualifications
Education & Experience
Required:
* Bachelor's Degree or equivalent work experience
* 2+ years of experience in a patient facing, education/training and/or highly advanced customer service role
Preferred:
* Health related certification
* Medical device or healthcare industry experience
Knowledge & Skills
* Ability to lift 20 pounds on a regular basis
* Ability to work remotely and travel to patients in a home, clinic or virtual environment
* Able to provide clear written and verbal communication to patients, caregivers, field staff and internal teams
* Strong interpersonal communication skills including the ability to empathize with patients and caregivers
* Strong critical thinking and decision-making skills in healthcare related situations
* High degree of confidence and professionalism interacting with people of diverse cultures, ages, and abilities
* Excellent organization and time management skills - proactive and efficient in scheduling and managing multiple appointments
* Able to apply new information received via online learning modules, virtual or in-person interactions to enhance the patient experience
* Skilled in teaching others
* Ability to stay focused and organized to complete assigned tasks
* Technology savvy to efficiently complete paperwork, update records and communicate progress
* Ability to be self-directed and work independently to overachieve results
Below is the starting salary range for this position, although offers may differ based on the candidate's location, job-specific knowledge, skills and experience.
$23.89 - $31.35 / HR
Additional benefits:
non-exempt - Our total compensation package includes medical, dental and vision benefits, retirement benefits, employee stock purchase plan, paid time off, parental leave, family medical leave, volunteer time off and additional leave programs, life insurance, disability coverage, and other life and work wellness benefits and discounts. Benefits may be subject to generally applicable eligibility, waiting period, contributions, and other requirements and conditions.
Auto-ApplyDirector Data Services - Data Governance
Pennsylvania jobs
This job is responsible for developing the strategy, planning and delivery of all aspects related to data governance, data warehousing, data management and related efforts for the organization. Directs the coordination of involvement of all business area Subject Manager Experts (SMEs) and other staff members. Promotes the proliferation of a data driven organization in end-user processes and the integration of applications; as well as the promotion of enterprise-wide thinking among business and technical areas. Responsible for defining, documenting, and making available data sources of truth throughout the enterprise. Participation in project management and budgeting to assure data related projects are included in the organizational roadmap and produce tangible results. Champions the use of data as an asset across the enterprise. Improvement and maturity of data sources to move through the life cycle of data, information, and knowledge.
ESSENTIAL RESPONSIBILITIES
* Perform management responsibilities including, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority.
* Assure all related projects or initiatives are delivered on time, within the specified budget and in accordance with the agreed upon scope.
* Define, build, and maintain a data warehouse/big data platform and associated data stores that maintain an enterprise focus and meet the needs of its varied stakeholders.
* Ensure that decisions are made reflecting that position and carefully managing on the part of the incumbent to satisfactorily resolve situations with competing priorities or different perceptions, particularly among senior management.
* Communicate and act as the ambassador for data management and data governance within the organization, which includes upward and downward communication of the outcomes produced through the efforts of the team and driving the organization to a data-driven operating approach.
* Accountable for service level agreements and expectations with end-users and external stakeholders.
* Ensure that the Enterprise Data Warehouse (EDW)/Big Data platforms meets the needs of its customers.
* Deliver/manage/monitor all data extracts, both to internal and external constituents.
* Other duties as assigned or requested.
EDUCATION
Minimum
* Bachelor's Degree in Business, Information Science or other related area, or relevant experience and/or education as determined by the company in lieu of bachelor's degree
Preferred
* Master's Degree Business, Information Science or other related area
EXPERIENCE
Minimum
* 10 years of information technology experience functioning in a data warehouse environment to include at least 5 years' performing in a managerial capacity
* 3 years of healthcare related experience
* Experience developing strategic plans and/or product road maps and communicating technical concepts to varying audiences
* Experience acting as liaison between business and technical teams, translating business terms to technical needs
Preferred
* None
SKILLS
* Analytical and problem solving skills
* Project management experience with multiple major development projects, demonstrating leadership skills and a track record of managing technical/business staff, financial resources and outside vendors
* Strong teamwork and interpersonal skills
* Ability to lead process improvement initiatives
* Strong knowledge and understanding of business needs
* Ability to establish and maintain high level of customer trust and confidence
* Demonstrated abilities in relationship management
* Strong communication skills
LICENSES AND CERTIFICATIONS
Required
* None
Preferred
* PMP
TRAVEL REQUIREMENT:
0 - 25%
LANGUAGE REQUIREMENT (other than English)?
None
PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS
Position Type
Office-Based
Office-Based Positions
An employee in this position works in an office environment. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours.
Teaches/Trains others regularly
Frequently
Travels regularly from the office to various work sites or from site-to-site
Does Not Apply
Works primarily out-of-the office selling products/services (Sales employees)
Does Not Apply
Physical Work Site Required
Yes
Lifting: up to 10 pounds
Does Not Apply
Lifting: 10 to 25 pounds
Does Not Apply
Lifting: 25 to 50 pounds
Does Not Apply
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$126,400.00
Pay Range Maximum:
$236,000.00
Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Auto-ApplyRemote Work From Home Data Entry
Philadelphia, PA jobs
Full Job Description
Remote Data Entry and Typist Employee Required
We are looking for ambitious individuals who are ready for a challenging yet rewarding career as part of our call center.
WORK OUT WORLD hires people who will produce exceptional results, who can deliver amazing service to our customers, while striving to inspire positive change within the Organization.
Whats a typical day as a Customer Experience Associate? Youll be FOR WORK OUT WORLD :
Receiving challenging calls transferred from agents.
Assisting and troubleshooting customer concerns
Verifying data and information using a verification process
Addressing customers questions while displaying exceptional customer service skills
Documenting both customer concerns and solutions
Meeting or exceeding all managed metrics
Keeping your community safe and making a difference
This job might be an outstanding fit if you:
Are an ambitious customer focused individual
Have the ability to handle stressful customer interactions
Have one year of Call Center, Sales, or leadership experience
Have strong computer skills with dual monitor experience preferred
Display excellent verbal and written communication skills plus problem-solving skills
Are able to handle/process high call volumes, at times while adhering to scheduled breaks/lunches in accordance business needs
Are be able to work from home with internet in a quiet area
Have your computer connected to the internet via an Ethernet cable (not Wi-Fi)
Equal Opportunity Employer
It is and will continue to be the policy of WORK OUT WORLD to practice a program of equal employment opportunity designed to assure that employment and advancement opportunities are made available to all employees and applicants on the basis of individual qualifications and regardless of race, color, creed, religion, national origin, sex, sexual orientation, disability, age, marital status, genetic information, gender identity, or their status with regard to public assistance.
Associate Architect - Oracle PaaS Administrator
Pennsylvania jobs
* CANDIDATE MUST BE US Citizen (due to contractual/access requirements)* We are seeking a highly skilled and experienced Oracle Platform as a Service (PaaS) Administrator to join our dynamic team. This pivotal role involves leading the definition and design of complex Oracle Financial PaaS processes and functions, facilitating the development of sophisticated enterprise business solutions, and contributing to strategic initiatives. The successful candidate will play a critical role in ensuring the robust, secure, and efficient operation of our Oracle PaaS environment, balancing functional requirements with service quality and adherence to enterprise policies and security standards. This role also involves providing leadership and mentorship in areas of expertise and architecture to peers, developers, management, and business users.
Key Responsibilities:
* Lead the design and definition of complex Oracle Financial PaaS processes and functions.
* Facilitate the development of advanced enterprise business solutions utilizing Oracle PaaS.
* Contribute to enterprise strategy development, including opportunity identification and business innovation.
* Select and ensure the effective application of appropriate design standards, methods, and tools.
* Review application designs to ensure optimal technology selection, efficient resource utilization, and seamless system integration.
* Ensure system architecture adheres to functional, service quality, security, and enterprise policy standards.
* Participate in customer walkthroughs, technical reviews, problem resolution, and decision-making processes.
* Provide leadership and mentorship to peers, developers, management, and business users on Oracle PaaS architecture and best practices.
* Manage Oracle Cloud Infrastructure (OCI) resources, including provisioning and maintaining compute, storage (Object Storage, Block Volumes), and networking components (VCNs, subnets, NSGs, security lists).
* Administer and configure Oracle PaaS services such as Oracle Integration Cloud (OIC), Autonomous Database (ADW, ATP), Oracle Analytics Cloud, and Oracle FDI, ensuring secure and efficient operation.
* Implement and manage Identity and Access Management (IAM) through IDCS or OCI IAM, including role setup, policies, single sign-on (SSO), and application/user provisioning.
* Conduct proactive monitoring, performance tuning, and cost optimization of Oracle PaaS environments.
* Implement and enforce security best practices, including encryption, patch management, vulnerability scanning, backup/recovery, access audits, Cloud Guard, and Data Safe, ensuring SOX compliance.
* Provide frontline support for incident management, diagnosing and resolving platform issues, coordinating with IT teams and vendors, and documenting operational processes.
* Develop and maintain automation scripts (Shell, Python) for streamlining tasks, ensuring peer review and version control.
* Maintain comprehensive technical documentation, oversee licensing, manage change control, and develop recovery plans.
* Collaborate effectively with developers, analysts, and security teams, and potentially mentor junior staff.
Core Skills and Experience:
* Oracle Cloud Infrastructure (OCI) Expertise: Compute, Storage (Object Storage, Block Volumes), Networking (VCNs, subnets, NSGs).
* Oracle PaaS Services: Oracle Integration Cloud (OIC), Oracle Data Integrator (ODI), Identity Cloud Service (IDCS), Autonomous Database (ADW, ATP), Oracle Analytics Cloud (OAC), Visual Builder Cloud Service (VBCS), APEX, WebLogic.
* Database Administration: Oracle Database administration and data transformation experience.
* Scripting & Automation: Proficiency in Shell/Bash scripting and Python. Java experience is a plus.
* Security & Compliance: IAM/Policy configuration, encryption, patching strategies, SOX compliance, and audit experience.
* APIs & Integrations: Experience with REST APIs and FDI SOAP.
* Performance Optimization: Proven ability in performance tuning, health checks, and cost tracking.
* Operational Excellence: Strong skills in incident triaging, technical documentation, backup strategies, and disaster recovery.
ESSENTIAL RESPONSIBILITIES
* Assists in providing strategic consultation to business customers in defining or designing less complex business processes, functions and organizational structures, as well as in researching, identifying and internally marketing enabling technologies based on customer capability requirements. Facilitates development of enterprise business solutions that combine knowledge of particular business processes and issues, general technological options, and process facilitation techniques. Participates in enterprise strategy development, including environmental analysis, opportunity identification, value cases and business innovation portfolio development.
* Assists in specifying and designing less complex systems, solutions, networks, infrastructure elements, or processes. Selects appropriate design standards, methods and tools and ensures that they are applied effectively. Reviews others' system design to ensure selection of appropriate technology, efficient use of resources and integration of multiple systems and technology. Establishes policy for selection of architecture components. Evaluates and undertakes impact analysis on major design options. Ensures that the system architecture balances functional, service quality and systems management requirements.
* Assists in using appropriate tools, including models of components and interfaces, to contribute to the development of architectures. Produces detailed component requirements, specifications and translates these into detailed solutions/designs for implementation using selected products. Provides advice on technical aspects of system development, integration (including requests for changes, deviations from specifications, etc.) and processes. Ensures that relevant technical and business strategies, policies, standards and practices are applied correctly.
* Assists in selecting and using tools and methods to establish, clarify, and communicate the functional and non-functional requirements of system users, their characteristics, and tasks. Identifies the technical, organizational, and physical environment in which less complex products or systems will operate. Identifies, proposes, initiates, and leads improvement programs, taking responsibility for the quality and appropriateness of the work performed and the realization of measurable business benefits. Modifies existing process improvement approaches and/or develops new approaches to achieving improvement.
* Assists in ensuring the resolution of a variety of architecture and business problems and serves as a technical or business resource for less complex project initiatives.
* Communicates effectively with all levels of organization
* Manages expectations of customers, partners and management
* Participates in customer walkthroughs and plans; design and technical walkthroughs; and problem resolution and decision making
* Interacts with departments across the organization as necessary, including the development and interpretation of less complex requirements for peers and other staff.
* Maintains an in-depth knowledge of specific technical aspects in area of expertise and provides advice regarding their application. The area of specific expertise may be any aspect of information or communication technology, technique, method, process, product, or application area.
* Provides leadership in the areas of expertise and architecture to their peers, developers, management and business users including technical expertise, coaching, and ad-hoc training by:
* Preparing presentations on less complex issues on the area of expertise
* Presenting to their peers to ensure consistency to Highmark's strategic direction.
* Other duties as assigned or requested.
EDUCATION
Required
* Bachelor's Degree in Information Technology or related field
Substitutions
* 6 years of related experience in lieu of a 4 year degree
Preferred
* Master's Degree
EXPERIENCE
Required
* None
Preferred
* Health insurance industry business knowledge
LICENSES or CERTIFICATIONS
Required
* None
Preferred
* Industry certifications
SKILLS
An Architect is not required to have experience in all of these, but is required to have those needed to support applications they are responsible for supporting. Current skill set are reviewed every other year, new skills may be required to meet changing business needs.
* Skills:
* IMS, DB2, Oracle and Teradata Databases, Data Warehousing
* COBAL, Visual Basic, C C++, SAS
* Java/JavaScript Framework
* PEGA, CSS3, Mobile, JSON, Cognos, Hadoop, SQL, J2EE, HTML5/XML
* Project Management Tools:
* Waterfall
* Agile
* Certification in application areas such as:
* Java Developer
* DB2, Cogno, PEGA, Enterprise Architect(SCEA), Project Management
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Never
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$57,700.00
Pay Range Maximum:
$107,800.00
Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Auto-ApplySr. Knowledge Analyst - Contact Center Content Specialist (Remote)
Pittsburgh, PA jobs
Description & Requirements Maximus is looking for a dynamic Senior Knowledge Analyst to serve as the dedicated Contact Center Content Specialist (CCCS). In this pivotal role, you'll collaborate closely with government and internal teams to identify content gaps, drive improvements, and ensure that agents are equipped with clear, effective, and bilingual resources.
*Position is contingent upon contract award*
This is a fully remote role.
Must have the ability to pass a federal background check.
Remote Position Requirements:
- Hardwired internet (ethernet) connection
- Internet download speed of 25mbps and 5mbps (10 preferred) upload or higher required (you can test this by going to ******************
- Private work area and adequate power source
Essential Duties and Responsibilities:
- Build and maintain knowledge base in SharePoint.
- Build document management processes and procedures.
- Assess knowledge base needs, inaccuracies, gaps; work quickly to resolve and make content current.
- Work cross-functionally with internal teams for maximum efficiency and accuracy in documentation content.
- Create hierarchy and ownership structure to sustain knowledge management.
- Empower contributions from key stakeholders to improve the knowledge base.
- Design and implement work flows to manage documentation process.
- Establish standard templates for all documentation for the teams to utilize in document creation.
- Collaborate with and support the Implementation Team to tune and evolve our Knowledge Base.
- Create, promote and apply best practices for writing, style and content in Microsoft style.
- Create training material in support of the Knowledge management process.
- Improve search results by honing and maintaining the knowledge base taxonomy, labels list and ensuring symptoms and subject terms are present in each article.
- Utilize SharePoint knowledge for site management, list creation, workflow creation/modification and document management within SharePoint.
• Coordinate with client content teams, and the Senior Training Manager to identify and address content gaps specific to contact center operations.
• Serve as a bilingual subject matter expert (English and Spanish) for contact center content development.
• Support the creation and refinement of training materials for contact center agents.
• Draft monthly action and improvement reports with recommendations on knowledge content, quality, customer satisfaction, and training materials.
• Represent the contact center perspective in content-related discussions and decisions.
• Work extensively with business partners and SMEs to perform knowledge needs analysis, develop and update training and knowledge resources that meet staff and stakeholder needs and organizational quality standards.
• Manage and develop knowledge articles, chat quick text scripts and email templates.
• Conduct audits of knowledge articles and procedures to ensure accuracy and relevance.
• Identify emerging contact center trends and coordinate content updates to address urgent needs.
• Collaborate with client content teams to create, update, and review contact center-specific content.
• Serve as a subject matter expert for assigned customer agencies.
• Salesforce and SharePoint experience preferred.
• Call center knowledge and experience preferred.
Minimum Requirements
- Bachelor's degree with 5+ years of experience.
- Advanced degree or professional designation preferred.
- Develops solutions to a variety of complex problems.
- Work requires considerable judgment and initiative.
- Exerts some influence on the overall objectives and long-range goals of the organization.
• Developing website content experience
• Self-motivated and able to work independently
EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************.
Minimum Salary
$
65,000.00
Maximum Salary
$
85,200.00
Easy ApplyVice President-Federal Communications and Marketing (Hybrid Remote - McLean, VA / DC Area)
Philadelphia, PA jobs
Description & Requirements Maximus is seeking a dynamic and experienced Vice President-Federal Communications and Marketing to join our innovative team. The ideal candidate will bridge the gap between technology, business process services and marketing in the Federal Government sector. In this role, you will be responsible for Team Leadership and Change Management in a large organization. The VP-Federal Communications and Marketing will collaborate with cross-functional teams to drive Federal solutions and offerings. If you are a strategic thinker with a passion for technology services and marketing, and if you thrive in a dynamic and collaborative environment, we invite you to apply to the position at Maximus.
This is a hybrid position with the need to go into the office a minimum of 3 days per week and occasionally attend meetings and/or events in the Tyson Corners, VA/ Washington, DC area. This position requires some travel. The selected candidate must live in this geographical area.
Key Areas of Responsibility
- Identify, plan, develop, and oversee differentiated and impactful marketing strategies/materials.
- Developing new programs for customer engagement including integrated marketing programs from concept to execution
- Drive Maximus Federal solutions and offerings.
- Manage digital and social media strategies across the federal market
- Build, manage, and coach a high-performing marketing team.
- Direct and support market research collection, analysis, interpretation of market data for short- and long- term market forecasts and reports.
- Work closely with the growth leaders to align sales and marketing strategies
- Maintain brand standards and ensure compliance across all marketing and communications channels.
- Build long-term relationships with employees, clients, government officials, and stakeholders.
- Serve as a collaborative and senior leader on the Maximus Communication & Marketing Team, helping to align strategy and outcomes across the company.
- Drive the implementation of marketing campaigns that meet business objectives and drive customer engagement.
- Develop relationships with associations, academia and industry partners to drive thought leadership and brand elevation.
This role will develop and oversee the Maximus Federal segment marketing strategy. Responsibilities include building brand visibility in the Federal marketplace, driving customer and partner engagement to support growth goals. This position will be responsible for developing annual marketing plans building strategy, managing the cross functional team and budget and, leveraging partner relationships, driving go-to-market solutions.
Qualifications:
-15+ years of experience in a Federal Marketing and Industry Analysis position including 7+ years managing a team.
-Previous experience at a corporation focused on the Federal sector.
-Bachelor's degree in Marketing, Business, or a related field; technical background and digital marketing are a plus. Additional experience in lieu of degree will be considered.
-MA degree in Marketing, Communication, or similar relevant field, preferred.
-Outstanding communication, presentation, and leadership skills.
-In-depth knowledge of the Federal sector.
-Critical thinker with problem-solving skills.
-Strong interpersonal and communication skills.
Key Competencies include the following: Marketing and Communication Strategies, Team Leadership, Technical Expertise, Cross-Functional Collaboration, Content Development, Sales Enablement, Product and Solutions Positioning and Change Management
EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************.
Minimum Salary
$
216,155.00
Maximum Salary
$
292,455.00
Easy ApplyBilling Specialist 2 - Pittsburgh, PA Region
Coraopolis, PA jobs
Job DescriptionDescription:
If you're detail-oriented, passionate about accuracy, and thrive in a fast-paced environment, we want to hear from you!
Gateway Rehab Center (GRC) has an outstanding opportunity for a remote Billing Specialist 2 who will be responsible for the billing of patient services, performing follow-up on outstanding accounts receivable, processing refunds, patient denials and write-offs.
This position receives infrequent supervision and instruction from the Manager of Billing Services.
This is a remote position. You MUST live in the Pittsburgh, PA region!
Responsibilities
Processes, edits, audits and posts service entries into the EHR.
Generates clean claims, invoices and patient bills for services provided to all patients based on third party payer criteria.
Monitors and collects outstanding accounts receivable and performs investigation and follow-up on open balances.
Reviews Explanation of Benefits/Remittance Advices for correct payment, copays, deductibles and denials.
Tracks, analyzes, and reports monthly to director regarding composition of outstanding accounts receivable, determining collectability and internal and external issues concerning receipt of payment.
Participates in the monthly closings and provides data and analysis for all payers.
Communicates with the utilization review department regarding authorizations issues and inquires.
Completes necessary processes for adjustments, write-offs, charity care and refunds.
Contacts Patient Benefit Coordinators, outpatient administrative support staff, therapists, and insurance companies for problem resolution with funding sources or patient services.
Maintains interdepartmental reports for patient accounts and collections.
Communicate with third party Collection Management Company and patients concerning self-pay balances or billing issues.
Assists in the FY audits.
Communicates with the Medical Records department for applicable data required for patient appeals and denials.
Works on special projects as needed.
Attends mandatory Gateway training and in-services.
Knowledge, Skills, and Abilities
Understanding of healthcare billing practices
Familiarity with commercial insurance providers, including prior authorizations and claim submissions.
Knowledge of the full billing cycle, including charge entry, claims processing, payment posting, and collections.
Knowledge of basic accounting principles.
Understanding of patient privacy laws and healthcare compliance standards.
Requirements:
High School diploma or equivalent required.
At least three years of billing experience in a healthcare setting.
Other Requirements
Pass a PA Criminal Background Check
Obtain PA Child Abuse and FBI Fingerprinting Clearances
Pass Drug Screen
2-Step TB Test
Work Conditions
Favorable working conditions.
Work from home.
Minimal physical demands.
Significant mental demands include routine decision making, continuous attention to detail and high mental and visual concentration.
Accuracy is critical in this position as errors may result in serious loss of revenue and delay of payments.
GRC is an Equal Opportunity Employer committed to diversity, equity, inclusion, and belonging. We value diverse voices and lived experiences that strengthen our mission and impact.