Prior authorization specialist jobs near me

THIS IS NOT A REMOTE ROLE. YOU MUST RESIDE IN THE COLUMBUS AREA TO BE ON-SITE DAILY The Construction Scheduler will work with the Project Manager to create timetables to manage both time and resources to ensure work is completed on time. Job Duties and Responsibilities: The Scheduler will manage the workload distribution and monitor the customer delivery and job installation progress. The Scheduler will coordinate with Project Management and Leads/Superintendents to create and maintain calendar for project implementation to completion. The Scheduler will identify and anticipate schedule disparities and correct or report to Project Management. The Scheduler will provide to the Project Manager all needed elements to issue Weekly/Monthly Reports The Scheduler performs other responsibilities as assigned. Physical and Mental Requirements: MUST have 2+ years experience with Primavera P6 The Scheduler must be self-motivated, positive in approach, professional and lead others to create, develop and implement project process improvement(s). The Scheduler must promote the Company culture and mission to all employees, vendors, clients and business partners. The Scheduler must have proven problem solving skills, critical thinking skills and the ability to effectively read, write and give oral presentation(s). The Scheduler must have proven high skill level to interpret blueprints and other project documents, including but not limited to, specifications, reporting and quality requirements. The Scheduler must have the ability to learn Company project management systems. Education, Certification, License, and Skill Requirements: Must possess at least a High School diploma or GED equivalency. Must have a working knowledge of Oracle Primavera and Microsoft Project Must have experience in customer interface, such as liaison between the customer and the Company. Must have a minimum of three (3) years of experience scheduling in telecommunications or a related technical or construction field. Must be proficient with Microsoft Office (Word, Excel and MS Project). Must meet Company minimum driving standards. Must be able to manage multiple tasks/projects simultaneously.

About us: At Trovo Health, we're bringing scalable superhuman support to healthcare providers. Our proprietary, clinically-backed AI coordinator acts as an extension of the care team to help enhance the patient experience, improve outcomes, and operate more efficiently. The Trovo Services Team is a network of experienced professionals who use our platform to complete care coordination workflows for our healthcare provider customers. The Trovo Services Team is fully remote. We're growing rapidly and are backed by Oak HC/FT - investors in leading healthcare and technology companies such as Ambience Healthcare, Devoted Health, VillageMD, CareBridge, Main Street Health, Maven Clinic, and more. About the Role: As a Prior Authorization Specialist on the Trovo Services Team, you will be instrumental in enhancing the patient experience by securing essential insurance approvals for healthcare services using AI-enhanced workflows. You'll collaborate with clinical teams and external partners to ensure efficient, compliant processing of prior authorization requests. This role requires expertise in healthcare authorization processes (medical and prescription) and proactive communication skills. Responsibilities Coordinate and manage prior authorization requests for imaging, diagnostics, interventions, medications, and procedures. Liaise between providers, patients, and insurers to clarify requirements, resolve issues, and drive approval. Collaborate with clinical and operational teams to ensure all documentation meets insurance protocols. Monitor authorization statuses, proactively following up on pending cases and addressing denials or requests for additional information. Utilize Trovo Health's internal tools and technology to streamline workflows and maintain accurate, up-to-date records. Identify and escalate patterns or barriers in the authorization process, suggesting improvements to increase efficiency. Communicate outcomes and next steps to providers and patients clearly and compassionately Minimum Qualifications 2+ years of experience in prior authorizations, healthcare administration, or a related role in a healthcare provider setting. Direct experience supporting providers and other medical staff or managing authorizations, ideally in specialty care (e.g., cardiology, women's health, gastroenterology, ophthalmology, etc.) Solid understanding of healthcare insurance, medical billing, and prior authorization protocols. Proficiency in CPT, ICD‑9, and ICD‑10 coding. Skilled communication and problem-solving, with the ability to manage multiple tasks and priorities effectively. Comfortable working with EHR systems, prior authorization portals, and healthcare software. Strong Additional Qualifications Experience in a technology‑forward healthcare setting. Knowledge of AI applications in healthcare administration. Familiarity with specialty care (e.g., cardiology, urology, gastroenterology, etc.) Compensation & Schedule Competitive pay of $25/hr-$33/hr based on candidate experience. Full-time (40 hours per week) and part-time (20+ hours per week) opportunities available. Life with the Trovo Services Team Fully remote work environment Comprehensive onboarding, training, and technology support Generous health, vision, and dental insurance for eligible team members Paid time off A mission-driven culture committed to empowering clinicians and improving access to preventive care Trovo Health is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Company Lumicera About Us Lumicera - Lumicera Health Services Powered by Navitus - Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity. .______________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at ************************************ to be considered for internal opportunities. Pay Range USD $18.67 - USD $21.96 /Hr. STAR Bonus % (At Risk Maximum) 0.00 - Ineligible Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8 hr shift in between Remote Work Notification ATTENTION: Lumicera is unable to offer remote work to residents of Alaska, Connecticut, Delaware, Hawaii, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, Nebraska, New Hampshire, New Mexico, North Dakota,Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, and Wyoming. Overview Lumicera Health Services is seeking a Prior Authorization Specialist I to join our team! Under direction from the Supervisor, Specialty Pharmacy Services, and pharmacists in the Specialty Pharmacy, the Prior Authorization Specialist I is primarily responsible for obtaining information and assisting providers and insurance companies in triaging prior authorizations for patients of the specialty pharmacy. The Prior Authorization Specialist's main objective is to answer phone calls and contact the doctors and patients via fax or phone or other communication means to facilitate and document prior authorization approval. The Prior Authorization Specialist may also be responsible for ensuring that all pertinent patient information is contained within the record. Patient information shall include demographics, allergies, medication history, comorbidities, and payer information. This position will function with and assist any other area in the facility as needed with regard to prior authorization type duties. Is this you? Find out more below! Responsibilities How do I make an impact on my team? Responsible for answering the inbound calls from patients, prescribers, and other healthcare professionals Responsible for contacting doctors to obtain necessary information Responsible for managing the assigned workflow queues Responsible for accurate and thorough documentation of information and prescription order set up The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee Other duties as assigned Qualifications What our team expects from you? High school diploma or GED Some college preferred CPhT Preferred Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure Minimum two years pharmacy support experience or healthcare environment experience preferred Ability to work scheduled hours, shifts may vary based on department needs. Hours of operation are 8am to 7pm Monday thru Thursday and 8am to 6pm on Friday Participate in, adhere to, and support compliance program objectives The ability to consistently interact cooperatively and respectfully with other employees What can you expect from Navitus? Top of the industry benefits for Health, Dental, and Vision insurance 20 days paid time off 4 weeks paid parental leave 9 paid holidays 401K company match of up to 5% - No vesting requirement Adoption Assistance Program Flexible Spending Account Educational Assistance Plan and Professional Membership assistance Referral Bonus Program - up to $750! #LI-Remote Location : Address Remote Location : Country US

It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. Job Summary: The Prior Authorization Clinician is responsible for reviewing all proposed hospitalization, home care, and inpatient/outpatient services for medical necessity and efficiency to ensure members receive the appropriate and timely care to support members in achieving optimal health outcomes. Our Investment in You: Full-time remote work Competitive salaries Excellent benefits Key Functions/Responsibilities: Determines medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines applying evidenced-based InterQual criteria, Medical Policy and benefit determination. Performs utilization review activities, including pre-certification, concurrent and retrospective reviews according to guidelines. Determines medical necessity of each request by applying appropriate medical criteria to first level reviews and utilizing approved evidenced based guidelines / criteria Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care services. Reviews, documents, and communicates all utilization review activities and outcomes including, but not limited to, all inquiries made and received regarding case communication. Refers cases to Physician Reviewer when the treatment request does not meet medical necessity per guidelines, or when guidelines are not available. Referrals must be made in a timely manner, allowing the Physician Reviewer time to make appropriate contact with the requesting provider in accordance with departmental policy and within each Medicaid, ACA, CMS or NCQA mandated turnaround times (TAT). Demonstrates strong interpersonal and communication skills when conducting reviews, interacting with physicians and staff, and ensures compliance with training on related policies and procedures. Sends appropriate system-generated letters to provider and member Provides guidance and coaching to other utilization review nurses and participate in the orientation of newly hired utilization nurses Follows all departmental policies and workflows in end-to-end management of cases. Participates in team meetings, education, discussions, and related activities Maintains compliance with Federal, State and accreditation organizations. Identifies opportunities for improved communication or processes May participate in audit activities and meetings Documents rate negotiation accurately for proper claims adjudication Identify and refer potential cases to Care Management Performs all other related duties as assigned Qualifications: Education: Nursing degree or diploma required Preferred/Desirable: Bachelor's degree Medicare and Medicaid knowledge Experience: 2+ years prior authorization experience and evidence-based guidelines (InterQual Guidelines) Managed care experience All employees working remotely will be required to adhere to WellSense's Telecommuter Policy Licensure, Certification or Conditions of Employment: Active RN License in the state of NH, or a compact eligible state that includes NH Pre-employment background check Ability to take after hours call, including evening/nights/weekends Competencies, Skills, and Attributes: Strong oral and written communication skills. Strong clinical judgement and critical thinking skills to assess complex cases and determine appropriate levels of care. Excellent communication and interpersonal skills to engage effectively with internal and external stakeholders Ability to work independently in a remote environment while maintaining adherence to timeliness and regulatory requirements. Proficiency in Microsoft Office applications and data management systems. Demonstrated organizational and time management skills Strong analytical and clinical problem-solving abilities with focus on quality improvement initiatives Working Conditions and Physical Effort: Fully remote position with possible travel to the Charlestown, MA office for team meetings and training sessions. Fast paced and dynamic work environment requiring adaptability and focus. Minimal physical effort required; primarily desk-based tasks such as documentation and virtual meetings. Regular and reliable attendance is essential. Compensation Range $35.58 - $51.44 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing. Note: This range is based on Boston-area data, and is subject to modification based on geographic location. About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This work-from-home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care. Key Responsibilities Review prior authorization requests for accuracy, appropriateness, and clinical necessity. Apply plan criteria, evidence-based guidelines, and regulatory standards to determinations. Communicate approval/denial decisions clearly to providers and patients. Collaborate with physicians, nurses, and medical directors on complex cases. Document outcomes in compliance with health plan policies and CMS/state regulations. Support process improvements to streamline workflow and turnaround times. What You'll Bring Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree. Licensure: Active and unrestricted pharmacist license in the U.S. Experience: Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. Skills: Excellent clinical review, documentation, and communication skills. Why This Role? Flexibility: 100% remote work from home with flexible scheduling options. Impact: Directly influence patient access to safe and cost-effective medications. Growth: Build specialized skills in utilization management and managed care. Rewards: Competitive compensation, benefits, and career advancement opportunities. About Us We are a confidential healthcare partner working with health plans and PBMs across the U.S.. Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations. Apply Today Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity - and enjoy the benefits of working from home while shaping the future of managed care.

About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health™, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi , the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit **************** Position Summary: The QA Pharmacist will use their state regulatory knowledge to perform routine auditing and monitoring processes to ensure quality, accuracy, and regulatory compliance of coverage requests and appeals. The QA Pharmacist will utilize a strong comprehension of regulatory requirements to ensure success in annual reporting, program audits, and ad hoc audits. Position Responsibilities: Complete monthly utilization management and appeals performance and process audits in alignment with applicable regulations, accreditation standards, and best practices. Create and maintain progress reports and audit results in accordance with regulatory/accreditation requirements and internal processes. Present audit results to leadership in a timely manner to address issues and ensure adherence to departmental procedures and regulatory/accreditation requirements (CMS, URAC, NCQA). Continuously review and remain informed of all regulatory/accreditation requirements and updates impacting the coverage request and appeals processes. Respond to inquiries from internal and external stakeholders regarding quality assurance processes, audit results, and compliance policies and procedures. Work independently and with team members as warranted by audit assignment. Assist in designing and implementing audit tools and programs, creating QA scorecards and guides in collaboration with all department stakeholders. Provide ongoing performance feedback, to team leads to ensure consistent performance. Assist management in identifying, evaluating, and mitigating operational, and compliance risks. Work in collaboration with operational leaders to identify training opportunities and recommend improvements to Work Instructions, Job Aids, and Policy and Procedures to improve performance. Minimum Qualifications: Active, unrestricted, pharmacist license required 2+ years of state regulatory and audit utilization management experience at a PBM or health plan required Extensive knowledge of how to operationalize regulatory requirements Strong oral and written communication skills required Intermediate to advanced Microsoft Excel skills required Possess strong analytical skills, attention to detail, quantitative, and problem-solving abilities Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven work environment Ability to multi-task and collaborate in a team with shifting priorities Preferred Qualifications: Familiarity/experience with URAC and NCQA accreditation requirements Utilization management and/or appeals audit experience 3+ years of compliance or regulatory experience at a PBM or health plan This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. #LI-BC1 Salary Range$135,000-$145,000 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at *********************************************

Quadris Team, LLC - A Revenue Cycle Management Group, is searching for that dynamic person to join us, working with our highly skilled Authorizations Team to fill the role of Prior Authorization Specialist for General Surgery. We are a 100% remote team supporting our clients across the United States! See us at ******************** The ideal applicant will reside in Pacific Standard Time or Mountain Standard Time Job Focus: Responsible for obtaining prior authorizations for facility services based on assigned specialty or clinic area. This position will secure the prior authorization and notify the rendering party in the timeliest manner possible so patients can receive necessary care and services with the least delay. Responsible for answering patient calls, providing outgoing patient communication regarding financial obligations and authorization status. Responsible for patient estimation, benefit education, and payment processing. Primary/Essential Expectations For Success: Accurately, efficiently and timely work prior authorization requests-referrals Receive request for prior authorizations through the electronic health record (EHR) and/or via phone, email or fax and ensure that they are properly and closely tracked and monitored Process referrals and submit medical records to insurance carriers to expedite prior authorization processes Manage correspondence with insurance companies, physicians, specialists and patients as needed, including documenting in the EHR as appropriate Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed Review accuracy and completeness of information requested and ensure that all supporting documents are present Review denials and follow up with provider to obtain medically necessary information to submit an appeal of the denial Prioritize the incoming authorizations by level of urgency and date of service Secure patient information in accordance with client policy/procedures Other duties as assigned Monitors WQs, and resolves accounts in a timely manner Stay up to date on insurance company policies and procedures related to prior authorizations Physical/Mental Demands, Environment: Prolonged periods of sitting at a desk and working on a computer Must be able to lift 15 pounds at one time Must be able to structure your home office to ensure patient information is secure meeting the regulatory expectations Skills Needed to Be Successful: Maintains compliance with regulations and laws applicable to job Professional level of communication with video, phone, and email Ability to effectively prioritize the work to meet deadlines and expectations Meets the quality and productivity measures as outlined by Quadris Brings positive energy to work Uses critical thinking skills Being present and focused on assigned tasks and eliminates distractions Being a self-starter Ability to work independently and within a team atmosphere Core Talent Essentials: High School diploma or equivalent 1+ years of experience working in health care, medical billing, with a focus on prior authorization preferred PACS (Prior Authorization Certified Specialist) Certification preferred Knowledge of insurance process and medical terminology preferred Honors and sets high expectations for patient confidentiality and customer service in accordance with Quadris Team policies and procedures and HIPAA requirements Advanced level of industry standard electronic medical record content Must have professional level skills in MS products such as Excel, Word, Power Point. Proficient application of business/office standard processes and technical applications

Remote Sales Insurance Specialist Are you enthusiastic, self-motivated, and eager to learn? Do you thrive in a fast-paced environment and aren't afraid of hard work? If so, we want to hear from you! At Globe Life: The Gelb Group, we are dedicated to protecting the hardworking middle class. As a Virtual Sales Insurance Specialist, you'll embark on a structured 3-6 month training program designed to provide you with in-depth industry knowledge and hands-on experience. You'll gain valuable insights into our history, mission, and vision while developing the skills necessary to excel and grow within our company. What Youll Do: Master the daily operations of the business through hands-on training. Work directly with customers to tailor permanent benefits that meet their family's needs. Build and maintain strong relationships with organizations such as the Police Association, Nurses Association, Firefighters, Postal Workers, Labor Unions, and more. Develop essential skills in communication, leadership, organization, time management, networking, and team building. Learn business logistics and strategies to maximize earnings and profitability. What Were Looking For: Leadership experience is a plus, but not required. A strong willingness to learn and be coachable. Ability to accept and apply constructive feedback. Strong people skills and a great sense of humor! Highly organized and team-oriented. Company Perks & Benefits: Incentive Trips to destinations like Cabo, Tulum, Vegas, and Cancun. 100% Remote Work from anywhere! Weekly training calls to support professional growth. Performance-based weekly pay & bonuses. Health insurance reimbursement. Life insurance & retirement plan. If youre ready to take your career to the next level, apply today with your most up-to-date resume! Its not about where you startits about where you finish! Overview: American Income Life has been a leading provider of life and supplemental benefits for working families since 1951. We have established strong relationships with unions and associations across the United States. As the company grows rapidly, we are now offering remote positions to serve families across all time zones nationwide. This is an entry-level position with a potential annual income ranging from $60,000 to $80,000. Responsibilities: Assist clients by providing information about products and services Address client questions regarding their coverage Continuously develop and maintain an understanding of evolving products and services Regularly review client agreements to identify opportunities for cost-effective improvements Qualifications: Previous experience in customer service, sales, or a related field (not required) Ability to build rapport with clients Strong multitasking and organizational skills Positive, professional demeanor Excellent written and verbal communication skills What We're Looking For: A sharp individual with an entrepreneurial mindset A team player who thrives under pressure Someone with professional communication skills Benefits: Comprehensive hands-on training Weekly pay Performance-based bonuses Commission-based income Residual income opportunities Company-paid trips Remote work flexibility Compensation details: 55000-100000 Yearly Salary PI15d4c42057db-31181-38920149

Top Healthcare Provider Network The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors . This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties. This position is primarily remote, candidates must reside in the Tri-State area (New York, New Jersey, or Connecticut). Note: There may be occasional requirements to visit the New York or New Jersey office for training, meetings, and other business needs. Job Summary: The Authorization Specialist II is responsible for verifying insurance policy benefit information, and securing payer required authorizations. This position is responsible for obtaining accurate and timely pre-authorizations for professional services prior to the patient s visit, scheduled admission, or immediately following hospital admission. Prior authorizations may include, but are not limited to surgical procedures, outpatient treatments, medications and diagnostic testing (i.e. ultrasounds, labs, radiology, IV therapy, referrals) Job Responsibilities: Verifies insurance coverage via system tools, payer portals, etc. and update changes in billing system. Confirms provider s participation status with patient s insurance plan/network. Determines payer referral and authorization requirements for professional services. Contacts patient and PCP to secure payer required referral for planned services. Documents referral in practice management system. Researches system notes to obtain missing or corrected insurance or demographic information. Reviews clinical documentation to insure criteria for procedure meets insurance requirements. Initiates authorization and submits clinical documentation as requested by insurance companies. Follows through on pre-certifications until final approval is obtained. Communicates with surgical coordinators regarding authorizations status or denials. Submits appeals in the event of denial of prior authorizations or denial of payment following procedures. Set up peer to peer calls with clinical providers and insurance companies, as needed. Calculate and document patient out of pocket estimates and provide to patient. Assists Supervisor with special projects and/or tasks. Assists Authorization-Referrals Specialist I with complex cases or questions. Serves as back-up to Authorization-Referrals Specialist III. Performs other job duties as assigned. Please note: While this position is primarily remote, candidates must be in a Columbia University approved telework state. There may be occasional requirements to visit the office for meetings or other business needs. Travel and accommodation costs associated with these visits will be the employee's responsibility and not be reimbursed by the company. Job Qualifications: High school graduate or GED certificate is required. A minimum of 1-year experience in a physician s billing or third payer environment. Candidate must demonstrate the ability to understand and navigate managed care eligibility, insurance billing requirements, and obtaining pre-authorizations. Candidate must demonstrate strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations. Including the ability to diffuse complex situations in a calm and professional manner. Must demonstrate effective communication skills both verbally and written. Ability to multi-task, prioritize, document, and manage time effectively. Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.) Functional proficiency and comprehension of medical terminology. Experience in Epic and or other electronic billing systems is preferred. Knowledge of medical terminology, diagnosis and procedure coding is preferred. Previous experience in an academic healthcare setting is preferred. Hourly Rate Ranges: $23.69 - $32.00 Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education. 61st Street Service Corporation At 61 st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle. We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.

**Join our dynamic team as a frontline patient care representative who interacts with our patients to provide exceptional and compassionate patient care! The patient care representative may have the option to work remotely after an introductory training period. General Job Summary: Vital to the success of our organization with providing OrthoCincy patients and all other callers a premier Ortho experience while focusing on their individual needs. Essential Job Functions: Schedules appointments for patients either by phone when they call in, through the company website or when requested from the clinic via computerized message system. Uses computerized system to match physician/clinician availability with patients' preferences in terms of date and time. Ability to handle a high volume of incoming calls, while maintaining a high standard of productivity, efficiency and accuracy while working under pressure. Must be able to respond to various inquiries made by patients, hospitals, insurance companies, as well as other medical entities. Engaging in active listening with all callers, while acting as a contact point person between patients, providers and staff. Maintains scheduling system so records are accurate and complete and can be used to analyze patient/staffing patterns. Updates physicians/clinicians or medical assistants. Ensures that updates (e.g. cancellations or additions) are input daily into master schedule. Send requests to clinic for prescription refills and follow up with patients on messages from clinic via computerized message system. Establish and maintain effective working relationships with patients, providers, co-workers, and the public. Maintaining a calm, pleasant and compassionate tone while being able to diffuse tense situations. Follows HIPAA regulations. Perform other duties necessary or in the best interest of the department/organization. Requirements Education/Experience: High school diploma. Minimum one year experience in a medical practice and/or position encouraged. Experience in a high volume call center a plus. Other Requirements: Schedules will change as department needs change. Performance Requirements: Knowledge: Knowledge of OrthoCincy's Mission, Vision and Values. Knowledge of medical practice protocols related to scheduling appointments. Knowledge of anatomy and medical terminology. Knowledge of computerized scheduling systems. Knowledge of customer service principles and techniques. Knowledge of OSHA and safety standards. Skills: Skill in communicating effectively with providers, employees, customers and patients. Skill in maintaining appointment schedule via computerized means. Effective in critical thinking skills. Strong communication skills in a professional manner during stressful and sensitive situations with patients of all ages. Abilities: Ability to multi-task effectively Ability to communicate calmly and clearly Ability to analyze situations and respond appropriately. Ability to alternate between multiple computer systems in a timely manner. Equipment Operated: Standard office equipment. Work Environment: Standard call center workstation. Mental/Physical Requirements: Involves sitting and viewing a computer monitor 90% of the work day. Must be able to remain focused and attentive without distractions (i.e. personal devices).

Citadel CPM is a California corporation, headquartered in Pasadena with offices in Fullerton, Long Beach, Riverside, and Sacramento, as well as Phoenix, Arizona. Citadel CPM was established in 2006 to provide professional construction project management services to Federal, State, and municipal agencies in the justice, corrections, education, healthcare, infrastructure, and military market sectors. ABOUT THE TEAM Our team is dedicated to making our clients' vision a reality while delivering projects on budget, schedule, scope, and quality expectations. Our team is committed to resolving issues in a professional and collaborative manner with integrity always foremost in mind. We are proud to know that Citadel CPM is regarded as a team of reputable professionals that clients seek out to help them manage their construction projects, and that industry professionals aspire to join. Citadel's reputation has been built on a set of three principles that form our core values: Integrity, Professionalism, and Responsiveness. ABOUT THE ROLE Citadel CPM is looking for an Owners Authorized Representative (OAR) I and II with minimum of 10 -15 years of experience in construction and/or a combination of Project and Construction Management of Commercial and/or Public/Educational Facility Construction to oversee all phases of assigned projects, including pre-construction, bid and award, construction, and close-out. Responsibilities include coordinating with public agencies, managing budgets and schedules, reviewing contractor activities, negotiating change orders, and ensuring compliance with regulations. Additionally, the role involves administering agreements, coordinating deliveries, and managing the project close-out process. ABOUT YOU You are an OAR construction professional with minimum of 10 -15 years of experience in construction and/or a combination of Project and Construction Management of Commercial and/or Public/Educational Facility Construction. Five (5) of the fifteen (15) years should have full responsibility for coordinating complex projects with construction values exceeding $10M and $20M. BASIC QUALIFICATIONS Manages, oversees, and coordinates all facets of the pre-construction, bid and award, construction, and close-out phase of all assigned projects. Reviews pre-construction documents and submits comments to Designer as necessary. Plans, organizes, and prepares reports to upper management with respect to the status and/or progress of the projects. Coordinates with all stakeholders and pertinent public agencies during pre-construction and construction to comply with all off-site work; coordinates with various client and Project staff. Manages both the project budget and schedule to meet the client's qualitative standards; monitors project budget on a monthly basis and ensures that the budget accurately reflects the project status/progress. Manages daily activities of the contractor, reviews contractor's construction schedules and submittals, and coordinates responses to the contractor's inquiries through Requests for Clarifications (RFC) and other related documents. Reviews substitution submittals from contractors to ensure compliance with specifications and/or client's requirements. Receives, reviews, and negotiates Contractor Change Order Proposal(s) to achieve a fair & reasonable price in accordance with the General Conditions; reviews and addresses any and all Schedule impacts in accordance with the project specifications in a timely manner. Reviews invoices and monitors payments for the contractor, architects, engineers, and any other pertinent parties. Administers provisions of Professional Service Agreements between Architects and the client. Coordinates delivery of related fixtures, furniture, and equipment (FF+E). Monitors and manages project close-out with respect to project certification with the Division of State Architects (DSA) and project financial close-out. Performs other related duties as assigned. REQUIRED QUALIFICATIONS 10 - 15 years full time paid professional experience in construction and/or a combination of Project and Construction Management of Commercial and/or Public/Education Facility Construction. 5 years of full responsibility in coordinating complex projects with construction values in excess of $10M and/or $20M. Design-Build experience. Experience utilizing Building Information Modeling (BIM). Experience with Leadership in Energy and Environmental Design (LEED) certified projects and/or the Collaborative for High Performing Schools (CHPS). Experience with Division of the State Architect (DSA) design/construction processes. Safety and OSHA Safety Regulations (OSHA 30 minimum) EDUCATION REQUIREMENTS You must have one of the following: Graduation from a recognized college or university with a bachelor's degree in Architecture, Engineering, or Construction Management. Graduation from a recognized college or university with a bachelor's degree. Candidate must be able to complete the Certified Construction Manager (CCM) credential within one (1) year of employment in the Facilities Services. College undergraduate but possess more than 20 years of Construction or Project Management experience and must complete the Certified Construction Manager (CCM) credential within one (1) year of employment in the Facilities Services Division. Possession of a valid Certified Construction Manager (CCM) credential which may substitute for the required education. PREFERRED LICENSES AND CERTIFICATES A valid Certificate of Registration as an Architect by the California Architectural Board or Professional Engineer by the State Board for Professional Engineers and Land Surveyors A valid Construction Manager (CCM) credential by the Construction Manager Certification Institute (CMCI) Citadel is committed to a diverse and inclusive workplace environment. Citadel is an equal opportunity employer and does not discriminate based on race, natural origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status. To request an interview accommodation please send an email to ************************* In compliance with the local law, we are disclosing compensation, or a range therefore for location where legally required. Actual salaries will vary based on several factors, including but not limited to external market data, internal equity, location, licenses, skill set, experience and/or performance. Base pay is only one component of Citadel's total compensation packages for employees. Pay range for the OAR I is $155,000 - $180,000 salary per year. Pay range for the OAR II is $170,000 - $195,000 salary per year. Featured Benefits Medical Insurance Vision Insurance Dental Insurance 401K Life and Long-Term Disability Insurances Paid Time Off (PTO) for personal time, sick days, and holidays Professional Development Reimbursement

The Tsui Group is seeking a candidate who is qualified and experienced in educational facility construction projects to serve as an Owner Authorized Representative I for a large educational client within Los Angeles County with the below duties: Manages, oversees and coordinates all facets of the pre-construction, bid and award, construction and close-out phase of all assigned projects Reviews pre-construction documents and submits comments to Designer as necessary Plans, organizes, and prepares reports to upper management with respect to the status and/or progress of the projects Coordinates with all pertinent public agencies during pre-construction and construction to comply with all off-site work; coordinates with various District and Project staff Manages both the project budget and schedule to meet the District's qualitative standards; monitors project budget on a monthly basis and ensures that the budget accurately reflects the project status/progress Manages daily activities of the contractor, reviews contractors' construction schedules and submittals, and coordinates responses to the contractors' inquiries thru the Requests for Clarifications (RFC) and other related documents Reviews substitution submittals from contractors to ensure specification and/or District requirements are complied with Receives, reviews, and negotiates Contractor Change Order Proposal(s) to achieve a fair & reasonable price in accordance with the General Conditions; reviews and addresses any and all Schedule impacts in accordance with the project specifications in a timely manner Reviews the process and monitors payments for the contractor, architects, engineers and any other pertinent parties Administers provisions of Professional Service Agreements between Architects and the District Coordinates District delivery of related fixtures, furniture and equipment Monitors and manages project close-out with respect to project certification with the Division of State Architects (DSA) and project financial close out Perform other related duties as assigned Requirements Required Experience: Minimum of 10 years full time paid professional experience in Construction and/or a combination of Project and Construction Management of Commercial and/or Public/Educational Facility Construction. Minimum of 3 years of experience with full responsibility for coordinating complex projects with construction values in excess of $10M. Additional Preferred Experience: Design Build Experience Experience utilizing Building Information Modeling (BIM) Experience with Leadership in Energy and Environmental Design (LEED) certified projects and/or the Collaborative for High Performing Schools (CHPS) Experience with Division of the State Architect (DSA) construction/design processes Safety and OSHA Safety Regulations (OSHA 30 minimum) Required Education: There are 3 ways to meet the education requirement: Graduation from a recognized college or university with a bachelor's degree in Architecture, Engineering, or Construction Management OR Graduation from a recognized college or university with a bachelor's degree. Candidate must be able to complete the Certified Construction Manager (CCM) credential within one (1) year of employment in the Facilities Services Division of the Los Angeles Unified School District. OR Possession of a valid Certified Construction Manager (CCM) credential which may substitute for the required education Preferred Licenses and Certificates: A valid Certificate of Registration as an Architect by the California Architectural Board or Professional Engineer by the State Board for Professional Engineers and Land Surveyors A valid Construction Manager (CCM) credential by the Construction Manager Certification Institute (CMCI) Benefits Salary Range: $146,000-$151,000 Medical, Vision, & Dental - 100% covered for the employee* Life and Disability Insurance 10.5 days of Vacation pay (Accrued) 6 days of Sick pay (Available Immediately) 13 days of Holiday pay 3% Employer Contribution 401k (After 1 year of service) Monthly Stipend for Cell Phone Laptop for work purposes

Functions as a liaison between patients and health care providers or agencies in assisting, organizing, coordinating, and providing Outreach and Enrollment Assistance to the uninsured which includes what's available in the Marketplace and Medicaid Expansion. Interpreting a foreign language into English and English into a foreign language to facilitate the health care service (if applicable). Reports to : Operations Supervisor Supervises : No Dress Requirement : Business casual or scrubs in accordance with Heart of Ohio Family Health Center's dress code policy Work Schedule : F/T Monday through Friday during standard business hours but will include some evenings and weekends as well. Times are subject to change due to business necessity Non-Exempt Job Duties : Essentials considered to the successful performance of this position: Collects and evaluates information about a patient regarding opportunities to assist in achieving patient/family healthcare coverage needs Conduct public education activities to raise awareness about Ohio's Healthcare Marketplace, health insurance coverage options, and Medicaid Expansion Contact and secure community presentation locations and recruitment of participants Provide information in a fair, accurate and impartial manner that is culturally appropriate Educates patient's regarding what is offered based on the needs of the patient Researches, and informs and patients about the health care options available Accurately and ethically interprets spoken foreign languages into English and English into a foreign language (if applicable) Accurately translates written foreign languages into English and English into a foreign language, as assigned (if applicable) Accurately, clearly and efficiently documents actions taken and activities performed Other related duties as assigned Job Qualifications (Experience, Knowledge, Skills and Abilities) Willingness to work with all cultural and socioeconomic groups without judgment or bias Demonstrates ability to cooperatively work/mediate with all age groups and family groups Compliance with the HIPAA law and regulation; ability to confidentially retain information, passing only necessary information to those needed to perform their duty Demonstrated ability to accurately and clearly translate, verbal and written, a foreign language into English and English into a foreign language Ability to work with minimal supervision and exercise sound independent judgment Strong verbal and written communication skills Preferred holder of interpreting certificate (if applicable) Some experience in community relations/education and public presentation preferred Experience in or with community healthcare a plus Must be able to work independently as well as with a team Reliable transportation a must Demonstrates competency in working sensitively and respectfully with people of various cultures and social status Knowledge of federal, state and local laws and regulations about health care. Ability to communicate (orally and in writing) in a professional manner Ability to maintain an established work schedule to ensure dependability and accuracy of work quality Equipment Operated : Telephone & Fax Computer & Printer Scanner Calculator Other office and medical equipment as assigned Facility Environment : Heart of Ohio Family Health operates in multiple locations, in the Columbus, OH area. All facilities have a medical office environment with front-desk reception area, separate patient examination rooms, nursing stations, pharmacy stock room, business offices, hallways and private toilet facilities. All clinical facilities are ADA compliant. Physical Demands and Requirements : these may be modified to accurately perform the essential functions of the position: Mobility = ability to easily move without assistance Bending = occasional bending from the waist and knees Reaching = occasional reaching no higher than normal arm stretch Lifting/Carry = ability to lift and carry a normal stack of documents and/or files Pushing/Pulling = ability to push or pull a normal office environment Dexterity = ability to handle and/or grasp, use a keyboard, calculator, and other office equipment accurately and quickly Hearing = ability to accurately hear and react to the normal tone of a person's voice Visual = ability to safely and accurately see and react to factors and objects in a normal setting Speaking = ability to pronounce words clearly to be understood by another individual

Job DescriptionDescription: Patient Care Representative - ARM Team Hybrid/Remote Join a Best Places to Work Winner - 18 Years Running! Do you have experience with medical systems and a passion for helping others? Looking for full-time work with a company known for its award-winning culture? KeyBridge Medical Revenue Care is seeking a compassionate, detail-oriented Patient Care Representative to join our ARM team. About KeyBridge At KeyBridge, we believe exceptional patient care starts with supporting exceptional people. As an 18-time Best Places to Work winner, we're committed to compassion, integrity, and excellence. Our mission is simple: bridge the gap between healthcare providers and their patients by delivering respectful, empathetic financial care in a call-center environment. Position Overview As an ARM Patient Care Representative, you'll serve as the trusted voice of our healthcare clients-guiding patients through billing questions, assisting with payments, and helping resolve account balances. This role is the perfect blend of customer service, problem-solving, and meaningful human connection. What You'll Do Deliver exceptional service: Manage inbound and outbound calls with professionalism and empathy, assisting patients with billing questions, payment options, and account concerns. Resolve issues efficiently: Apply strong problem-solving and analytical skills to provide accurate, timely solutions while maintaining compliance and meeting performance standards. Navigate multiple systems: Work across various medical and internal systems to locate information and support patients with complex inquiries. Collaborate & communicate: Maintain clear, thorough documentation of all interactions, support team members, and help mentor new representatives when needed. Live our values: Foster trust, teamwork, and integrity with patients, clients, and colleagues every day. Requirements: What We're Looking For: Strong written and verbal communication skills, with excellent active listening Ability to multitask and work efficiently across multiple systems Experience using medical systems (billing systems such as Epic, Cerner, etc.) Proficiency with Microsoft Office (Outlook, Teams) Positive, professional attitude with a drive to succeed Ability to understand and follow written, oral, and visual instructions Prior remote-work experience Ability to pass ACA certification tests when eligible Spanish-speaking skills a plus

Patient Registration Specialist Hospital Registration and Check In - Remote, work from home Who We Are vRS Corporation provides virtual registration services to hospitals and clinics. In a time of shortage of staffing, changing work environments and a desire for work from home jobs, vRS has developed a system that allows medical providers to staff their registration areas through technology and onsite Virtual Interactive and Engagement Workstaions (V.I.E.W.) TM that connect to virtual registration agents working from home. Through video technology we are able to do everything an onsite in person registration specialist would be able to do. Job Summary The Patient Registration Specialist is responsible for assisting patients during the on-site registration and arrival process for scheduled and unscheduled visits as well as completing financial clearance functions. This individual completes the registration for visits by collecting accurate demographic information, insurance information, and collecting patient liability (if known) at the time of service. This individual is also responsible for financial clearance functions on assigned scheduled accounts during registration downtimes. The Patient Registration Specialist greets and serves patients and internal team members in a professional, friendly, and respectful manner to promote positive encounters. What We'll Love About You Excellent verbal and written communication skills. Excellent interpersonal and customer service skills. Excellent organizational skills and attention to detail. Education Required: High school diploma or equivalent Experience Preferred: At least 1-2 years prior registration experience Functional computer skills and comfort using different programs long with computer navigation combined with excellent typing skills. Ability to multi-task in a fast-paced environment Ability to work with a large number of people/calls daily and covering urgent requests Ability to maintain strict confidentiality Licensure/Certification/Registration CHAA preferred Why Work Here Competitive pay & Full Time 40 hours/week PTO and sick time after 90 days Individual Coverage Healthcare Reimbursement Arrangement (ICHRA) Healthcare reimbursement program for medical insurance 401k plan Company-sponsored life insurance with supplemental buy up options Great co-workers Remote Work Technical Requirements Minimum internet bandwidth requirements - Minimum requirements assume that the entire bandwidth will be available and used for the individual working from home. If other users are using the bandwidth, it is the individual's responsibility to ensure these minimum requirements are met for their work use. 25 Mbps download speed 5 Mbps upload speed Use ***************************** to test speed RTT (round trip time) 100ms or less to “AWS Workspaces US East (N. Virginia)” Please use ************************************************ to test you RTT Must be able to hardline into your home router. No Wi-Fi connections. If connection distance is more that 12 feet away from home router and network cable, it will need to be special ordered and we will need to know the specific length. Internet Service Provider (ISP) must be through Coax, DSL, or Fiber connections. No Satellite or wireless via cell phone providers is permitted. Willing to install necessary authenticator application for multi-factor authentication on your smartphone including Microsoft Authenticator App and Imprivata ID App as well as any others needed based on client access requirements. Will be required to be on camera for your shift Remote Work Physical Space Requirements Employees working remotely are required to maintain a space that is a closed space where people other than the employee will not be accessing the space during working hours and otherwise within the household cannot hear conversations going on between the employee and clients or patients. The employee can not have children or other family members present during work and will need to be able to focus on work 100%. No PHI or HIPAA data may be printed or written down in home locations. Employees need to utilize electronic resources and system to contain PHI and HIPAA data for security and compliance. Company-provided computers and equipment may not be used by anyone other than the employee and will need to be secured in a way where others do not have access to the equipment, preferably in a locked office. Employees need to have a quiet, secure work space that is free from outside noise and distractions while working in order to be able to focus on work and maintain confidentiality. We are always looking for great people to join our team. If you are passionate about customer service, enjoy working with a fantastic team, and are motivated to make a difference in patients' lives every day, then apply today with vRS! *******************************************

As an Authorization Specialist II, you will help ensure patients receive timely access to therapy by overseeing prior authorization workflows, supporting clinical partners, and guiding team members through consistent, high‑quality processes. You will play a key role in improving efficiency, enhancing service delivery, and supporting a compassionate, patient‑focused care experience. Responsibilities Oversee authorization processes, including formulary exceptions and renewal timelines, ensuring accuracy and compliance. Direct daily workflow for authorization specialists, aligning operations with patient needs and departmental priorities. Develop work schedules, lead staff meetings, and communicate updates regarding internal processes and contracts. Support recruitment, onboarding, training, and competency development to maintain a skilled team. Monitor team performance, provide feedback, and recommend corrective action when needed. Ensure productivity, regulatory compliance, and accreditation standards are consistently met. Serve as a resource for team members, helping troubleshoot authorization issues and operational challenges. Collaborate on identifying process efficiencies and presenting improvement ideas to leadership. Perform responsibilities according to organizational competencies and behaviors. Complete additional duties as assigned to support operational excellence. Required Qualifications High school diploma or GED. Minimum 2 years of experience in pharmacy claims, pharmacy technician support, or related healthcare roles. Knowledge of medical terminology and coordination of benefits. Proficient computer and Microsoft Office skills. Strong customer service orientation and ability to maintain confidentiality. Preferred Qualifications Experience with payer websites and authorization requirements. Familiarity with pharmacy payer systems and workflows. Ability to work independently with minimal supervision. Strong organizational, communication, and time‑management skills. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an hourly rate of 19 - 29 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. Performs a variety of administrative and clerical duties to manage patient registration and patient financial obligation. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. High school graduate or equivalent. 2. State criminal background check and Federal (if applicable), as required for regulated areas. CORE JOB DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing and scans insurance cards & photo identification. Provides to the patient, information concerning insurance, payment of bills and hospital procedures. 2. May complete managed care responsibilities in regard to obtaining pre-certification and authorizations. 3. Prepares WVU Medicine standard consent form, notice of privacy practice and/or other necessary paperwork related to registration and presents to patient/family/legal guardian for signatures. Obtains electronic signature for consent to treat and patient financial obligations. 4. Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems. 5. Prepares armband for patient identification. 6. Balances daily receipts and cash drawer for patient payments as needed. Follows up on accounts as indicated by system flags (courtesy dismissal/comments/red stickers). 7. May initiate various screenings and obtains all pertinent information for coverage and completes appropriate paperwork. 8. Performs medical necessity checks and completes Advanced Beneficiary Notice as needed. 9. Schedules, reschedules, or cancels patients in accordance with hospital workflows. 10. Checks for order completeness and validate order against scheduled service. PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, and grasping. 2. Visual acuity must be within normal range. 3. Manual dexterity to operate keyboards, fax machines, telephones, and other business equipment. 4. Sitting and/or standing for extended periods of time. 5. Reading and comprehension ability. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. High volume, fast paced environment. 2. Exposure to communicable disease. 3. Frequent interactions with patients, medical staff, and support staff daily on a continual basis. SKILLS AND ABILITIES: 1. Ability to accurately utilize applicable computer software and equipment for access processing & demonstrates ability to follow down time procedures. 2. Demonstrate knowledge of procedure to report and/or document unsafe/hazardous conditions, incidents and defective equipment in compliance with hospital policy. 3. Requires considerable attention to detail, the ability to be organized and to be able to perform multiple tasks simultaneously. 4. Requires the ability to memorize a considerable amount of information, and to be able to reference information not retained from written sources or from appropriate personnel. 5. Requires the ability to understand medical insurance requirements for payment and basic knowledge of covered services. 6. Excellent written and verbal communication skills and the ability to understand written and verbal communication. 7. Basic knowledge of medical terminology. Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: SYSTEM West Virginia University Health System Cost Center: 535 SYSTEM Centralized Clearance Center

Who we are: Access TeleCare is the largest national provider of telemedicine technology and solutions to hospitals and health systems. The Access TeleCare technology platform, Telemed IQ, enables life-saving patient care through telemedicine and empowers healthcare organizations to build telemedicine programs in any clinical specialty. We provide healthcare teams with industry-leading solutions that drive improved clinical care, patient outcomes, and organizational health. We are proud to be the first provider of acute clinical telemedicine services to earn The Joint Commission's Gold Seal of Approval and has maintained that accreditation every year since inception. We love what we do and if you want to know more about our vision, mission and values go to accesstelecare.com to check us out. What you'll be responsible for: We are seeking an experienced and detail-oriented Patient Registration Specialist. The Patient Registration Specialist will support the team by accurately capturing patient demographic data and insurance coverage details to ensure correct insurance billing. This role requires a strong understanding of healthcare eligibility processes and insurance verification protocols throughout the assignment. What you'll work on: * Perform comprehensive patient registration, including obtaining accurate demographic and insurance information from multiple Electronic Medical Record (EMR) systems and entering this info into Access TeleCare's billing system * Verify insurance eligibility and coverage benefits using payer portals, phone calls, and real-time eligibility tools * Identify and resolve issues related to insurance eligibility, including coordination of benefits and out-of-network policies * Escalate complex coverage or registration issues to management or the billing department as needed * Maintain compliance with HIPAA and all regulatory guidelines regarding patient data and insurance handling * Other duties as assigned What you'll bring to Access TeleCare: * High school diploma required * A minimum of 1-2 years' experience in Revenue Cycle, Registration and Medical Billing * Solid understanding of registration and billing * Knowledge of medical terminology, anatomy, and physiology * Must also have a focus on regulatory and billing requirements * Ability to maintain confidentiality * Strong communications skills (written and oral) as well as demonstrate the ability to work effectively across departments * Demonstrated proficiency with Microsoft office programs (Excel, Word, and PowerPoint) communication, and collaboration tools in various operating systems * Ability to work effectively under deadlines and self-manage multiple projects simultaneously * Strong analytical, organizational, and time management skills * Flexibility, detail-oriented, and adaptability in a fast-paced environment * Ability to thrive in a high growth, fast-paced organization and 100% Remote based environment * Must be able to remain in a stationary position 50% of the time About our recruitment process: We don't expect a perfect fit for every requirement we've outlined. If you can see yourself contributing to the team, we would like to speak with you. You can expect up to 2 interviews via Zoom. Access TeleCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration without regard to race, age, religion, color, marital status, national origin, gender, gender identity or expression, sexual orientation, disability, or veteran status.

Registration Specialist Registration Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare organization, passionately dedicated to improving the health and well-being of our community. With a history dating back to 1898, LMHS remains a cornerstone of healthcare excellence, catering to the evolving needs of Licking County. Our cutting-edge facility provides a comprehensive spectrum of patient care services, from life-saving emergency medicine to the comforting embrace of home healthcare, with a unique range of specialized medical services, including cancer, heart health, maternity, and mental wellness. When you join the LMHS team, you become a vital part of your local community Hospital. Working at LMHS is not just a job, it is a unique opportunity to directly impact the health and well-being of your friends, family, and neighbors. You will be providing care in a place in which you are personally connected, where the impact of your work extends beyond the Hospital doors and into the heart of our community. Our commitment to diversity, equity, and inclusion ensures that every member of our community is served with respect and compassion. Join us in our mission - dedicated to patient safety, utilizing state-of-the-art technology, and with a passionate team of highly trained and compassionate individuals who strive to improve the health of the community. Position Summary According to established policies and procedures, schedules outpatients for all ancillary services, and obtain precertification information on all inpatients and outpatients. Performs various other clerical and record keeping tasks related to registration, scheduling, precertification, and preadmission testing. Responsibilities Prepares demographic, medical and insurance information by direct interview of patients and/or families; enters all necessary information into computer records; prioritizes according to urgency status so that service to the patient is not delayed unnecessarily; prepares complete and accurate forms and other various materials for pre-registration or registration of all inpatients and outpatients. Maintains the confidentiality of information acquired through the performance of job duties. Greets customers in a timely and courteous manner, presenting a positive, professional appearance and attitude and demonstrating excellent interpersonal skills. Maintains work area in a professional and efficient manner, keeping supplies and equipment in an orderly, clean and safe condition. Performs quality improvement studies and serves on project teams, as needed, representing the department and LMH as a cooperative and contributing team member. Accurately schedules all outpatients requiring tests or procedures in the ancillary departments from verbal or written orders of physicians or their staff using established procedures and minimizing the number of visits each patient is required to make. Has minimal indirect responsibility for the welfare of others by coordinating all tests and preps, ensuring that complex preps do not interfere with other tests scheduled for the patient, and advising patients and physicians' staff regarding proper prep for each test and the time that the patient will be required to report to the Hospital. Contacts various departments regularly to gather information regarding changes to be made in the computerized daily appointment schedules. Receives bookings from physician offices for future admissions and outpatient surgeries, advising them of current insurance requirements, such as precertification. Ensures that prior authorization for service is obtained according to established Hospital policy. If necessary, notifies admitting physician and/or patient when insurance company refuses admission authorization. Notifies insurance companies and third-party payers of admissions and outpatient surgeries the next working day following registration and reports authorized days via computer system to Patient Accounting. Review future elective admissions and outpatient surgeries for benefits and precertification requirements, reporting all required information to the appropriate Hospital department. Responsible for ensuring that personal performance reflects the LMHS Mission, Vision, Standards of Behavior and Service Goals. Practices acceptable universal precautions and isolation techniques. Requirements Work requires a high school level of knowledge to be able to read, write, perform simple arithmetic calculations and deal effectively with people. Basic analytical ability is required to gather and interpret data in situations where the problems are not difficult or complex. Work requires familiarity with the variety of tests ordered for each patient, including preps required, and familiarity with various forms, insurance requirements, medical terminology, Meditech computer operation and departmental procedures, generally acquired through six months experience. Must have exceptional interpersonal skills to deal effectively with internal and external customers. Must have aptitude and ability to prioritize and organize work effectively, using discretion, initiative, and independent judgement to follow through with assignments. Work requires the ability to meet deadlines and to concentrate and pay attention to details. Must be able to maintain flexibility by accepting and adjusting to rapid change. In the absence of the department manager, may coordinate departmental activities. Minimum requirement, high school diploma or GED. Licking Memorial Health Systems is an equal opportunity employer and maintains compliance with all state, federal, and local regulations. Licking Memorial Health Systems does not discriminate against applicants because of race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors protected by law.