Provider Relations Specialist remote jobs

🚀 Hiring: Service Assurance Specialist 📍 Preferred Locations: Atlanta, GA | Dallas, TX | Tampa, FL | Bridgeton, MO 🕒 Contract Role | Mostly Remote (Post-Training) *** Initial training will be three weeks of Monday - Friday 08:00 - 17:00 ET / 07:00 - 16:00 CT Job will be Night Shift We're seeking a Service Assurance Specialist to monitor service quality, troubleshoot network issues, and ensure reliable system performance. Key Requirements: Bachelor's in IT, Computer Engineering, or related field 3+ years in service assurance or network operations Strong analytical & troubleshooting skills Experience with service monitoring tools and KPIs Excellent communication skills Nice to Have: Networking fundamentals, UNIX/Linux, OSI model, TL1

Job Details: Job Title: Customer Services Specialist II Work from home: Monday & Friday Onsite: Tuesday, Wednesday & Thursday Duration: 6 Months Summary: Reviews analyzes, evaluates, validates provider/producer information against business/credentialing requirements and maintains information on Credentialing databases. Supports extensive research and analysis of sensitive provider/producer issues; addresses data integrity issues. Process agent onboarding contracts. Verify insurance licenses, add appointments. Work with agents to ensure records are complete and validated. Utilize various systems and websites to ensure accuracy. Job Responsibility Reviews analyzes, evaluates, validates provider/producer information against business/credentialing requirements and maintains information on Credentialing databases. Supports extensive research and analysis of sensitive provider/producer issues; addresses data integrity issues. Process agent onboarding contracts. Verify insurance licenses, add appointments. Work with agents to ensure records are complete and validated. Utilize various systems and websites to ensure accuracy. Required Qualifications High School Diploma or GED (required) 1-3 years of customer service experience Insurance industry knowledge (preferred) Strong attention to detail and quality standards Excellent organizational skills with the ability to prioritize and manage multiple tasks Strong analytical and research skills Ability to work independently with minimal supervision Excellent verbal and written communication skills (emails, memos, letters) Ability to handle confidential information reliably and tactfully Proficiency with Microsoft Office applications (Word, Excel, Access) and internet-based tools Ability to build and maintain effective working relationships with internal teams and external partners Education Master's Degree level Family Nurse Practitioner program with current National Board Certification and State of Employment license to practice in the Advanced Practice Nurse role. About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit ************************ US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Recruiter Details: Name:- Pihul Kumar Raj Email:- **************************** Internal Id #- 25-55013

About the Company We are looking for a Security Solutions Specialist I to support the planning, configuration, documentation, and coordination of security system installations for our clients. This role is responsible for system programming, workflow oversight, customer communication, and technical documentation, and requires independent judgment and the ability to manage multiple priorities in a remote-work environment. About the Role We are looking for a Security Solutions Specialist I to support the planning, configuration, documentation, and coordination of security system installations for our clients. This role is responsible for system programming, workflow oversight, customer communication, and technical documentation, and requires independent judgment and the ability to manage multiple priorities in a remote-work environment. Responsibilities Develop project installation plans, equipment lists, and configuration documentation. Coordinate schedules, programming requirements, material needs, and installation workflows. Prepare system configuration files, naming conventions, credential programming, and database updates. Review engineered drawings, perform red-line updates, and maintain accurate as-built documentation. Create and maintain client-specific documentation, user guides, and maintenance records. Conduct system testing protocols and prepare written test reports. Communicate progress, risks, and recommendations to project managers and clients. Track job status and prepare weekly project status updates. Serve as a customer point of contact for configuration, access rights, and programming support. Review system performance and recommend improvements. Qualifications A.S. or A.A.S. in Technology, Engineering, or a related field (Bachelor's preferred). 0-3+ years of experience in security systems or low-voltage integration. Experience with access control, CCTV/VMS, and intrusion systems preferred. Required Skills Strong organizational skills and ability to manage multiple projects. Ability to exercise independent judgment and recommend solutions. Strong communication skills with clients and internal teams. Understanding of low-voltage systems, networking basics, and device integration. Proficiency with documentation tools, spreadsheets, and project planning software. Ability to interpret specifications, drawings, and system diagrams. Preferred Skills Experience with access control, CCTV/VMS, and intrusion systems preferred. SMC is an equal opportunity employer. Employment and promotional opportunities are based upon individual capabilities and qualifications without regard to race, color, religion, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, genetic information, veteran status, or any other protected classification as established under federal, state, or local law.

See yourself at Radian? We see you here too. At Radian, we see you. For the person you are and the potential you hold. That's why we've embraced a new way of working that lets our people across the country be themselves, be their best and be their boldest. Because when each of us is truly seen, each of us gives our best - and at Radian, we'll give you our best right back. Studies have shown that job seekers may hesitate to apply for jobs unless they meet every single qualification listed. We strive to see the potential in each applicant, so if you're excited about this role but your experience or education level doesn't align perfectly with every qualification in the job description, we encourage you to apply anyway. You may be just the right candidate for this or other roles. See Yourself as a Client Relations Account Specialist The client relations account specialist is responsible for the overall success of the customer. The specialist will provide support for title and settlement customers while understanding all internal processes of the departments that deliver products and services. The specialist is a resource for operations, sales, and management to assist in managing operational effectiveness, take-away items, relationship building, SLA reporting, on boarding and off boarding activities, order management, and client service. Primary Duties and Responsibilities Handles all client inquiries via telephone/e-mail while acting as the client facing piece of the organization. Documents/assigns all inquiries in system and follow up is performed as needed until resolution. Identifies escalations and prioritzes them. Manages 3rd party web sites for purposes of order retrieval/confirmation, communication during processing and uploading of completed reports. Manages monthly SLA distribution to clients Performs web demos, creates/resets user IDs & passwords and provides fee quotes for requests that fall outside of standard pricing metrics. Acts as conduit between the customer and sales/operations teams Other related duties as assigned Qualifications College degree with 3 years' experience in real estate and/or vendor management industry is preferred. ALTA best practices experience preferred. Proficiency in Microsoft Office (Outlook, Excel and Word) Knowledge of client-based systems; Attention to detail Motivated and positive team player; Excellent verbal, written and interpersonal skills Ability to problem solve and multi-task in a fast-paced environment. Education and Credentials Required: Associate/Technical Degree Preferred: Bachelor's Degree Other Certifications:: High School Diploma and 5 years related experience if a college degree has not been obtained See Why You Should Work With Us Competitive Compensation: anticipated base hourly rate from $19.00 to $27.00 based on skills and experience. This position is eligible to participate in an annual incentive program. Rest and Relaxation. This role is eligible for 20 days of paid time off annually, which is prorated in the year of hire based on hire date. In addition, based on your hire date, you will be eligible for 9 paid holidays + 2 floating holidays. Parental leave is also offered as an opportunity for all new parents to embrace this exciting change in their lives. Our Company Makes an Impact. We've been recognized by multiple organizations like Bloomberg's Gender-Equality Index, HousingWire's Tech 100, and The Forum of Executive Women's Champion of Board Diversity. Radian has also pledged to SHRM's CEO Action for Inclusion & Diversity commitment. Comprehensive Health Benefits. Multiple medical plan choices, including HSA and FSA options, dental, vision, and basic life insurance. Prepare for your Future. 401(k) with a top of market company match ( did we mention the company match is immediately vested?! ) and an opportunity to participate in Radian's Employee Stock Purchase Plan (ESPP). Homebuyer Perks. Our Homebuyer Perks program helps employees navigate the home searching, buying, selling, and refinancing processes and provides valuable financial benefits to encourage, enable, and support home ownership. Additional Benefits. To learn more about our benefits offerings, visit our Benefits Page. #LI-DNI The application period for the job is estimated to be 20 days from the job posting date. However, this timeline may be shortened or extended depending on business needs and the availability of qualified candidates. Radian will consider for employment qualified applicants with arrest or conviction records in a manner consistent with the requirements of the law, including any applicable fair chance law. See More About Radian Radian is a fintech servicing the mortgage and real estate services industry. As a team, we pride ourselves on seeing the potential of every person, every idea and every day. Seeing each other at Radian goes far beyond our open, flexible culture. It means seeing our people's potential - and creating inspiring career paths that help them get there. Or seeing new pathways and innovating for the future of our industry. It means seeing each other for all that we are. And it means seeing our purpose as one that extends beyond the bottom line - having an impact on communities across the country to help more people achieve the American Dream of homeownership. We hope you'll see yourself at Radian. See more about us at Radian.com. Defining Roles for Radian's Future Understanding the qualities and characteristics that define a Leader and an Employee is important to building our future-fit workforce. Radian's future is only as bright as its people. For that reason, our People Plan includes profiles to support the qualities and characteristics that each Leader as well as each Employee should embody upon hire or via development. EEO Statement Radian complies with all applicable federal, state, and local laws prohibiting discrimination in employment. All qualified applicants will receive consideration for employment without regard to gender, age, race, color, religious creed, marital status, gender identity, sexual orientation, national origin, ethnicity, ancestry, citizenship, genetic information, disability, protected veteran status or any other characteristic protected by applicable federal, state, or local law. An applicant's criminal history may have a direct, adverse, and negative relationship with some of the material job duties of this position. The material duties include those listed in the “Primary Duties and Responsibilities” section above, as well as the ability to adhere to Company policies, exercise sound judgment, effectively manage stressful situations, work safely and respectfully with others, exhibit trustworthiness, and safeguard confidential information belonging to the Company and its customers. Pursuant to the California Fair Chance Act, Los Angeles County Fair Chance Ordinance for Employers, Fair Chance Initiative for Hiring Ordinance, and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Equal Opportunity Employer Details To learn more about Radian's Code of Conduct and Ethics and workplace conduct, please click [here]. Radian participates in E-Verify [Link] (en español [Link]). Learn more about your rights under immigration laws [Link] (en español [Link]). View the "Know Your Rights: Workplace Discrimination is Illegal" poster [Link]. View “Employee Rights under FMLA” [Link]. View “Employee Rights under EPPA" [Link]. Accommodation Whether you require an accommodation for the job application or interview process, Radian is dedicated to a barrier-free employment process and encourages a diverse workforce. If you have questions about the accommodation process, please e-mail ******************. Please note that you may redact or remove age-related information that identifies your age, date of birth, or dates of attendance at or graduation from an educational institution on any additional application materials you submit as part of the application. Additional application materials include but are not limited to, resumes, CVs, transcripts, or certifications.

Globe Life AO is expanding and hiring Remote Client Success Specialists to join our mission-driven team. This position is perfect for individuals who are motivated, growth-oriented, and excited about helping others-while enjoying the flexibility of a fully remote career. Whether you're starting fresh or seeking a change, this role offers an opportunity to learn, grow, and build a rewarding career from wherever you are. We provide comprehensive training, mentorship, and tools to help you succeed. Why You'll Love This Role Fully Remote: Work from home or anywhere with a reliable internet connection. Weekly Pay: Consistent weekly pay with performance-based bonuses and unlimited earning potential. Professional Training: No prior experience required-virtual workshops and mentorship are provided. Union Benefits: Access to OPEIU Local 277 membership and professional representation. Health & Life Coverage: Medical reimbursement and company-paid life insurance (including Accidental Death Benefits). Recognition & Rewards: Enjoy incentive trips, team events, and leadership development opportunities. Career Growth: Structured advancement paths with mentorship and leadership support. Key Responsibilities Conduct virtual consultations to help clients understand their benefit options. Guide new members through enrollment and provide ongoing support. Address client inquiries with professionalism and clear communication. Develop customized benefit solutions aligned with client needs and goals. Build and maintain long-term client relationships through trust and consistency. Manage your schedule and maintain accurate digital records. Qualifications Excellent communication and interpersonal skills. Strong organizational abilities and time management skills. Quick learner with the ability to adapt to new systems and processes. Self-motivated and comfortable working independently in a virtual setting. Team-oriented mindset and willingness to learn from mentorship and feedback. Authorized to work in the United States with reliable Wi-Fi and a Windows-based computer. Why Globe Life AO At Globe Life AO, you'll have the chance to build a career-not just a job. We believe in empowering people to achieve financial independence and professional fulfillment through meaningful work. Our environment emphasizes collaboration, integrity, and personal development, giving you the flexibility to design your ideal career path. If you're ready to take the next step toward a flexible, growth-focused, and purpose-driven career, we'd love to connect with you. Apply today and join a team where your success and impact go hand in hand.

Exceed the expectations of our residential mortgage borrowers & business partners through superior service, simple processes, and effective communications. We deliver on this mission by empowering our employees by encouraging and recognizing superior performance and innovative solutions, by promoting teamwork and divisional cooperation. **This is a Hybrid Position at our Tempe, AZ location & Fort Washington, PA location** Primary Function The Client Relations Specialist III is responsible for assisting the borrower and production sales team in the coordination of all functions related to the processing and closing of loans. Direct Reports N/A Principal Duties Serve as subject matter expert (SME) regarding company policies, procedures, and technology. Manages external business partners' status and internal business partners' multi-state pipeline. Serves as primary liaison between external/internal business partners and operations staff. Conducts daily review and follow-up with borrowers and vendors regarding outstanding items; gathers necessary documentation. Communicates to manager if unable to achieve a timeline or to resolve an error. Escalates any fraud files to Risk Management Leadership Team. Assists internal business partners with non-responsive clients and conflict resolution. Communicates to key stakeholders, including internal business partners and clients, on status/needs. Performs data entry to update all internal computer systems and loan files with notes regarding all actions that affect the loan process in accordance with company requirements. Reviews title reports, payoffs, appraisals, income documents, hazard insurance, and all supporting conditions for required standard compliance. Executes Review Approval Process. Coordinates scheduling of loan closings with internal business partner and closing agent. Attends regular pipelines meetings and system training updates. Performs related duties as assigned by management. This position is considered a non-loan originator position, meaning participants may not engage in activities of a loan originator, including: communicating directly with borrowers about credit qualification or loan terms, which includes pricing concessions or other transaction-specific terms or conditions. Education and Experience Requirements High school diploma or equivalent, required. Bachelor's degree, preferred. 5+ years processing experience in high volume mortgage setting. Experience with DU, DO, and LP systems. Knowledge, Skill, and Ability Requirements Knowledge of FHA and FNMA policies and guidelines. Knowledge of mortgage loan processing, compliance, investor products, and underwriting guidelines. Working knowledge of various fraud tools. While this description is intended to be an accurate reflection of the position's requirements, it in no way implies/states that these are the only job responsibilities. Management reserves the right to modify, add or remove duties and request other duties, as necessary. #MW1 A good faith estimate of the compensation is: 47,700.00 - 75,240.00 Compensation for this position may also include other elements, including medical, financial, various paid time off benefits, and a bonus based on individual and company performance, variable or annual. Placement within the range will be based on a variety of factors, including but not limited to, skills, experience, qualifications, location, etc. Additional Information: While this description is intended to be an accurate reflection of the position's requirements, it in no way implies/states that these are the only job responsibilities. Management reserves the right to modify, add or remove duties and request other duties, as necessary. All employees are required to have smart phones that meet Company security standards with the ability to install apps such as Okta Verify and Microsoft Authenticator. Employment will be contingent on this requirement. Company Benefits: Newrez is a great place to work but we are only as strong as our greatest asset, our employees, so we believe in rewarding them! Medical, dental, and vision insurance Health Savings Account with employer contribution 401(k) Retirement plan with employer match Paid Maternity Leave/Parental Bonding Leave Pet insurance Adoption Assistance Tuition reimbursement Employee Loan Program The Newrez Employee Emergency and Disaster Fund is a new program to support our team members Newrez NOW: Our Corporate Social Responsibility program, Newrez NOW, empowers employees to become leaders in their communities through a robust program that includes volunteering, philanthropy, nonprofit grants, and more 1 Volunteer Time Off (VTO) day, company-paid volunteer day where all eligible employees may participate in a volunteer event with a nonprofit of their choice Employee Matching Gifts Program: We will match monetary employee donations to eligible non-profit organizations, dollar-for-dollar, up to $1,000 per employee Newrez Grants Program: Newrez hosts a giving portal where we provide employees an abundance of resources to search for an opportunity to donate their time or monetary contributions Equal Employment Opportunity We're proud to be an equal opportunity employer- and celebrate our employees' differences, including race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, and Veteran status. Different makes us better. CA Privacy Policy CA Notice at Collection

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 Provider Relations Consultant - NH will act as the primary liaison between Provider Relations Consultants and internal Plan departments such as Claims, Benefits, Audit, Member and Provider Enrollment and Clinical Services to effectively identify and resolve claim issues. This individual will also work closely with the leadership team to identify issues and report trends. Our Investment in You: Full-time remote work Competitive salaries Excellent benefits Key Functions/Responsibilities: Investigate, document, track, and assist with claims resolution Interact with various operational departments to assure accurate and timely payment of claims in accordance with the plan's policies and procedures Identify system changes impacting claims processing and work internally on resolution Identify systematic issues and trends and research for potential configuration related work Analyze trends in claims processing and assist in identifying and quantifying issues Run claim reports regularly to support external provider visits Develop and enhance our physician, clinician, community health center and hospital relationships through effective business interactions and outreach Act as liaison for all reimbursement, issues with providers Facilitates resolution of complex contractual and member/provider issues, collaborating with internal departments as necessary Provides general education and support on WellSense products, policies, procedures and operational issues as needed Manages flow of information to and from internal departments to ensure communication regarding Plans changes and updates May outreach to providers according to Plan initiatives Facilitates problem resolution Initiates Plan interdepartmental collaboration to resolve complex provider issues Identifies system updates needed and completes research related to provider data in Onyx and Facets Processes reports as needed to support provider education, servicing, credentialing and recruitment Ensures quality and compliance with State Agencies and NCQA Other responsibilities as assigned Understands and implements Plan polices & procedures Qualifications: Education: Bachelor's degree in Business Administration, related field or an equivalent combination of education, training and experience is required Experience: 2 or more years of progressively responsible experience in a managed care or healthcare environment is preferred Experience with Medicare and Medicaid Reimbursement Methodologies Understanding of provider coding and billing practices Certification or Conditions of Employment: Must have valid driver's license and access to a car Competencies, Skills, and Attributes: Experience with ICD-10, CPT/HCPCS Codes, and billing claim forms Ability to work as a team member, to manage multiple tasks, to be flexible, and to work independently and possess excellent organizational skills Proven expertise utilizing Microsoft Office products Effective communication skills (verbal and written) Strong follow-up skills Proficient in multi-tasking Ability to set and manage priorities Working Conditions and Physical Effort: Travel up to 50% Compensation Range: $57,500- $83,500 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

Join us for an exciting career with the leading provider of supplemental benefits! Our Promise Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards. At Avesis, the Provider Relations Representative plays a vital role in connecting our dental provider community with the resources, education, and support they need to thrive. As a key member of our Provider Relations Department, you'll be the bridge between Avesis and our participating provider network, ensuring that our partners are equipped, informed, and engaged every step of the way. If you're a self-driven communicator who thrives on building relationships and solving problems, this is the role for you. Your expertise and passion will directly contribute to Avesis' mission of delivering high-quality, accessible dental care to our members, while also supporting and nurturing the growth of our provider community. Join us in making a meaningful impact in the healthcare space! In this role, you will combine the flexibility of a hybrid work environment with the opportunity to build lasting partnerships both remotely and in the field. You will lead efforts to foster the best-in-class provider education, tackle provider inquiries and issues, and manage a variety of initiatives that enhance our relationships with the provider network. Our chosen candidate must reside within the state of Kentucky due to the travel component of this role. Functional Competencies: Provider Relations encompasses several diverse provider administrative duties to improve the Avesis provider experience including direct provider engagement and training with the goal of resolution of issues. Conduct provider outreach via in-person/video/phone or email by providing training, orientation, and coaching for performance improvement within provider practices. Provide guidance through education to enable Avesis network providers to become more self-sufficient in confirming eligibility, claims submission and payment by use of available tools. Consistently documents all provider interactions, including calls, emails, virtual and in-person visits, in accordance with departmental standards. Ensures that notes are clear, timely, and accurately reflect the nature of the communication to support ongoing relationship management, issue resolution, and continuity of service across teams. Maintains thorough and timely records to ensure accountability, transparency, and effective information sharing across teams. Conduct monthly and/or quarterly meetings with provider groups documenting discussions, issues, attendees, action items, researching claims or prior authorization issues on site and routing to the appropriate party for resolution. Owns and manages relationship and performance of assigned provider groups. Serves as the primary point of contact for assigned providers. Communicate and shares provider claims and directory reporting both internally and externally and additional reporting as necessary. Complete provider orientation via phone, email, in-person and/or virtually for all applicable product lines to train, resolve issues, and educate staff/providers. Perform onsite facility reviews, when applicable and conduct quarterly face-to-face visits within the assigned territory and/or market. Work closely and coordinates with Avesis Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, Account Management, and other staff to develop operational solutions for various provider network projects. Educate providers regarding state program, group policies, and/or health plan policies and procedures and state/federal regulation for compliance requirements. Investigate and respond to complex provider related issues and initiate change of provider demographic related database information. Responds to general provider contract inquiries, provider education and non-routine claim issues. Attend work-related events/conferences while representing the organization and brand in a professional manner. Coaches, mentors, and develops junior team members as applicable. Core Competencies: Knowledge of health plan operations. Knowledge of provider/health plan contracts/agreements. Microsoft applications and other windows-based applications to include an intermediate level in Microsoft Excel and databases. Knowledge of and intermediate ability to use various computer programs such as Microsoft Office including spreadsheets, databases, word processing and presentation software and programs/systems utilized in data analysis. Behavioral Competencies Collegiality: building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth. Initiative: readiness to lead or take action to achieve goals. Communicative: ability to relay issues, concepts, and ideas to others easily orally and in writing. Member-focused: going above and beyond to make our members feel seen, valued, and appreciated. Detail-oriented and thorough: managing and completing details of assignments without too much oversight. Flexible and responsive: managing new demands, changes, and situations. Critical Thinking: effectively troubleshoot complex issues, problem solve and multi-task. Integrity & responsibility: acting with a clear sense of ownership for actions, decisions and to keep information confidential when required. Collaborative: ability to represent your own interests while being fair to those representing other or competing ideas in search of a workable solution for all parties. Minimum Qualifications: High School Diploma or equivalent. 1 to 2+ years of Dental office experience. Comprehension of Medical/Dental Terminology. Must reside within the state of Kentucky. A valid driver's license with proof of auto insurance and the ability to use your own vehicle. The ability to travel up to 50% is required to meet prospective clients, existing customers, attend trade shows and other meetings as needed. Travel times may vary and can range from short overnight trips to extended stays. As this role is a remote role, you are required to maintain internet service that allows you to complete your essential job duties without issue. Rates of 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN are sufficient. Preferred Qualifications: Bachelor's degree Previous Provider Relations Experience Dental Assisting National Board (DANB) certified or Certified dental assistance (CDA). 1 year of experience with provider credentialing and contracting processes. 1 year of dental insurance claim experience, as well as the ability to analyze data to resolve provider claim issues. At Avēsis, we strive to design equitable, and competitive compensation programs. Base pay within the range is ultimately determined by a candidate's skills, expertise, or experience. In the United States, we have three geographic pay zones. For this role, our current pay ranges for new hires in each zone are: Zone A: $46,080.00-$76,800.00 Zone B: $50,220.00-$83,700.00 Zone C: $54,050.00-$90,080.00 FLSA Status: Salary/Exempt This role may also be eligible for benefits, bonuses, and commission. Please visit Avesis Pay Zones for more information on which locations are included in each of our geographic pay zones. However, please confirm the zone for your specific location with your recruiter. We Offer Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way. Competitive compensation package. Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period. Life and disability insurance. A great 401(k) with company match. Tuition assistance, paid parental leave and backup family care. Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent. Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best. Employee Resource Groups that advocate for inclusion and diversity in all that we do. Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability. How To Stay Safe Avēsis is aware of fraudulent activity by individuals falsely representing themselves as Avēsis recruiters. In some instances, these individuals may even contact applicants with a job offer letter, ask applicants to make purchases (i.e., a laptop or gift cards) from a designated vendor, have applicants fill out W-2 forms, or ask that applicants ship or send packages of goods to the company. Avēsis would never make such requests to applicants at any time throughout our job application process. We also would never ask applicants for personal information, such as passport numbers, bank account numbers, or social security numbers, during our process. Our recruitment process takes place by phone and via trusted business communication platform (i.e., Zoom, Webex, Microsoft Teams, etc.). Any emails from Avēsis recruiters will come from a verified email address ending in @ Avēsiscom. We urge all applicants to exercise caution. If something feels off about your interactions, we encourage you to suspend or cease communications. If you are unsure of the legitimacy of a communication you have received, please reach out to ********************. To learn more about protecting yourself from fraudulent activity, please refer to this article link (************************************************** If you believe you were a victim of fraudulent activity, please contact your local authorities or file a complaint (Link: ******************************* with the Federal Trade Commission. Avēsis is not responsible for any claims, losses, damages, or expenses resulting from unaffiliated individuals of the company or their fraudulent activity. Equal Employment Opportunity At Avēsis, We See You. We celebrate differences and are building a culture of inclusivity and diversity. We are proud to be an Equal Employment Opportunity employer that considers all qualified applicants and does not discriminate against any person based on ancestry, age, citizenship, color, creed, disability, familial status, gender, gender expression, gender identity, marital status, military or veteran status, national origin, race, religion, sexual orientation, or any other characteristic. At Avēsis, we believe that, to operate at the peak of excellence, our workforce needs to represent a rich mixture of diverse people, all focused on providing a world-class experience for our clients. We focus on recruiting, training and retaining those individuals that share similar goals. Come Dare to be Different at Avēsis, where We See You!

Vālenz Health is the platform to simplify healthcare - the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey - from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible. About Our Opportunity As a Provider Relations Representative, you will educate providers and members about specific plan designs while also addressing their inquiries related to reimbursement, appeals, and network access. To be successful in this role, you will have a passion for customer care-or customer love as we say! Things You'll Do Here: Facilitate inquiries from providers regarding reimbursement rates. Negotiate ongoing and single case agreements (SCAs) Direct members to in-network or RBP accepting providers. Focus on the member journey and minimizing disruption to providers. Develop trust with members and providers to ensure long-term relationships. Anticipate and identify issues and escalate to the appropriate manager or team leader. Ensure that the best possible solutions are offered by adhering to established rules regarding client rate structures, turn-around-times, and success rates. Facilitate the appeals process. Maintain compliance with company policies and procedures. Performs related duties as assigned by supervisor. Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties. What You'll Bring to the Team: 1+ years of experience in customer service. Experience working independently and completing assignments within given instructions, routines, and accepted practices. Excellent verbal and written communication skills. Ability to work in a fast-paced, customer focused, and deadline-driven environment. A plus if you have: Experience working in healthcare environment with providers. Where You'll Work: This is a fully remote position, and we'll provide all the necessary equipment! Work Environment: You'll need a quiet workspace that is free from distractions. Technology: Reliable internet connection-if you can use streaming services, you're good to go! Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software. Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA. Why You'll Love Working Here Valenz is proud to be recognized by Inc. 5000 as one of America's fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare . With this commitment, you'll find an engaged culture - one that stands strong, vigorous, and healthy in all we do. Benefits Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card. Spending account options: HSA, FSA, and DCFSA 401K with company match and immediate vesting Flexible working environment Generous Paid Time Off to include vacation, sick leave, and paid holidays Employee Assistance Program that includes professional counseling, referrals, and additional services Paid maternity and paternity leave Pet insurance Employee discounts on phone plans, car rentals and computers Community giveback opportunities, including paid time off for philanthropic endeavors At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.

About SynapticureAs a patient- and caregiver-founded company, Synapticure provides instant access to expert neurologists, cutting-edge treatments and trials, and wraparound care coordination and behavioral health support in all 50 states through a virtual care platform. Partnering with providers and health plans, including CMS' new GUIDE dementia care model, Synapticure is dedicated to transforming the lives of millions of individuals and their families living with neurodegenerative diseases like Alzheimer's, Parkinson's, and ALS. The RoleSynapticure is seeking a Provider Relations Manager to serve as a trusted relationship-builder and key account manager for our provider partners. This remote-first position focuses on nurturing long-term relationships with primary care and neurology practices, driving program adoption, and ensuring ongoing engagement and satisfaction. While the majority of your work will be conducted remotely, you'll travel approximately 30% of the time to meet with provider groups, attend key events, and support local engagement efforts. Some door-to-door practice outreach (10-20%) may be required to introduce Synapticure programs to new clinics and strengthen relationships in the field.This role is ideal for a relationship-driven professional with experience in healthcare account management, provider engagement, or field sales who thrives on connecting virtually and in-person to expand access to quality neurodegenerative care. Job Duties - What You'll Be Doing Build and manage strong relationships with provider partners, practice managers, and clinical leadership across assigned territories Serve as Synapticure's relationship owner, ensuring ongoing satisfaction and sustained adoption of programs Conduct virtual and in-person meetings to communicate Synapticure's mission, capabilities, and impact Identify provider needs and use a consultative approach to deliver tailored solutions that improve workflow and patient experience Track and report provider engagement activities, progress toward goals, and insights gathered from the field Coordinate with internal teams (Clinical Operations, Implementation, and Product) to resolve issues and improve program delivery Support new program rollouts through remote and in-person training sessions, onboarding, and troubleshooting Execute strategic outreach campaigns, including limited door-to-door provider engagement when introducing new markets or services Collaborate with leadership to develop growth plans and identify new opportunities for partnership Represent Synapticure at regional meetings and healthcare networking events as needed In person outreach to members Requirements - What We Look For In You 5+ years of experience in healthcare account management, provider relations, or field engagement Demonstrated success managing provider or client relationships remotely with periodic travel Excellent written and verbal communication skills; confident engaging both clinical and administrative audiences Highly organized, proactive, and adaptable to changing priorities Comfortable using CRM tools and virtual collaboration platforms (Zoom, Salesforce, etc.) Understanding of healthcare delivery models and practice operations preferred Familiarity with neurodegenerative care, behavioral health, or telehealth models is a plus Willingness to travel ~30% and perform in-person outreach (10-20%) We're founded by a patient and caregiver, and we're a remote-first company where empathy and excellence guide every interaction: Relentless focus on patients and caregivers. We are determined to deliver exceptional care and support to every individual we serve. Empathy and humanity. We meet every challenge with compassion, understanding, and hope. Curiosity and adaptability. We listen first, learn continuously, and evolve based on the needs of patients and partners. Optimism and action. We move with urgency and positivity to make meaningful change. Travel ExpectationsThis is a remote position with approximately 30% travel to provider sites, conferences, and community events. Most travel is regional and planned in advance, though limited door-to-door outreach may be required for new practice introductions.

As a member of the DMEPOS (Durable Medical Equipment Prosthetics, Orthotics and Supplies) team you will provide education and training for network providers, staff, suppliers, physicians, beneficiaries, and referral agents as necessary. You will develop and produce all training and educational materials for virtual and onsite training classes. Description Logistics: CGS (cgsadmin.com)- one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This is a full-time remote position. You will work an 8-hour shift scheduled during our normal business hours of 8:00 a.m. - 5:00 p.m. Some overnight and weekend travel will be required for in-person conferences and presentations. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. What You'll Do: Develops/prepares/reviews/updates all provider education materials. These may include: web-based training, computer-based training, ACT (ask the contractor) calls, outreach presentations/proposals, listserv articles, new highlights, calendar of events, job aids, resource tools, and web page content. Conducts/facilitates meetings, workshops, training classes, teleconferences with providers, provider groups, staff, suppliers, physicians, beneficiaries, referral agents. Develops relationships with providers, provider groups, staff, suppliers, physicians, beneficiaries, referral agents, state/local medical/professional associations. Responds to educational needs. Acts as liaison between division/above mentioned groups and appropriate state/federal agencies to ensure training needs are met. Responds to/resolves problems/issues identified through meetings, workshops, correspondence, etc. Performs administrative functions in support of education and training. Produces/generates various reports to management and provides feedback on activities to management. Contributes/participates/completes special projects as assigned. To Qualify For This Position, You'll Need the Following: Required Education: Bachelor's degree equivalency: 4 years job related work experience or an Associate's and 2 years job related work experience. Required Skills and Abilities: Demonstrated skills related to training materials development. Demonstrated skills related to classroom presentations to large groups. Working knowledge/understanding of government healthcare programs, HIPAA policies, procedures. Demonstrated proficiency in word processing, spreadsheet, database software. Good judgment skills. Demonstrated proficiency in spelling, punctuation, grammar skills. Demonstrated verbal and written communication skills. Analytical and critical thinking skills. Basic business math proficiency. Ability to persuade, negotiate, or influence others. Ability to handle confidential or sensitive information with discretion. Ability to identify learning objectives. Strong course design skills to include use of media/other instructional methods. Ability to evaluate progress in addition to actual delivery of training sessions. Required Software and Tools: Microsoft Office. We Prefer That You Have the Following: Preferred Skills and Abilities: Experience developing virtual and onsite training classes. Medicare knowledge and experience. DMEPOS (Durable Medical Equipment Prosthetics, Orthotics and Supplies) experience. Our Comprehensive Benefits Package Includes The Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. What To Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information.

Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you! Modivcare is looking for an experienced Director - Provider Relations to join our team. This role is responsible for defining, implementing, and maintaining a compliant, effective, and efficient transportation provider network within assigned markets. The Director will oversee all programs across these markets, ensuring consistent, high-quality service delivery and operational leadership. This role will also manage client relationships and client contracts for their region. This position will drive key strategies related to provider performance, compliance, and risk mitigation, while also cultivating a culture of engagement and continuous improvement. This position will ultimately be on-site in the Little Rock area. This role… Establishes and monitors key performance indicators (KPIs) for transportation providers and prepares performance and compliance reports for leadership review. Acts as an escalation point for complex provider issues and facilitates resolutions. Provides operational guidance, compliance support, and technology training to transportation providers. Ensures provider quality standards are met and swiftly addresses any deficiencies. Leads provider relations efforts across markets in alignment with regional and corporate objectives. Partners with the Network team to execute network expansion strategies and risk mitigation plans. Oversees provider credentialing compliance and collaborates with credentialing teams to streamline processes. Coordinates with internal business units (e.g., Safety, Network Planning, Product, Finance, IT, HR, and CI) to align initiatives and secure support. Administers corrective action plans for provider contract deficiencies and approves liquidated damages when appropriate. Remains informed on industry trends, competitor activity, and regulatory developments to inform strategic direction. Champions employee engagement and development through proactive talent planning and mentoring. Creates an environment of innovation and continuous improvement through Lean initiatives and process enhancements. Leads talent strategy across state reports including succession planning, employee engagement, and performance management. Serves as main point of contact for clients and manages the client contract. May lead projects and perform other duties as assigned. Requires some local travel to meet with clients. We are interested in speaking with individuals with the following… Bachelor's degree required. Ten (10) plus years of experience in NEMT, logistics, or healthcare preferred. Five (5) plus years of leadership experience. Advanced industry experience preferred. Contract and client management experience strongly preferred. Tableau experience preferred. Or equivalent combination of education and/or experience. Ability to lead development, execution, and deployment of provider network initiatives. Strong organizational planning and budgetary administration skills. Proficient in statistical and financial analysis techniques. High proficiency in Microsoft Office Suite (Outlook, Excel, Word, PowerPoint). Excellent relationship management and process improvement abilities. Effective written and verbal communicator with strong presentation skills. Strong listening and interpersonal skills with a customer-focused, results-oriented mindset. Salary: $111,000 - $149,900 Bonus eligible based on individual and company performance. Modivcare's positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings. We value our team members and realize the importance of benefits for you and your family. Modivcare offers a comprehensive benefits package to include the following: Medical, Dental, and Vision insurance Employer Paid Basic Life Insurance and AD&D Voluntary Life Insurance (Employee/Spouse/Child) Health Care and Dependent Care Flexible Spending Accounts Pre-Tax and Post --Tax Commuter and Parking Benefits 401(k) Retirement Savings Plan with Company Match Paid Time Off Paid Parental Leave Short-Term and Long-Term Disability Tuition Reimbursement Employee Discounts (retail, hotel, food, restaurants, car rental and much more!) Modivcare is an Equal Opportunity Employer. EEO is The Law - click here for more information Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at ***************************

What are important things that YOU need to know about this role based in Macon, Georgia? • Seeking a self-driven rock star that has Medicaid and dental field experience - based in Georgia (Macon area) • Given the nature of the work, the person will be in field 3 to 4 days per week and working from a home office the remainder of the time. What will YOU be doing for us? Provide support to specific market by researching, working with internal staff, and providing resolution to high value providers. Utilize knowledge of market and potential providers to resolve specific network deficiency issues through proper recruiting practices. What will YOU be working on? • Build and maintain appropriate relationships with provider network and clients by ensuring regular communications and timely problem resolution. • Develop training and presentation materials relative to market needs. • Host regular training sessions for new and existing providers to promote use of provider web portal and address questions on any other necessary procedures. • Act as resource to both client and providers in the network to resolve complex claim issues for high volume or high value provider offices. • Utilize the provider-related modules in the Enterprise System to research claim and reimbursement questions. • Accurately and timely assess issues presented from provider offices that can be handled by other internal resources and provide offices with appropriate contacts to obtain resolution. • Utilizing follow up requests from internal staff or client direction, recognize potential market deficiencies and network to obtain referrals for potential providers. • Recruit and work with potential providers to discuss potential contract terms or negotiations needed to resolve network deficiencies. • Through establishment of positive relationships with providers in the geography, arrange care with out of network providers for single case agreements including recommending a provider, negotiating the fee and securing the single case agreement contract. • Through regular networking events, maintain contact with potential clients and provide any necessary information to generate potential interest. • Work collaboratively with internal sales staff to relay potential leads for sales opportunities. • Using automated systems, maintain updated data on client owned provider networks by verifying accuracy and handling any exceptions or issues. • Coordinate and conduct provider advisory board meetings and town hall meetings. • Identify appropriate community relationships and develop partnerships designed at increasing visibility of client programs. • Build and maintain relationships within SKYGEN. • Support Credentialing and Network Development strategies. Additional Responsibilities: • Provide feedback to Provider Relations team regarding potential topics for provider training references and materials. • Field calls from medical, dental, vision, and therapy providers with questions on the provider web portal. • Assist department with administrative tasks and additional duties as needed. • Conduct site audit data collection. • Conduct mobile unit audits. • Work with Clients and Providers to analyze market, system and operational trends and develop and propose solutions and interventions to improve the client/provider/member experience and/or reduce costs. What qualifications do YOU need to have to be GOOD candidate? • Bachelor's degree in a related field or equivalent years of experience. • 3-5 years of job related experience (provider relations, account management, or managed care). • Excellent communication written and verbal communication skills. • Ability to think strategically regarding the direction of the market, provider needs and the client relationship. • Ability to build and maintain collaborative working relationships with diverse individuals. • Ability to exercise influence without formal authority. • Ability to ensure timely problem resolution despite multiple priorities. • Intermediate knowledge of Microsoft Office products including Word, Excel, and email. What qualifications do YOU need to have to be GREAT candidate? • Bachelor's Degree in Business or a related field. • Experience in a managed care environment. • Experience working in the field or with field issues. The salary range is listed below for your reference. Please keep in mind that your education and experience along with your knowledge, skills and abilities are taken into consideration when determining placement within the range.

Provider Relations - Network Development Specialist Remote At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders - internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!! JOB SUMMARY You can shine with us as a Provider Relations Specialist within our Government Programs Network Development team. This is a full-time (40 hours per week) remote position based in Texas. In this position you will visit Healthcare provider offices and provide education about the network programs and products. This position requires travel, which could require overnight stays and requires an active and valid Driver's License. Up to 70% travel within a geographic service area/territory, primarily to meet with providers on a frequent basis, and at times with little advance notice. COMPENSATION The salary range for this position is $58,000-$62,000 annually. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity. JOB ROLES AND RESPONSIBILITIES * Meet with Healthcare Provider office staff providing education about Claritev programs and products. * Cultivate and foster business relationships with contracted providers and their office administration staff. * Distribute printed materials to Healthcare Provider office staff. * Address and resolve Provider concerns and issues within established guidelines. * Coordinate Provider education meetings (both in-person and virtual) as needed. * Serve as an internal point of contact for network issue resolution originating from Customer Service calls and inquiries * Track both the number and type of Provider visits and produce weekly visit report. * Provide directions to providers, clients and members on processes as needed. * Meet our quality, customer service, productivity and service level performance standards on a consistent basis REQUIREMENTS * Minimum bachelor's degree in related or applicable field, or HS Diploma (or GED) and four (4) years' experience related to network development * Minimum 1-year experience in provider relations and network development, or equivalent provider/payer experience, successfully working with healthcare providers * Valid Driver's License and access to dependable transportation * Up to 70% travel within a geographic service area/territory, primarily to meet with providers on a frequent basis, and at times with little advance notice * Knowledge of Healthcare office settings and Healthcare operations * Strong oral, and written presentation skills and ability to interact with all levels of a provider organization * Strong communication skills (written, verbal and listening), analytical, negotiation, business acumen, organization, strategic, multitasking and prioritization skills * Ability to understand and explain government-sponsored payment methodologies * Ability to research answers from multiple sources timely and effectively * Ability to work efficiently in a fast-paced environment with competing priorities * Ability to work from home effectively * Ability to travel daily within geographic service area, as well as out of state travel to attend Claritev sponsored meetings, appropriate professional conferences or other business travel purposes. REQUIREMENTS * Minimum bachelor's degree in related or applicable field, or HS Diploma (or GED) and four (4) years' experience related to network development * Minimum 1-year experience in provider relations and network development, or equivalent provider/payer experience, successfully working with healthcare providers * Valid Driver's License and access to dependable transportation * Up to 70% travel within a geographic service area/territory, primarily to meet with providers on a frequent basis, and at times with little advance notice * Knowledge of Healthcare office settings and Healthcare operations * Strong oral, and written presentation skills and ability to interact with all levels of a provider organization * Strong communication skills (written, verbal and listening), analytical, negotiation, business acumen, organization, strategic, multitasking and prioritization skills * Ability to understand and explain government-sponsored payment methodologies * Ability to research answers from multiple sources timely and effectively * Ability to work efficiently in a fast-paced environment with competing priorities * Ability to work from home effectively * Ability to travel daily within geographic service area, as well as out of state travel to attend Claritev sponsored meetings, appropriate professional conferences or other business travel purposes. BENEFITS We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities. Your benefits will include: * Medical, dental and vision coverage with low deductible & copay * Life insurance * Short and long-term disability * Paid Parental Leave * 401(k) + match * Employee Stock Purchase Plan * Generous Paid Time Off - accrued based on years of service * WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service * 10 paid company holidays * Tuition reimbursement * Flexible Spending Account * Employee Assistance Program * Sick time benefits - for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits. EEO STATEMENT Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here. APPLICATION DEADLINE We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted. #LI-KB1

Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service. Job Duties This role serves as the primary point of contact between Molina Health plan and the for non-complex Provider Community that services Molina members, including but not limited to Fee-For-Service and Pay for Performance Providers. It is an external-facing, field-based position requiring a high degree of job knowledge, communication and organizational skills to successfully engage high volume, high visibility providers, including senior leaders and physicians, to ensure provider satisfaction, education on key Molina initiatives, and improved coordination and partnership. • Under minimal direction, works directly with the Plan's external providers to educate, advocate and engage as valuable partners, ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service. Effectiveness in driving timely issue resolution, EMR connectivity, Provider Portal Adoption. • Conducts regular provider site visits within assigned region/service area. Determines own daily or weekly schedule, as needed to meet or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or CMS guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members. • Provides on-the-spot training and education as needed, which may include counseling providers diplomatically, while retaining a positive working relationship. • Independently troubleshoots problems as they arise, making an assessment when escalation to a Senior Representative, Supervisor, or another Molina department is needed. Takes initiative in preventing and resolving issues between the provider and the Plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters. • Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians. For example, such meetings would occur to discuss and resolve issues related to utilization management, pharmacy, quality of care, and correct coding. • Independently delivers training and presentations to assigned providers and their staff, answering questions that come up on behalf of the Health plan. May also deliver training and presentations to larger groups, such as leaders and management of provider offices (including large multispecialty groups or health systems, executive level decision makers, Association meetings, and JOC's). • Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives. Examples of such initiatives include: administrative cost effectiveness, member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, Provider Website, etc.). • Trains other Provider Relations Representatives as appropriate. • Role requires 60%+ same-day or overnight travel. (Extent of same-day or overnight travel will depend on the specific Health Plan and its service area.) Job Qualifications REQUIRED EDUCATION: Associate's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: • 2 - 3 years customer service, provider service, or claims experience in a managed care setting. • Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for service, capitation and various forms of risk, ASO, etc. PREFERRED EDUCATION: Bachelor's Degree in a related field or an equivalent combination of education and experience PREFERRED EXPERIENCE: • 3+ years experience in managed healthcare administration and/or Provider Services. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

The Rapid Resolution Specialist is responsible for providing quality services and solutions to our clients while maintaining a high level of client satisfaction. You will be responsible for determining problem severity, performing basic remediation, and assigning service requests to appropriate resources. ESSENTIAL FUNCTIONS: Respond to client calls, client emails, system alerts and other correspondence in an appropriate and timely manner. Participate as a primary resource within the inbound calling contact center for Managed IT clients. Determine problem severity, establish priorities, and assign service request to the appropriate resource. Accurately and promptly log client problem information and create a service request. Provide prompt communications to clients (internal and external) on detailed status information and estimated resolution times for issues. Remediate support requests for move/add/change type work. Troubleshooting and remediate support requests for basic and intermediate break/fix type work. Verify systems and applications functionality to identify proper resources to assign for resolution. Verify and maintain client contact and database information. Participate in best practices and follow operations procedures to create efficiencies. Accurately maintain and comply with documentation and administrative procedures in a timely basis to include time entry process. Attend required company and departmental meetings. Act in accordance with Marco policies and procedures as set forth in the employee handbook. EDUCATION AND EXPERIENCE: High School diploma and two years of relevant experience or an Associate's degree; or equivalent combination of education and experience. Previous IT experience preferred. REQUIRED SKILLS: Proficiency with business collaboration tools including MS Office applications, Outlook and company specific programs. Solid customer service abilities including telephone skills. Excellent verbal and written communication with internal and external clients. Excellent organizational and time/task management skills with the ability to prioritize tasks and work within a defined timeline and to operate with changing priorities. Ability to gather and analyze information. Performs work with accuracy and thoroughness. Excellent follow through to see tasks through completion. Function collaboratively as part of a fast-paced, client orientated team. Pay Range: $19.94 - $29.92 hourly + bonus The pay range listed for this position is based on candidate's skill level, experience, relevant licenses, and educational background. For detailed information about our benefits, please visit our careers page at ************************* Location: This is a remote-eligible position, however, Marco Technologies requires employees to reside within one of the following states: DE, FL, IA, IL, IN, KY, MD, MI, MN, MO, ME, NE, ND, NJ, PA, RI, SD, TX, WI

The Rapid Resolution Specialist is responsible for providing quality services and solutions to our clients while maintaining a high level of client satisfaction. You will be responsible for determining problem severity, performing basic remediation, and assigning service requests to appropriate resources. ESSENTIAL FUNCTIONS: Respond to client calls, client emails, system alerts and other correspondence in an appropriate and timely manner. Participate as a primary resource within the inbound calling contact center for Managed IT clients. Determine problem severity, establish priorities, and assign service request to the appropriate resource. Accurately and promptly log client problem information and create a service request. Provide prompt communications to clients (internal and external) on detailed status information and estimated resolution times for issues. Remediate support requests for move/add/change type work. Troubleshooting and remediate support requests for basic and intermediate break/fix type work. Verify systems and applications functionality to identify proper resources to assign for resolution. Verify and maintain client contact and database information. Participate in best practices and follow operations procedures to create efficiencies. Accurately maintain and comply with documentation and administrative procedures in a timely basis to include time entry process. Attend required company and departmental meetings. Act in accordance with Marco policies and procedures as set forth in the employee handbook. EDUCATION AND EXPERIENCE: High School diploma and two years of relevant experience or an Associate's degree; or equivalent combination of education and experience. Previous IT experience preferred. REQUIRED SKILLS: Proficiency with business collaboration tools including MS Office applications, Outlook and company specific programs. Solid customer service abilities including telephone skills. Excellent verbal and written communication with internal and external clients. Excellent organizational and time/task management skills with the ability to prioritize tasks and work within a defined timeline and to operate with changing priorities. Ability to gather and analyze information. Performs work with accuracy and thoroughness. Excellent follow through to see tasks through completion. Function collaboratively as part of a fast-paced, client orientated team. Pay Range: $19.94 - $29.92 hourly + bonus The pay range listed for this position is based on candidate's skill level, experience, relevant licenses, and educational background. For detailed information about our benefits, please visit our careers page at ************************* Location: This is a remote-eligible position, however, Marco Technologies requires employees to reside within one of the following states: DE, FL, IA, IL, IN, KY, MD, MI, MN, MO, ME, NE, ND, NJ, PA, RI, SD, TX, WI

Building at Check At Check, we make paying people simple . In doing that, we're not just building our own business- we're building payroll businesses together with every one of our partners. As the inventors of embedded payroll, we're redefining how people get paid and making it easier for payroll businesses to launch, grow, and thrive. Check out the full story | Tune in. Check is far more than just API infrastructure. We're a springboard for building and scaling payroll businesses. Our Team Payroll is broken. Come fix it alongside a team that's as passionate as you are! At Check, you'll use creative problem-solving, critical thinking, and grit to impact every business we build. We view problems to solve and jobs to be done as opportunities to contribute to the solution; we ignore conventional role boundaries in favor of the unique strengths and value each builder brings to our team and to our mission. Join us if you're ready to roll up your sleeves and redefine payroll. Let's simplify the complex, make a real impact, and create a better future for businesses of every size. The Work The Tax Resolution team makes sure our partners and Product stay strong by resolving payroll tax notices quickly and accurately. We're the detectives of Check, uncovering the root cause of every notice and giving partners the insights they need to keep their clients protected. As a Tax Notice Resolution Agent, you'll be the first line of defense when agencies issue notices about payroll filings or payments. Partners count on Check to handle these complex, time-sensitive communications. You'll take in notices, investigate issues, and work directly with federal, state, and local agencies to secure fast resolution. Your work will reduce risk for employers, build partner trust in Check, and drive our mission to deliver a seamless embedded payroll experience. In this role, you will: Triage and resolve tax notice queues by priority, keeping partners informed with clear, timely updates. Engage directly with federal, state, and local agencies to investigate root causes, drive resolution, and pursue penalty abatements. Surface complex or systemic issues to product, engineering, and compliance for deeper investigation and long-term fixes. Spot trends across notices and recommend improvements that reduce risk and speed up resolution. Maintain and refine SOPs to capture best practices for agency outreach and notice handling. Collaborate with Payroll Ops, R&D, and Revenue to streamline tax workflows and strengthen partner trust in Check. Tools for the job Many backgrounds could fit this role, but ideal candidates will have some or all of the following: 3-5 years of experience in payroll tax compliance, tax notice resolution, or payroll operations Solid understanding of payroll tax regulations across federal, state, and local agencies Clear, confident communication skills with the ability to translate complex tax issues into plain language for partners Proven track record of handling sensitive employer information with care and discretion Familiarity with payroll systems, tax filing platforms, or case management tools Highly organized, detail-oriented, and comfortable managing multiple priorities in a fast-paced environment We build best when we come together on level ground. Travel and Office Policy The Check team is distributed across the US, and we have offices in New York City and San Francisco. While we embrace remote work, we believe time together in person is where we do our best work. We offer ample opportunities and encourage employees to attend team off-sites, events, and hackathons a couple of times a year! We expect all employees to attend our annual 3-day company retreat in the fall. For our in-office and hybrid employees, our offices are open all week. We provide meals on Tuesdays and Thursdays, and the team hosts regular happy hours, game nights, etc. What we offer: For full-time employees, Check offers company-sponsored medical, dental, vision, short-term/long-term disability, and basic life insurance coverage, effective on their first day of work. We also provide stock options, flexible PTO and sick leave, 16 weeks of fully paid parental leave for all new parents, flexible return-to-work, 10 annual holidays, a 401k retirement plan, and a $100 monthly stipend for home internet and mobile phone expenses. The expected range in San Francisco, NYC, LA, and Seattle is between $92,500 and $102,500. The expected range for all other locations is between $78,500 and $88,500. We accept applications on an ongoing basis with no specified deadline. Remote work at Check requires the ability to perform all responsibilities without distraction or disruption, while maintaining quality, effective communication, and productivity. Check is proud to be an Equal Opportunity employer. We do not discriminate based on race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender, gender identity, gender expression, transgender status, sexual stereotypes, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We also consider qualified applicants with criminal histories, provided they are consistent with applicable federal, state, and local laws. Check is committed to providing reasonable accommodations for candidates with disabilities in our recruiting process. Check participates in E-Verify and will provide the federal government with Form I-9 information from all new employees to confirm that they are authorized to work in the U.S. Check does not use E-Verify to pre-screen applicants.

Our Company Amerita Amerita is a leading provider of Specialty Infusion services focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. As one of the most respected Specialty Infusion providers in America, we service thousands of patients nationwide through our growing network of branches and healthcare professionals. The Refund/Dispute Specialist is responsible for processing incoming payer refund requests by researching to determine whether the refund is appropriate or a payer dispute is warranted in accordance with applicable state/federal regulations and company policies. The Refund/Dispute Specialist works closely with other staff to identify, resolve, and share information regarding payer trends and provider updates. The employee must have the ability to prioritize, problem solve, and multitask. This is a Remote opportunity. Applicants can reside anywhere within the Continental USA. Schedule: Monday-Friday, 7:00AM to 3:30PM Mountain Time We Offer: • Medical, Dental & Vision Benefits plus, HSA & FSA Savings Accounts • Supplemental Coverage - Accident, Critical Illness and Hospital Indemnity Insurance • 401(k) Retirement Plan with Employer Match • Company paid Life and AD&D Insurance, Short-Term and Long-Term Disability • Employee Discounts • Tuition Reimbursement • Paid Time Off & Holidays Responsibilities Reverses or completes necessary adjustments within approved range. Ensures daily accomplishments by working towards individual and company goals for cash collections, credit balances, medical records, correspondence, appeals/disputes, accounts receivable over 90 days, and other departmental goals Understands and adheres to all applicable state/federal regulations and company policies Understands insurance contracts in terms of medical policies, payments, patient financial responsibility, credit balances, and refunds Verifies dispensed medication, supplies, and professional services are billed in accordance to the payer contract. Validates accuracy of reimbursement and the appropriate deductible and cost share amounts billed to the patient per the payer remittance advice. Reviews remittance advices, payments, adjustments, insurance contracts/fee schedules, insurance eligibility and verification, assignment of benefits, payer medical policies and FDA dosing guidelines to determine if a refund or dispute is needed. Completes payer/patient refunds as needed and validates receipt of previously submitted refunds/disputes. Creates payer dispute letters utilizing Amerita's standard dispute templates and gathers all supporting documentation to substantiate the dispute. Submits disputes to payers utilizing the most efficient resources, giving priority to electronic solutions such as payer portals. Scans and attaches disputes to patient's electronic medical record in CPR+. Works closely with intake, patients, and payers to settle coordination of benefit issues. Communicates new insurance information to intake for insurance verification and authorization needs. Submits credit rebill requests as needed to the billing department or coordinates patient-initiated billing efforts to insurance companies. Initiates and coordinates move and cash research requests with the cash applications department. Utilizes approved credit categorization criteria and note templates to ensure accurate documentation in CPR+ Works within established departmental goals and performance/productivity metrics Identifies and communicates issues and trends to management Qualifications High School diploma/GED or equivalent required; some college a plus A minimum of one to two (1-2) years of experience in revenue cycle management with a working knowledge of Managed Care, Commercial, Government, Medicare, and Medicaid reimbursement Working knowledge of automated billing systems; experience with CPR+ and Waystar a plus Working knowledge and application of metric measurements, basic accounting practices, ICD 9/10, CPT, HCPCS coding, and medical terminology Solid Microsoft Office skills with the ability to type 40+ WPM Strong verbal and written communication skills with the ability to independently obtain and interpret information Strong attention to detail and ability to be flexible and adapt to workflow volumes Knowledge of federal and state regulations as it pertains to revenue cycle management a plus Flexible schedule with the ability to work evenings, weekends, and holidays as needed About our Line of Business Amerita, an affiliate of BrightSpring Health Services, is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness, and entrepreneurial spirit of a local provider. For more information, please visit ****************** Follow us on Facebook, LinkedIn, and X. Salary Range USD $18.00 - $20.00 / Hour