RCM OPEX Specialist
Miami, FL jobs
The RCM OPEX Specialist plays a critical role in optimizing the financial performance of healthcare organizations by ensuring that revenue cycle management processes are efficient and compliant with industry regulations. This position requires detail-oriented professionals who can navigate complex insurance claims and reimbursement processes.
Essential Job Functions
Manage internal and external customer communications to maximize collections and reimbursements.
Analyze revenue cycle data to identify trends and proactively remediate suboptimal processes.
Maintain fee schedule uploads in financial and practice operating systems.
Review and resolve escalations on denied and unpaid claims.
Collaborate with healthcare providers, payors, and business partners to ensure revenue best practices are promoted.
Monitor accounts receivable and expedite the recovery of outstanding payments.
Prepare regular reports on refunds, under/over payments.
Stay updated on changes in healthcare regulations and coding guidelines.
*NOTE: The list of tasks is illustrative only and is not a comprehensive list of all functions and tasks performed by this position.
Other Essential Tasks/Responsibilities/Abilities
Must be consistent with Femwell's core values.
Excellent verbal and written communication skills.
Professional and tactful interpersonal skills with the ability to interact with a variety of personalities.
Excellent organizational skills and attention to detail.
Excellent time management skills with proven ability to meet deadlines and work under pressure.
Ability to manage and prioritize multiple projects and tasks efficiently.
Must demonstrate commitment to high professional ethical standards and a diverse workplace.
Must have excellent listening skills.
Must have the ability to maintain reasonably regular, punctual attendance consistent with the ADA, FMLA, and other federal, state, and local standards and organization attendance policies and procedures.
Must maintain compliance with all personnel policies and procedures.
Must be self-disciplined, organized, and able to effectively coordinate and collaborate with team members.
Extremely proficient with Microsoft Office Suite or related software; as well as Excel, PPT, Internet, Cloud, Forums, Google, and other business tools required for this position.
Education, Experience, Skills, and Requirements
Bachelor's degree preferred.
Minimum of 2 years of experience in medical billing, coding, revenue cycle or practice management.
Strong knowledge of healthcare regulations and insurance processes.
Knowledgeable in change control.
Proficiency with healthcare billing software and electronic health records (EHR).
Knowledge of HIPAA Security preferred.
Hybrid rotation schedule and/or onsite as needed.
Medical coding (ICD-10, CPT, HCPCS)
Claims management (X12)
Revenue cycle management
Denials management
Insurance verification
Data analysis
Compliance knowledge
Comprehensive understanding of provider reimbursement methodologies
Billing software proficiency
Enrollment Specialist (East Coast)
Remote
Hello Heart is on a mission to change the way people care for their hearts. The company provides the first app and connected heart monitor to help people track and manage their heart health. With Hello Heart, users take steps to control their risk of heart attacks and stroke - the leading cause of death in the United States. Peer-reviewed studies have shown that high-risk users of Hello Heart have seen meaningful drops in blood pressure, cholesterol and even weight. Recognized as the digital leader in preventive heart health, Hello Heart is trusted by more than 130 leading Fortune 500 and government employers, national health plans, and labor organizations. Founded in 2013, Hello Heart has raised more than $138 million from top venture firms and is a best-in-class solution on the American Heart Association's Innovators' Network and CVS Health Point Solutions Management platform. Visit ****************** for more information.
About The Role
Our clients are seeing the immense value and health benefits for their employees and we're constantly getting new users, which means we're looking for an Enrollment Specialist to assist in enrolling our new users at events around the United States, with an emphasis on the East Coast. We are looking for someone who is currently based on the East Coast, preferably in the Northeast, near a major airport, as this role requires heavy travel around the country during our peak months.
Hello Heart believes in every employee being taken care of from their toes to their heart and everything else! This is a salaried position, with full medical benefits paid (health, dental, vision), and equity in the company.
Responsibilities:
Create delightful member interactions, ensuring member experience is top of the line.
Partner with Customer Success and our clients to design and execute successful enrollments and engagement campaigns, both virtually and in-person.
Travel onsite to clients to drive users' enrollment process in different locations across the United States.
Assist with Marketing and Customer Success teams with feedback on how to improve enrollment events, actively providing solutions and problem-solving.
Own member questions live and on-site, and escalating more complex issues to our Support and Developer teams as needed.
Qualifications:
Bachelor's degree or equivalent work experience
Currently located on the East Coast, strong preference for the Northeast, near a major airport
2+ years experience working a customer-facing position, ideally working in a field role or events role managing logistics
Professional work experience in a travel-heavy role with the ability to travel at least 50% of the time seasonally
Comfortable working at different hours of the day. (ie, split shifts, early mornings, late nights to accommodate enrollment schedules)
Ability to lift up to 30 pounds
A valid Driver's License
Nice to have: Bilingual in Spanish, both conversationally and in writing
The US base salary range for this full-time position is $65,000.00 to $75,000.00. Salary ranges are determined by role and level. Compensation is determined by additional factors, including job-related skills, experience, and relevant education or training. Please note that the compensation details listed in US role postings reflect the annual salary and bonus only, and do not include equity or benefits.
Hello Heart has a positive, diverse, and supportive culture - we look for people who are collaborative, creative, and courageous. Oh, and if you want to see some recent evidence of the fun things we do at Hello Heart, check out our Instagram page.
Auto-ApplyPayor Enrollment Specialist (SC/NC/GA Remote only)
Greenville, SC jobs
Join our Mission: Join the forefront of women's healthcare with OB Hospitalist Group (OBHG), the nation's largest and only dedicated provider of customized obstetric hospitalist programs. Celebrating over 19 years of pioneering excellence, OBHG has transformed the landscape of maternal health. Our mission-driven company offers a unique opportunity to elevate the standard of women's healthcare, providing 24/7 real-time triage and hospital-based obstetric coverage across the United States. If you are driven to join a team that makes a real difference in the lives of women and newborns and thrive in a collaborative environment that fosters innovation and excellence, OBHG is your next career destination!
Payor Enrollment Specialist Position Summary: Processes credentialing and re-credentialing applications and Credentialing Vendor requests for OBHG health care providers. Preference for candidates residing SC, NC, and GA.
Hourly Compensation: $21.00 - $24.00 (based on experience)
Fully remote work, equipment provided.
What We Offer - More of The Good Stuff:
A mission based company with an amazing company culture.
Paid time off & holidays so you can spend time with the people you love.
Medical, dental, and vision insurance for you and your loved ones.
Health Savings Account (with employer contribution) or Flexible Spending Account options.
Paid Parental Leave
Employer Paid Basic Life and AD&D Insurance.
Employer Paid Short- and Long-Term Disability.
Optional Short Term Disability Buy-up plan.
401(k) Savings Plan, with ROTH option.
Legal Plan.
Identity Theft Services.
Mental health support and resources.
Employee Referral program - join our team, bring your friends, and get paid.
Payor Enrollment Specialist Responsibilities: Essential
Maintain credentialing information by reviewing, entering and following up on missing
Establish and maintain professional relationship with providers, insurance providers, client contacts and account service/credential
Submit and follow up on request for signatures in a timely
Respond to credentialing
Contact and respond to request to/from hospitals and health payers for verification of provider's credentials, ensuring credentialing and licensing processes are completed
Responsible for the processing and preparation of the applications for insurance payer participation with the ability to manage multiple facilities'/payers' enrollment requirements, which includes non-application requests that are indicated by OBHG staff and/or facility/payer.
Track credentialing application
Maintains providers/practitioner files including maintenance of the OBHG provider database, individual CAQH profiles and providers rosters by identifying who may need updating or re credentialing and process
Maintains and updates CRM, Mail and Utility Logs for provider's licensure, board certifications and certificate of
Escalate non-responsiveness of MD to Supervisor with documentation of
Meet required turnaround times and accuracy
Ensure all Protected Health Information is kept in a secure location at all times and maintain Compliance by communicating credentialing request, status and issues to the Corporate Compliance
Participate in the credentialing committee as
Perform other duties as assigned by Payer Enrollment Manager and/or Management
Payor Enrollment Specialist Essential Skills/Credentials/Experience/Education
Five years' experience in payor enrollment for Medicaid and Managed Care payors.
Strong organizational skills and attention to
A minimum of a High School Diploma or equivalent is required; some college or equivalent experience is preferred.
Preferred Skills/Credentials/Experience/Education
Strong telephone
Strong computer skills, proficient in Word, Excel &
Preferred understanding of medical
CPCS credentialing
Physical Demands (per ADA guidelines)
Physical Demands:
Sitting for long periods of Occupation requires this activity more than 66% of the time (2.6+ hrs/day)
Travel Demands:
May require occasional travel to corporate headquarters in Greenville, SC
Enrollment Specialist
Florida jobs
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!
O.N.E Purpose:
Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
The Opportunity:
CAREER OPPORTUNITY OFFERING:
Bonus Incentives
Paid Certifications
Tuition Reimbursement
Comprehensive Benefits
Career Advancement
This position pays between $16.00 - $18.15/hr. based on experience
**REMOTE Opportunity**
The EDI - EFT & ERA Enrollment of Cash Application performs all enrollment activities across Ensemble Health Partners which includes hospital and physician locations. The EDI - EFT & ERA Enrollment Specialist is responsible for the timely and accurate enrollment processing within multiple Clearinghouses for both client and payer for the EDI related file processing. Job duties include, but are not limited to, submitting enrollment applications through the clearinghouses, utilizing payer portals for EDI related maintenance, working with other departments within Ensemble to keep up-to-date client W9's & Bank letters, connection set up between the client and their clearinghouse, verifying all files are being transferred correctly and available for electronic processing by the Ensemble cash teams.
Essential Job Functions:
Responsible for driving the Ensemble culture through values and customer service standards.
Accountable for outstanding customer service to all external and internal contacts.
Develops and maintains positive relationships through effective and timely communication.
Takes initiative and action to respond, resolve and follow up regarding issues with all customers in a timely manner
Maintain multiple payer portals for each client to ensure timely enrollment of EFT's (Electronic Funds Transfers) to the validated client bank account
Maintain multiple payer site set ups for each client to ensure timely enrollment for ERA delivery to correct client clearinghouse
Accuracy of information when completing all submitted enrollment forms that contain client banking data
Utilizing & maintaining multiple client EFT & ERA set ups for multiple payer websites
Work from multiple client clearinghouses
Maintain Administrative access to client related information according to Ensemble's Compliance standards as well as federal guidelines
Enrollment submission follow up
Meeting Productivity and Quality
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.
Job Experience: 3 to 5 Years
MUST HAVES:
3-5 years of Healthcare Cash Posting, Medical Office, Insurance, or Billing back-ground preferred
Previous EFT - (Electronic Funds Transfer), ERA - (Electronic Remittance Advice)/835, EDI - (Electronic Data Interchange) experience is required.
Must have advanced knowledge and experience with Excel (possessing the ability to use spreadsheets, graphing, tables, calculations, and automation efficiently to process large quantities of data relevant to business tasks).
Revenue Cycle
Preferred Knowledge, Skills and Abilities:
Associates degree or equivalent experience preferred but not required
Join an award-winning company
Five-time winner of “Best in KLAS” 2020-2022, 2024-2025
Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024
22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024
Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024
Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023
Energage Top Workplaces USA 2022-2024
Fortune Media Best Workplaces in Healthcare 2024
Monster Top Workplace for Remote Work 2024
Great Place to Work certified 2023-2024
Innovation
Work-Life Flexibility
Leadership
Purpose + Values
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
Associate Benefits - We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
Our Culture - Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
Growth - We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
Recognition - We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact *****************.
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role's range.
EEOC - Know Your Rights
FMLA Rights - English
La FMLA Español
E-Verify Participating Employer (English and Spanish)
Know your Rights
Auto-ApplyEnrollment Campaign Representative (Temporary)
Remote
Are you looking for an opportunity to make a difference? At Mesa Labs we're passionate about protecting the vulnerable by enabling scientific breakthroughs, ensuring product integrity, increasing patient and worker safety, and improving quality of life around the world.
Salary Range: $18-22/hr
This position supports our SDC business. Sterilization and Disinfection Control division manufactures and sells biological and chemical indicators that assess the effectiveness of sterilization and disinfection processes for pharmaceutical, healthcare, and dental industries.
Job Summary
The Temporary Customer Service Representative will be responsible for a critical outbound calling campaign focused on assisting existing customers with maintaining a high level of compliance with their Mail-in Biological Monitoring Services. This role is a key driver for ensuring customer compliance to State and Local Health Board requirements, CDC recommendations, and continuity of service. The ideal candidate will be a self-motivated and results-oriented individual with a strong focus on customer service, excellent communication skills, and the ability to manage a high volume of outbound calls.
Duties/Responsibilities
Make 75-100 outbound calls daily to a provided list of existing customers whose Mail-in Biological Monitoring Services accounts are not enrolled in automatic renewal.
Utilize a provided script to explain the benefits of auto-renewal and guide customers through the enrollment process.
Clearly and professionally communicate the importance of maintaining compliance with sterilization testing services.
Answer customer questions related to their services, billing, and the auto-renewal process.
Accurately document customer interactions and update account information in the CRM system (currently NetSuite).
Collaborate with the existing customer service team as needed for complex inquiries or escalations.
Meet or exceed daily and weekly targets for the number of sterilizers enrolled in auto-renewal.
Experience/Education
Two years in a customer service, sales, or outbound call center environment.
Knowledge and Skillsets Required
Skills:
Strong verbal communication skills with a clear and professional phone demeanor.
Proficiency in using a CRM system (e.g., Salesforce, HubSpot, NetSuite) and other relevant software.
Ability to work independently and manage time effectively in a remote working environment.
High level of attention to detail for accurate data entry and documentation.
Resilience and a positive attitude when facing customer objections.
Technical Requirements:
Reliable high-speed home/remote internet connection.
Dedicated quiet workspace for making professional calls.
Necessary computer hardware, dual monitors, headset, etc. will be provided by Mesa Labs
Mesa Labs is an Equal Employment Opportunity Employer.
Mesa Labs prohibits unlawful discrimination and harassment against applicants or employees based on age, race, sex, color, religion, creed, national origin or ancestry, disability, military status, sexual orientation, or any other status protected by applicable state or local law. Please note that Mesa Labs conducts criminal background checks upon offer acceptance.
Outreach and Enrollment Specialist
Tallahassee, FL jobs
The Outreach and Enrollment Specialist reports to the Mobile Health Services and Outreach Administrator. Duties and responsibilities include increasing access to care through application and enrollment assistance for people who may be eligible for the new affordable insurance options available beginning in 2023.
Requirements
RESPONSIBILITIES AND DUTIES:
Respond to incoming requests for assistance regarding Mobile Health Services and Outreach.
Provide information in a fair, accurate, and impartial manner.
Remain current with eligibility requirements.
Work cooperatively with BCHC providers and personnel to carry out goals and objectives of Mobile Health Services and Outreach.
Assist with the implementation and coordination of Mobile Health Services and Outreach activities such as staging events, some after or before normal business hours, evenings, and weekends.
Assist with presentations for community groups and referral sources.
Attend all required training sessions at the federal, state and local level and meetings concerning MHS & O.
Safeguard data, maintain strict confidentiality of information, and perform required reporting.
Accurately complete data collection and enrollment process.
Conduct “in reach” with BCHC patients and “outreach” with non- BCHC patients in all service areas.
Monitor and report all patient correspondence including patient/non-patient completed enrollments.
Provide educational materials regarding insurance options to community partners including health departments, hospitals, urgent cares, physician's offices, and human services agencies and collaborate and coordinate outreach efforts with them.
Organize work to meet goals, objectives, and deadlines.
Multi-task and prioritize duties.
Assist with development of promotional materials at the appropriate literacy level.
Other duties as assigned.
QUALIFICATIONS:
High school diploma or equivalent experience.
Friendly out-going personality which shows compassion and dedication to helping others.
Ability to work effectively with underserved and diverse populations.
Experience in planning and implementing projects and coordination of functions and setting goals and meeting timelines promptly.
Comply with all applicable federal and state training requirements related to the development of expertise in eligibility, enrollment, and program specifications.
Able to work accurately, independently and as part of a team.
Must be able and willing to travel as needed, have dependable transportation, and valid driver's license.
Enrollment Specialist
Miami, FL jobs
LE0016 MMMFL Holdings, LLC
It's fun to work in a company where people truly BELIEVE in what they're doing!
We're committed to bringing passion and customer focus to the business.
We currently have an opening for an Enrollment Specialist. This position will be responsible to work with the daily operational processes of the Enrollment Department, as well as maintain compliance with CMS and Company's policies and procedures.
Duties and Responsibilities:
Analyze and validate the needed steps of eligibility process of the Enrollment application
Process enrollment applications, disenrollment request, PBP Changes and Cancellation request
Work with Sales Application and understand the different workflows and queues.
Work with Customer Service Application Programs including the Pharmacy applications on a daily basis
Ensure that all eligibility and demographic changes received from the beneficiary are process in an accuracy and timely matter
Ensure privacy and confidentiality of the protected health information (PHI) and corporate information accessible as part of the position's functions
Coordinate sales and customer service incident process and inquiries response.
Analyze, provide input, feedback and guidance on the resolution of member enrollment inquiries and service requests
On a daily basis revise that all complete, incomplete and denial letters area process as required
Comply with the monthly close process, including any reporting requirements.
Provide feedback to the Enrollment Manager of any process that can be modify or improved in the daily process
Ensure to meet a minimum of a 90% of the individual metric result
Ensure the privacy and confidentiality of the protected health information (PHI) and corporate information accessible as part of the position's functions.
Comply with CMS policies, Medicaid Agency Policies, MOC requirements, Procedures and CMS guidelines for Enrollment and Operational Processes for MA-PD products including internal Policies and Procedures
Participate in all departmental training sections and keep up to date changes in CMS guidelines and regulations.
Attend to all trainings per guidelines of the MOC related to functions of enrollment and customer service
Notify Manager of any processes not in compliance with the Plans' policies and MOC requirements, which includes SNP, and MA-PD.
Assist Manager or Participate in any special project assigned by the Enrollment Management.
Skills and Qualifications:
2+ years of related experience in the area of Enrolment
Understanding in the process flow for the enrollment and PBP applications.
Understanding in the process flow for incomplete applications.
Understanding in the process flow for the disenrollment and cancellation requests
Understanding in the process flow for the enrollment files and basic file setup.
Time Management Skills: establishing priorities and accomplishing tasks in a timely manner
Ability to operate On Base System and its workflow queues
Experience with Office, Word, Excel, Power Point and Outlook
Skills in establishing and maintaining effective working relationships with employees, policy-making bodies
Self-directed with good organizational skills
Skill in organizing work, making assignments and achieving goals and objectives
MMM of Florida is an equal opportunity employer. We are committed to providing a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the organization. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives.
As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. We are dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!
Auto-ApplyOutreach & Enrollment Specialist
Bellingham, WA jobs
Compensation:
Non-exempt, hourly
The standard wage range for this role is $25.18 to $29.58 per hour
It may be possible to earn more over time up to $34.02 per hour
Work Schedule:
Monday - Friday
Full time, 40 hours, days
Who We Are
Unity Care NW is a private, non-profit, federally qualified health center (FQHC) that has been proudly and successfully serving the greater Whatcom County area since 1982. With clinics located in Bellingham & Ferndale, we offer comprehensive primary medical, behavioral health and dental care, as well as pharmacy services to a diverse and often underserved patient population of all ages. Employing more than 300 caring and compassionate employees, our mission is to increase the years of healthy life in the people & communities we serve.
What We Value
Respect
Integrity
Accountability
Collaboration
Innovation
We strive to demonstrate our Values in Action in all that we do. We value each individual on our team and aim to onboard a workforce of the very best talent, whose ambitions and values align with ours.
Job Summary
As an Outreach & Enrollment Specialist, you would be responsible for connecting patients to high quality, affordable health care services by providing insurance enrollment, health care navigation support, and outreach to medically underserved populations. Primary responsibilities and duties include:
Assists patients and community members with insurance enrollment.
Assists with implementing outreach campaigns to connect patients to insurance and related resources.
Documents and reports progress on all outreach and enrollment activities as required.
Connects patients and community members to UCNW services and community resources.
Processes Sliding Fee Discount Program applications.
What We Offer
A friendly & collaborative team environment
A competitive compensation package
Benefits Include:
Medical, dental, & vision insurance
401(k) retirement plan with employer match after 1 year of eligibility
6 paid holidays
Generous paid time off: 108 hours accrued in Year 1 gradually increasing to 196 hours per year over 10 years
Paid sick leave
Other paid leaves for Bereavement, Jury Duty & Bone Marrow/Organ Donation
Life/AD&D insurance
Variety of optional insurances including Supplementary Life/AD&D, Short Term and Long Term Disability, Critical Illness, Accident, and Travel as well as Identity Theft Protection
Flexible Spending Account
Self-funded Health Savings Account on Base Medical Insurance Plan
Employee Assistance Program
Alternative transportation incentives
Healthy Living reimbursement
Unique programs including Medical Hardship Payroll Loans, Employee Referral Bonuses & Will preparation services
Requirements
Professional and Technical Knowledge:
Possesses a basic level of written and verbal communications skills, computational and computer skills and mathematical knowledge at a level typically acquired through completion of a general studies high school program.
Possesses specific knowledge of Community Health (related field, or lived experience), processes and practices, typically learned on the job, or which may include a series of training sessions that would comprise a few weeks if done consecutively.
Must possess additional expertise in the field of Community Health (related field, or lived experience), acquired through practice or exposure to various conditions, beyond the formal knowledge (or on the job training), allowing employees to perform more advanced techniques.
Six (6) months related experience and/or training preferred.
Bachelor's degree in a related field preferred.
Experience working with underserved populations and cultural competency strongly preferred.
Technical Skills:
Knowledge of health insurance options including Medicare, Medicaid, private insurance, and managed care programs preferred.
Ability to work in a demanding, fast-paced environment with constant public contact, frequent interruptions, and occasional crisis situations.
Ability to understand and respond effectively and with sensitivity to special population groups, including those defined by race, ethnicity, language, age, gender, sexual orientation, economic standing, & others.
Keyboarding speed of 55 wpm and data entry skills; accuracy is essential.
Knowledge of and proficiency in Microsoft Office suite programs including but not limited to Word, Excel, PowerPoint, SharePoint, etc.
Communications Skills:
Possesses ability to effectively communicate information that is complex and/or technical to co-workers and others.
Able to exercise tact and diplomacy in the resolution of mild conflicts or disagreements that occur on the job that would be considered at a level of basic “customer service”.
Prepares effectively written communication (e.g., correspondence, memos, letters, emails) conveying information.
Effectively communicates information during informal and formal verbal interactions.
Ability to communicate bilingually in Spanish, a plus.
To apply, visit our Careers Page at ******************** For news on our organization & future job postings, please follow us on LinkedIn at ***********************
Unity Care NW has an Employee Health Program for the safety of our patients and staff. The program requires all new employees to have up to date vaccines for Covid-19 and influenza. More information about this program is provided throughout the recruitment process.
If you feel this job posting is missing any required compensation or benefit information, please contact ***********. Other questions can be addressed throughout the recruitment process for candidates selected to move forward.
Easy ApplyMembership Enrollment Specialist - 9Round - Franchise #9R1010 in Kennewick, WA
Kennewick, WA jobs
Making Members Stronger, Physically and Mentally Those aren't just words on paper, they're words we live by. Our mission at 9Round is Making members stronger in 30 minutes, physically and mentally. We're dedicated to enriching people's lives through our kickboxing fitness program, and our team is the most important part of making our mission a reality.
Does our mission statement speak to you? Are you someone who is outgoing, loves the fitness industry, enjoys helping people achieve a healthy lifestyle? Do you thrive on working in an upbeat environment and having the opportunity to turn your passion of fitness into a paying career?
If this is you, LOOK NO FURTHER! 9Round Kennewick can't wait for you to join our team!
Worried about not having any fitness, training or sales experience?? Don't be.....we will provide ALL of the training needed! You will be initially trained to do all requirements of a 9Round Trainer. Your day to day will involve completing first time workouts with prospects, marketing, calls/texts, and membership enrollment. You would be responsible for helping new & existing members build a healthy lifestyle, guiding our members toward their goals, supporting them each step of the way and celebrating their every accomplishment/WIN!
Primary Duties:
* Complete our online training program as a trainer
* Must believe in the 9Round workout and have a passion for helping others meet their fitness and/or weight loss goals
* Help grow our membership community through new membership enrollment
* Build rapport and member relationships to encourage member retention
* Be the first point of contact for a new prospect and first-time workout.
* Calling, texting or emailing existing/new members & prospects
* Completing outgoing member follow up calls/texts
* Help building the 9Round brand in the community using local studio marketing efforts (networking, building key collaborations, community events, etc.)
* Greet all members with energy and enthusiasm as they come into the studio
* Proficiently explain and demonstrate the exercises for each part of the Daily Workout, which include kickboxing, weighted, and functional exercises
* Understanding our PULSE heart rate technology
* Cleaning and tidying the facility, including the workout space, administrative and lobby area, and bathroom/changing rooms
Interests/Experience:
* Passionate about fitness.
* Customer service experience.
* Excellent verbal communication and listening skills.
* Loves being part of a team.
* Ability to motivate & inspire.
* Ability to adapt quickly to each client's individual needs.
* Basic computer skills.
* Retail, sales and/or fitness industry experience preferred but not required.
* High school diploma or equivalent
Physical Requirements:
The physical demands described here are representative of those that must be met to successfully perform the essential functions of this job. This person must be able to perform the exercise, verbally explain each exercise and make corrections where needed with confidence and knowledge.
Salary Information:
This position will pay minimum wage with bonus potential.
Diversity, Equity, and Inclusion
9Round is an equal opportunity employer committed to creating a diverse workforce. We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, service member status, amnesty or status as a covered veteran, or any other protected classification under applicable federal, state, and local laws.
This position is subject to a background check for any convictions directly related to its duties and responsibilities. Only job-related convictions will be considered and will not automatically disqualify the candidates.
9Round Franchising, LLC is the franchisor of the 9Round franchised system. Each 9Round franchised location is independently owned and operated by an independent franchisee, and there is no joint employer relationship between 9Round and its franchisees. Franchisees have the sole right to hiring, firing, scheduling, assigning, training, promoting, disciplining, and compensating its employees. As a service to its independently owned and operated franchisees and for brand management purposes only, 9Round may list employment opportunities available throughout the franchised network so those employment opportunities may be conveniently found by interested parties at one central location. Employees at a franchise location are solely and exclusively employed by the Franchisee and are not employees of 9Round Franchising, LLC.
Acknowledgement*
I understand that I am applying for a position with an employer that is an independently owned and operated 9Round franchisee, not the franchisor, 9Round Franchising, LLC, or any of its affiliates. With respect to any position with a franchisee, I understand and agree that any information I provide in this application will be submitted directly to the independent franchisee, who is solely responsible for all employment related matters in their studio. This means, among other things, that the independent franchisee is solely responsible for and unilaterally makes all decisions concerning my employment, including hiring, firing, discipline, supervision, staffing and scheduling. 9Round Franchising, LLC will not receive a copy of my application, will have no control over whether I receive an interview or am ultimately hired, does not control and is not responsible for the employment policies and practices of independent franchisees, and does not employ independent franchisee's employees. If I am hired to work at an independent franchisee's studio, the independent franchisee, and not 9Round Franchising, LLC, will be my employer. By submitting my application and resume, I am confirming that I am agreeing and consenting to the foregoing.
Compensation: $14.49 per hour
Credentialing Enrollment Specialist
Charlotte, NC jobs
Department:
13213 Enterprise Corporate - Payor Relations
Status:
Full time
Benefits Eligible:
Yes
Hours Per Week:
40
Schedule Details/Additional Information:
has a first shift schedule between normal business hours of 8am to 5pm.
Pay Range
$23.65 - $35.50
Essential Functions
Performs primary source verifications of documentation required for managed care credentialing and re-credentialing of MGD providers.
Provides issue resolution and support regarding billing issues as they relate to provider enrollment and credentialing for MGD providers and the Central Billing Office.
Enters provider data in the ECHO database according to established departmental processes and provides feedback to other System entities as to the status of the applicants.
Performs follow-up on needed information (expired licenses, board certifications insurance and DEA registrations) on an ongoing basis and ensures receipt of same in a timely manner.
Prepares physician files for file audits by managed care organizations, Corporate Compliance and accreditation entities.
Conducts practice site visits for practices within MGD. Facilitates communication tools and or activities to maintain timely and accurate flow of information to Managed Care Organizations (MCOs) and the System.
Reviews hard copy and electronic provider directories and other information produced by managed care organizations reflecting MGD and the System's demographics and participation.
Provides Team member support to the CPN Credentialing and Quality Review Committee.
Physical Requirements
Perform most duties under normal office conditions which may include sitting for long periods of time, standing, walking, using repetitive wrist/arm motion or lifting articles 20-50 pounds. Work is subject to time sensitivity, heavy volumes, and frequent interruptions, either by phone or other employees. Must use frequent and variable body movements during filing and maintaining records. Require frequent verbal and written communication in English to employees, corporate staff, providers, and external agencies. Require occasional travel to other corporate offices. Use of personal vehicle required. Intact sense of sight and hearing required.
Education, Experience and Certifications
High school diploma or GED required; Bachelor's degree preferred. Three years' experience in a role that performs or supports provider credentialing, privileging, and/or enrollment in either a hospital, managed care plan or CMS environment is required. Knowledge of and experience with personal computers, Windows and Microsoft applications, copier and fax machines and multi-line telephone required. Experience in typing, word processing, and business correspondence is required. Certification through National Association of Medical Staff Services (NAMSS) as Certified Provider Credential Specialist (CPCS) or Professional Medical Services Management (CPMSM) preferred.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:
Compensation
Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance
Benefits and more
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
Auto-ApplySpecialist-Payer Enrollment
Memphis, TN jobs
With direct impact on reimbursement timelines, patient satisfaction, and regulatory compliance, the Payer Enrollment Specialist plays a foundational role in healthcare administration. By ensuring timely and accurate enrollment of healthcare providers with commercial and government payers, this position directly contributes to the financial health of the organization and uninterrupted access to care for patients. Effective payer enrollment minimizes delays in reimbursement, supports provider scheduling, and ensures compliance with payer-specific and regulatory requirements. The specialist serves as a liaison between providers, internal departments, and payers to streamline application processing, manage revalidations, and resolve enrollment-related issues. Attention to detail, understanding of credentialing standards, and proactive communication are essential for success in this role.
Job Responsibilities:
Verify all required documentation for provider enrollment with insurance payers (e.g., applications, licenses, certifications).
Submit enrollment applications and documentation required for both new providers, as well as location adds or practice changes
Maintain and update records of provider enrollment status, ensuring that all information is accurate and up-to-date.
Complete timely revalidation through payer portals, recredentialing applications, or profiles such as CAQH to ensure that providers maintain enrollment with commercial and governmental payers.
Follow up with payers to ensure timely and accurate processing of provider enrollments within payer-specific turnaround time metrics, communicating directly with payer representatives to resolve enrollment issues or discrepancies, and escalating trends or new payer requirements to leadership
Monitor payer enrollment timelines and ensure that all required steps are completed in a timely manner to avoid delays in provider participation.
Address provider inquiries regarding enrollment status, billing issues, or payer-specific requirements.
Coordinate with other internal departments (e.g., credentialing, billing) to ensure that enrollment information is aligned across systems.
Research and maintain current knowledge of payer-specific enrollment requirements and changes, ensuring that provider data is compliant with payer guidelines.
Support the creation and maintenance of documentation for payer enrollment processes and procedures.
Monitor and Resolve Enrollment-Related Claim Denials: Investigate and resolve claim denials or rejections related to provider enrollment issues, including missing or incorrect NPI, TIN, or payer ID information.
Maintain Accurate Provider Data: Ensure provider information is accurately reflected in payer systems to prevent claim processing delays or denials.
Follow Up with Payers: Communicate with insurance payers to verify provider enrollment status and resolve any issues affecting claims adjudication.
Experience
2 years focused payer enrollment experience
Education
High School/GED
Credentialing/Payer Enrollment certificate from an accredited facility.
Credentialing Enrollment Specialist
Charlotte, NC jobs
Department: 13213 Enterprise Corporate - Payor Relations Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: has a first shift schedule between normal business hours of 8am to 5pm. Pay Range $23.65 - $35.50
Essential Functions
* Performs primary source verifications of documentation required for managed care credentialing and re-credentialing of MGD providers.
* Provides issue resolution and support regarding billing issues as they relate to provider enrollment and credentialing for MGD providers and the Central Billing Office.
* Enters provider data in the ECHO database according to established departmental processes and provides feedback to other System entities as to the status of the applicants.
* Performs follow-up on needed information (expired licenses, board certifications insurance and DEA registrations) on an ongoing basis and ensures receipt of same in a timely manner.
* Prepares physician files for file audits by managed care organizations, Corporate Compliance and accreditation entities.
* Conducts practice site visits for practices within MGD. Facilitates communication tools and or activities to maintain timely and accurate flow of information to Managed Care Organizations (MCOs) and the System.
* Reviews hard copy and electronic provider directories and other information produced by managed care organizations reflecting MGD and the System's demographics and participation.
* Provides Team member support to the CPN Credentialing and Quality Review Committee.
Physical Requirements
Perform most duties under normal office conditions which may include sitting for long periods of time, standing, walking, using repetitive wrist/arm motion or lifting articles 20-50 pounds. Work is subject to time sensitivity, heavy volumes, and frequent interruptions, either by phone or other employees. Must use frequent and variable body movements during filing and maintaining records. Require frequent verbal and written communication in English to employees, corporate staff, providers, and external agencies. Require occasional travel to other corporate offices. Use of personal vehicle required. Intact sense of sight and hearing required.
Education, Experience and Certifications
High school diploma or GED required; Bachelor's degree preferred. Three years' experience in a role that performs or supports provider credentialing, privileging, and/or enrollment in either a hospital, managed care plan or CMS environment is required. Knowledge of and experience with personal computers, Windows and Microsoft applications, copier and fax machines and multi-line telephone required. Experience in typing, word processing, and business correspondence is required. Certification through National Association of Medical Staff Services (NAMSS) as Certified Provider Credential Specialist (CPCS) or Professional Medical Services Management (CPMSM) preferred.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:
Compensation
* Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
* Premium pay such as shift, on call, and more based on a teammate's job
* Incentive pay for select positions
* Opportunity for annual increases based on performance
Benefits and more
* Paid Time Off programs
* Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
* Flexible Spending Accounts for eligible health care and dependent care expenses
* Family benefits such as adoption assistance and paid parental leave
* Defined contribution retirement plans with employer match and other financial wellness programs
* Educational Assistance Program
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
Payor Enrollment Specialist
Rome, GA jobs
Primary Responsibilities:
Create provider records in the practice management system
Manage and complete provider enrollment applications
Maintain participation with managed care organizations as defined by Payer Contracting
Maintain participation with Medicaid and Medicare services including MA and CMO plans
Facilitate claims billing by maintaining payer assigned privileges and billing numbers in the practice management system
Maintain enrollment dashboard and payer enrollment table within practice management system
Complete electronic remittance advice (ERA) enrollments and prepare electronic funds transfer (EFT) documents for CFO signature
Collaborate with various insurance carriers, internal and external team members to resolve payer questions and issues.
Maintain documentation and reporting regarding provider enrollments in process within the credentialing database
Responsible for understand specific application requirements for each payer including pre-requisites, forms required, licensure, CLIA, supporting documentation and regulations.
Research payer enrollment guidelines as needed for non-contracted payers.
Provide enrollment status reports to management and key personnel
Responsible for claims follow up for denials and edits related to payer enrollment
Maintain referring provider billing table
Maintain DEA license within the practice management system
Set up departments in practice management
Enter department numbers in the practice management systems
Education Requirement:
Proficiency in Athena practice management highly preferred
A minimum of three to five years of relevant work experience in payer enrollment, credentialing, or claims billing/follow up required.
Must possess or be willing to develop general knowledge of CAQH, PECOS, and credentialing systems.
Skill Requirement:
Must have strong computer skills
Excellent organizational skills
Excellent verbal and written communication skills.
Strong interpersonal skills including the ability to effectively communicate with persons internal and external the organization, including physicians and other staff.
Attributes and Qualifications Requirements:
Ability to work independently
Ability to exercise judgement and make decisions
Ability to multi-task
Auto-ApplyCredentialing and Enrollment Specialist
Gastonia, NC jobs
Job Summary: Perform all tasks necessary to ensure healthcare providers are successfully credentialed, re-credentialed and terminated with all third party payers timely. # Responsible for completion of enrollment documents, building and maintaining provider table files, fee schedules, department table files, and enrollment and numbers table files.
Educate CMG practices at the time of enrollment regarding the use of supervising physicians for mid-level billing, and supervising physicians for newly enrolled physicians and locum tenens.
#### Qualifications: Bachelors Degree preferred; high school degree required.
Minimum of one year#experience with physician insurance credentialing or with insurance companies in the area of physician billing and insurance follow up.
# Must demonstrate excellent analytical, organizational and communication skills.
# Must be able to effectively use Excel and Word.
# Attention to detail, accuracy and completeness a must.
# Be professional in appearance and behavior.
EOE AA M/F/Vet/Disability
Credentialing Enrollment Specialist
Charlotte, NC jobs
Back to Search Results
Credentialing Enrollment Specialist
Charlotte, NC, United States
Shift: 1st
Job Type: Regular
Share: mail
Auto-ApplyEnrollment Specialist
Boynton Beach, FL jobs
Description:
International College of Health Sciences (ICHS) is seeking an enthusiastic and detail-oriented Enrollment Specialist to support the admissions efforts of the organization. This role is vital in systematically and ethically recruiting qualified applicants for admissions to the College, in accordance with college, state, federal, and accreditation regulations. The ideal candidate will possess strong communication and organizational skills and will uphold the mission, vision, and core values of ICHS. Located in the vibrant Boynton Beach area of Florida, ICHS is dedicated to shaping the future of healthcare professionals through innovative educational approaches.
Onsite: Boynton Beach, FL
Schedule: Tuesday to Saturday, 11:00 am to 8:00 pm eastern
Purpose
The Enrollment Specialist will be responsible for driving the admissions process by managing inquiries, providing clear and accurate information to prospective students, and ensuring all required documentation and compliance standards are met. This position supports prospective students throughout their application process, guides them through the completion of enrollment requirements, and promotes the College's programs and offerings.
Responsibilities
Admissions Management and Communication
Independently manage inquiries to achieve prompt contact and performance activity using approved recruitment policies.
Make prompt and effective contact with inquiries, redirect unqualified candidates, and document all interactions in the College Student Management System.
Maintain a high quantity of outgoing phone calls and scheduled interviews to meet activity requirements.
Secure new inquiries through Personally Developed Referrals.
Address applicant concerns and support their transition into the College.
Guide prospective students through the completion of the enrollment process and assist applicants in completing program applications.
Compliance and Information Accuracy
Uphold the highest standard of ethics and truthfulness in communications regarding educational programs, facilities, costs, financing, licensure, completion, graduation, and placement data.
Provide clear and accurate information per college, federal, state, and accreditation guidelines.
Ensure compliance with applicable regulations; communication may be monitored/recorded as needed.
Collaborate effectively across college departments for efficient student enrollment.
Outreach and Events
Represent the College at high school, community outreach, and other events, schedule and present on behalf of the College.
Provide tours to prospective students prior to enrollment.
Student Records and Compliance
Ensure all required enrollment documents are complete and organized before the student attends class.
Document all recruitment and enrollment activities in the student management system as required by policy.
Additional Responsibilities
Complete other duties or tasks as assigned.
Demonstrate a cooperative, professional, and student-focused approach.
Follow all department and college operating procedures.
Requirements:
Qualifications
Education / Experience / Knowledge
Associate's degree or higher preferred; High school diploma or equivalent required. One (1) to three (3) years of relevant experience or equivalent combination of education and experience.
Required Experience and Skills
Sincere interest in helping others achieve life goals.
Excellent written and verbal communication skills.
Strong interpersonal, organizational, and problem resolution skills.
Goal-oriented and highly ethical.
Proficiency in MS Office and basic computer skills.
Ability to interact effectively as a leader and member of a team.
Flexibility and adaptability to changing assignments and priorities.
Ability to manage multiple tasks and meet deadlines successfully.
Desired
Experience in student recruitment, admissions, or higher education preferred.
Additional Information:At no time may work be performed, or computer systems accessed, from outside of the U.S. Individuals hired must be able to perform essential duties satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Please note that the responsibilities outlined in this job description are not exhaustive and may be supplemented as necessary. International College of Health Sciences provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, pregnancy or any other characteristic protected by federal, state, or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Enrollment Representative - Intake
Altamonte Springs, FL jobs
CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services. Job Details: The Enrollment Representative - Intake coordinator is responsible for managing all incoming documents, the creation of new patient and prescriber records and the distribution of documentation to appropriate departments. The Intake coordinator strives to work efficiently and accurately to provide appropriate and timely information to other departments.
Responsibilities
Perform intake of initial patient referrals received including but not limited to the collection and data entry of patient demographics, prescriber, medical, therapy, insurance and financial information.
Create new patient accounts within appropriate systems in a timely manner.
Files incoming documents accurately in corresponding patient chart.
Effectively communicates all incoming documents to appropriate department.
Follow current referral Intake process flow.
Responsible for complying with all applicable Policies and Procedures.
Participate and perform other duties as assigned by leadership
Skills & Abilities
Demonstrate the BioPlus C.A.R.T. values.
Competence
Accountability
Respect
Trust
Excellent Computer Skills.
Knowledge of medical terminology.
Excellent communication skills.
Ability to work cooperatively and be a liaison between departments when needed.
Professional Image
Qualifications
High School Diploma or Equivalent
At least 1 year of data entry or pharmacy technician experience
Specialty pharmacy experience preferred
CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants encouraged to apply. Drug-free work environment. Must be eligible to work in this country.
Qualifications
Requirements
High School Diploma or equivalent
Minimum of one year of administrative experience in a professional office or health care environment
Registered Pharmacy Technician or CPhT is preferred
Additional Information
BioPlus offers competitive compensation packages including health care, 401(k), growth potential, and a challenging and exciting work environment.
BioPlus is an Equal Opportunity Employer
Enrollment Representative - Benefit Investigator
Altamonte Springs, FL jobs
As one of the largest and most respected specialty pharmacies, BioPlus creates a meaningful difference to our patients, prescribers, payers, and pharmaceutical partners. Our 2 - Hour Patient Acceptance Guarantee gives a quick response to prescribers and patients for critical, time - sensitive treatments. As we continue to grow, we need exceptionally talented, bright, and driven people. If you would like to help us continue to be the innovative leader in our industry, this is your chance to join our team.
Job Description
Representative that gathers pertinent verification of insurance benefits and prepares the appropriate documentation in adherence with company's 2-hour brand promise. Works efficiently and provides appropriate and timely information to other departments.
Participation in all aspects of patient's insurance verification functions in adherence to company's 2-hour brand promise.
Responsibilities
Responsible for accurately completing benefit investigations with adherence to company's 2-hour brand promise
Must be proficient in Pharmacy Benefit and Major Medical coverage including Commercial, Medicare B and Supplements, Medicare D and State Medicaid
Responsible for a complete understanding of health insurance benefit structure including copay structure, co-insurance, deductibles, out of pocket, coordination of benefits, etc
Adjudicate claims through Pharmacy Benefit Managers
Ability to read and understand paid and rejected claims
Ability to be able to read Rx and select appropriate dose/units per day supply
Must have great customer service phone skills with the ability to use persistence and ask the right questions to obtain thorough and accurate information
Ability to work independently and within a team setting. Must present positive attitude to create a positive work environment
Adapt to departmental and company procedures as necessary
Update sales staff and verification team with pertinent information
Other Duties as assigned by Manager/Supervisor of Admissions Enrollment
Skills & Abilities
Excellent Computer Skills
Knowledge of medical terminology
Excellent communication skills
Ability to work cooperatively and be a liaison between departments when needed
Professional image
Ability to adhere to C.A.R.T. principles
Qualifications
Requirements
High School Diploma or Equivalent
At least 1 year of insurance verification experience
Certified and Registered Technician preferred
Additional Information
BioPlus offers competitive compensation packages including health care, 401(k), growth potential, and a challenging and exciting work environment.
BioPlus is an Equal Opportunity Employer
Peer Specialist
Punta Gorda, FL jobs
Job Details 1700 EDUCATION AVE - PUNTA GORDA, FL Full Time High School $16.25 - $17.82 Hourly Up to 25% Day Nonprofit - Social ServicesDescription
Make a lasting difference in the lives of individuals in recovery. Join our mission-driven team!
The Peer Specialist serves as a vital member of the Substance Use and Court Services program, providing peer-based support to individuals with substance use disorders (SUD), mental health (MH) disorders, and may also be involved in the judicial system. This role uses lived experience to engage individuals in recovery, offer encouragement, promote self-advocacy, and support treatment goals. The Peer Specialist assists with community reintegration, facilitates group discussions, attends court proceedings, and ensures individuals feel supported through their recovery journey. The work occurs across office, court, and community settings and is rooted in recovery-oriented principles and collaboration with a multi-disciplinary team.
What We Offer
Competitive salary and sign-on bonus.
Comprehensive Benefits:
Health, dental, vision, and life insurance.
Paid Time Off (PTO) and 11 paid holidays.
403(b) Retirement Plan with 9% employer contribution (for eligible staff).
Employer-sponsored contributions to a Health Savings Account (HSA) with qualifying plans.
Tuition reimbursement, Public Service Loan Forgiveness (PSLF) eligibility, and HRSA loan repayment opportunities.
Qualified Supervisor to provide clinical supervision for licensure candidates.
Career Growth Opportunities: We invest in our leaders!
Qualifications
High school diploma or equivalent.
Ability to become a Certified Recovery Peer Specialists within one (1) year of employment.
One (1) year experience working with individuals in recovery from SUD or MH required.
Two (2) years in personal recovery required.
Must maintain high standards of ethical and professional conduct, while adhering to agency policies and procedures.
Ability to work independently and as part of a team, in collaboration with other community partners.
Ability to manage stressful situations and display appropriate work demeanor and boundaries.
Strong understanding of confidentiality, personal boundaries, and peer ethics.
Ability to demonstrate excellent customer service.
Ability to pass a level II Background clearance and drug test.
Enrollment Specialist - Broad Street
Pace, FL jobs
Employment Type:Full time Shift:Description:
Enrollment Specialist
Trinity Health PACE Broad Street
Hours- Monday through Friday
Sign on - $7,500
The Enrollment Specialist plays a key role in introducing prospective participants and their families to the PACE (Program of All-Inclusive Care for the Elderly) model. This position supports the entire enrollment process, from initial referral to eligibility assessment, ensuring accurate documentation and seamless communication between participants and the interdisciplinary team.
Position Highlights and Benefits:
· Day-1 Benefits (Low-cost medical, dental, and vision insurance plans).
· Opportunity to get paid daily - through DailyPay
· Paid holidays and generous Paid Time Off (PTO)
· Up to $4,000 in tuition reimbursement annually
· Discounts with major vendors; AT&T, Verizon, Ford Motor Company, General Motors, Quicken Loans.
What You Will Do:
Serve as the first point of contact for new referrals.
Educate prospective enrollees and families about the PACE program.
Gather and input clinical, financial, and demographic data into CRM and Electronic Health Records.
Coordinate all stages of the enrollment process, including scheduling assessments and assisting with Medicaid applications.
Develop and maintain strong relationships with referral sources, families, and community partners.
Represent the organization at community outreach events, health fairs, and informational sessions.
Minimum Qualifications:
Associate's degree with 2+ years in sales or marketing preferred (or equivalent experience).
Valid driver's license, auto insurance, and reliable transportation required.
Strong communication, interpersonal, and organizational skills.
Proficiency in Microsoft Office and experience with CRM/EHR platforms.
Ability to work independently and adapt to a dynamic work environment.
Position Highlights and Benefits:
Impactful work improving the lives of seniors and their families.
Collaborative, values-driven culture.
Competitive compensation and benefits package.
Training and career development opportunities.
Ministry/Facility Information:
Broad Street is proud to be part of Trinity Health PACE, a nationally recognized program that helps older adults live independently while receiving comprehensive care. Our mission-driven team is committed to dignity, compassion, and service excellence in every interaction.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are 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, veteran status, or any other status protected by federal, state, or local law.
Auto-Apply