Recovery specialist work from home jobs

Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider compliance. Collaborates with health plans and vendors to facilitate recovery of outstanding overpayments. Monitors and controls backlog and workflow of claims and ensures that claims are settled in a timely fashion and in accordance with cost-control standards. Essential Job Duties • Prepares written provider overpayment notifications and provides supporting documentation such as explanation of benefits (EOBs), claims and attachments. • Maintains and reconciles department reports for outstanding payments collected, past-due overpayments, uncollectible claims and autopayment recoveries. • Prepares and provides write-off documents that are deemed uncollectible, and ensures collections efforts are exhausted for write-off approval. • Researches simple to complex claims payments using tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources to validate overpayments made to providers. • Completes basic validation prior to offset to include, eligibility, coordination of benefits (COB), standard of care (SOC) and diagnosis-related group (DRG) requests. • Enters and updates recovery applications and claim systems for multiple states and prepares/creates overpayment notification letters with accuracy; processes claims as a refund or auto debit in claim systems and in recovery application. • Follows department processing policies and procedures including, claims processing (claim reversals and adjustments), claim recovery (refund request letters, refund checks, claim reversals), and reporting and documentation of recovery as explained in departmental Standard Operating Procedures (SOPs). • Responds to provider correspondence related to claims recovery requests and provider remittances where recovery has occurred. • Collaborates with finance to complete accurate and timely posting of provider and vendor refund checks and manual check requests to reimburse providers. • Supports claims department initiatives to improve overall claims function efficiency. • Meets claims department quality and production standards. • Completes basic claims projects as assigned. Required Qualifications • At least 1 year of experience in a clerical role in a claims, and/or customer service setting - preferably in managed care, or equivalent combination of relevant education and experience. • Research and data entry skills. • Organizational skills and attention to detail. • Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. • Customer service experience. • Effective verbal and written communication skills. • Microsoft Office suite and applicable software programs proficiency. Preferred Qualifications • Claims recovery experience. • Health insurance experience in a managed care setting. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Why you should join our At-Bay Security team: At-Bay is a fast-growth InsurSec company (Insurance x Cybersecurity) on a mission to bring innovative products to the market that help protect small businesses from digital risks. As an InsurSec provider, we uniquely combine insurance with mission-critical security technologies, threat intelligence, and human expertise, to bridge the critical security capability gap that exists among SMBs in the community. We believe InsurSec is an $80B market opportunity and we are excited to introduce our Senior Incident Response Recovery Specialist role to the security team in order to help expand our reach and influence in the business and security community, of which we serve 40,000 customers. The Role: We seek an experienced Incident Response Recovery Specialist to join the At-Bay Response & Recovery team. The Senior DFIR Recovery Specialist will support the Response & Recovery remediation team and report to our Incident Response Engineer. Responsibilities: Accountable for overseeing, measuring, and driving efforts to systematically increase the maturity and effectiveness of cyber security incident response and recovery processes, setups, and controls for At-Bay's Response and Recovery Team. Gains and helps maintain an end-to-end understanding of relevant client landscape (networks, endpoints, platforms, applications, dependencies, cloud services, on-premise setups, etc.). Engages with global and local operational Security & IT teams, collaborates closely with all relevant functions across the client base, and consults with external experts & stakeholders. Provides deep security expertise in the context of reviews of detection measures, post-mortem analysis of cyber incident responses, and IT recovery exercises; supports and helps coordinate major real cyber security events. Provides assurance & evidence for the formal security control objectives in this area and contributes accordingly to the overall needs of At-bay's clients. Identifies gaps in detection, response, recovery controls, and details and drives security risk reduction activities. In this role, we value: Great educational background, preferably in the fields of computer science or engineering for technical project managers. Proven working experience as a project administrator in the information technology sector. Solid technical background, with understanding or hands-on experience in Windows, Linux, and OSX Excellent client-facing and internal communication skills. Excellent written and verbal communication skills. Solid organizational skills, including attention to detail and multi-tasking skills. Required Skills: Play a key role in post-breach firewall reconfiguration, including rule audits, segmentation updates, and blocklist implementations to harden perimeter defenses. Collaborate with threat intel and SOC teams to develop and deploy IOCs and custom firewall rulesets (e.g., Palo Alto, Fortinet, Cisco ASA) during active incident response. Create and execute firewall recovery workflows to ensure secure rollback and containment during ransomware and APT-level incidents. Install/Replace, configure, and optimize network hubs, routers, and switches (e.g., higher-level protocols, tunneling). Develop and implement network backup and recovery procedures. Diagnose network connectivity problems. Implement new system design procedures, test procedures, and quality standards. Install and maintain network infrastructure device operating system software (e.g., windows OS, virtual machines). Integrate new systems into existing network architecture. Monitor network capacity and performance. Skill in writing code in a currently supported programming language (e.g., Java, Python, PowerShell). Patch network vulnerabilities to ensure that information is safeguarded against outside parties. Provide feedback on network requirements, including network architecture and infrastructure. Test and maintain network infrastructure, including software and hardware devices. An understanding of forensic data collection tools and procedures is a plus. Work location: USA, Remote ( EST ) Travel 50-75% to client locations primarily along the East Coast; flexibility to travel nationwide as needed. Our estimated base pay range for this role is $115,000 - $130,000 per year. Base salary is determined by a variety of factors including but not limited to market data, location, internal equitability, domain knowledge, experiences and skills. In general, if the position sparks your interest we encourage you to apply - our team prioritizes talent. #LI-CK1

**Come join our amazing team and work remote from home!** The Claims Recovery & Loss Analysis Specialist is responsible for performing financial reconciliation on all liquidated loans. Identify additional recovery opportunities to mitigate losses for both Carrington Mortgage Services and its clients. Research incurred losses on liquidated loans, determining responsibility and identifying bill back opportunities. Determine the root cause for all avoidable losses, work under general direction analyzing multiple data elements in order to apply the proper decision rationale and attaching evidentiary information to accurate written summaries. Perform all duties in accordance with the company's policies and procedures, all US state and federal laws and regulations, wherein the company operates. The target pay range for this position is $22.50/hr - $25.00/hr. **What you'll do:** + Reconcile all loan advances once the GSE or Government Mortgage Insured "expense" claim has been paid. + Maintain updates in LoanServ and input the assign and completion tasks upon the date the action occurs. + Respond to and make all corrections identified during the Quality Review Process within 24 hours of receipt. + Responsible for learning new skills and expand job knowledge to better perform assigned duties. + Maintain monthly performance in alignment with quality expectations. + Analyze multiple data elements in order to apply the proper decision rationale and provide evidentiary support to complete accurate written summaries. + Research incurred losses, using analytical skills and subject matter knowledge to determine responsibility and identify bill back opportunities. + Complete ad hoc Loss Analysis as required. + Responsible for staying abreast of relevant changes to GSE or Government Mortgage Insured guidelines, industry standards and client expectations. + Ensure timely completion of projects and tasks when assigned. If unable to meet a deadline, the deadline must be renegotiated prior to the initial deadline date. + Look for opportunities to improve the department's processes and procedures, to reduce costs and eliminate non-essential and manual processes and activities. + Keep Team Lead and Supervisor informed of all trends and problems including, but not limited to, claim denials/curtailments and claim payment offsets. + Moderate working knowledge of all Default Servicing processes up to and including Loss Mitigation, Bankruptcy, Foreclosure, Conveyance and Claims in addition to mortgage servicing state, federal and agency guidelines and timelines. + Moderate background in financial and loss analysis including ability to determine: all funds/advances due CMS have been recovered. + Moderate Accounting Background--Must possess the ability to complete financial reconciliations. + Moderate computer skills with MS Word, Excel. + Strong attention to details and excellent time management and organizational skills. + Comprehensive writing skills, including proper punctuation and grammar, organization, and formatting. + Ability to work under general direction to accomplish department goals and reduce/mitigate financial loss to CMS and its Clients. + Ability to substantiate facts and properly document them. + Ability to work effectively and develop rapport with all levels of staff, management, Investors/Insurers and 3rd parties. + Ability to make decisions that have moderate impact to immediate work unit. + Ability to identify urgent matters requiring immediate action and properly escalating them. + Ability to handle multiple tasks under pressure and changing priorities. **What you'll need:** + High School diploma required; Associate/Bachelor Degree in accounting or other related field preferred. + One (1) or more years' mortgage servicing default experience. + One (1) or more years' Loan Servicing platform experience for all default related activities such as Foreclosure, Bankruptcy, Default MI Claims, Loss Mitigation, etc. + Previous FHA, VA, USDA and PMI claims experience preferred **Our Company:** Carrington Mortgage Services is part of The Carrington Companies, which provide integrated, full-lifecycle mortgage loan servicing assistance to borrowers and investors, delivering exceptional customer care and programs that support borrowers and their homeownership experience. We hope you'll consider joining our growing team of uniquely talented professionals as we transform residential real estate. To read more visit: ************************** . **What We Offer:** + Comprehensive healthcare plans for you and your family. Plus, a discretionary 401(k) match of 50% of the first 4% of pay contributed. + Access to several fitness, restaurant, retail (and more!) discounts through our employee portal. + Customized training programs to help you advance your career. + Employee referral bonuses so you'll get paid to help Carrington and Vylla grow. + Educational Reimbursement. + Carrington Charitable Foundation contributes to the community through causes that reflect the interests of Carrington Associates. For more information about Carrington Charitable Foundation, and the organizations and programs, it supports through specific fundraising efforts, please visit: carringtoncf.org. **Notice to all applicants: Carrington does not do interviews or make offers via text or chat.** \#LI-SY1 Carrington is an equal opportunity employer. It is the policy of the company that applicants be considered for positions for which they qualify without regard to race, color, religion, sex, gender identity, national origin, ancestry, age, marital status, sexual orientation, protected veterans status, physical or mental disability or any other legally protected category. Carrington will make reasonable accommodations for known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the company.

Boulder Care is hiring a Peer Recovery Specialist for a 100% remote, full-time position. We are looking for individuals who: * Reside in one of the following states: AL, AK, AZ, CA, CO, FL, GA, KS, ID, IN, MD, MI, NM, NY, NC, NV, OH, OR, PA, TN, TX, WA, and WY * Have a peer certification active and in good standing in your state of residence * Have a minimum of 2 years of documented, professional experience working in peer support (this is a hard requirement; applications without this experience clearly shown on the resume will not be considered) * 1 or more years experience navigating adjunctive OUD treatment resources and referral processes * Have a minimum two years of recovery from lived-experience in substance use and/or co-occurring mental health disorders (self-attested) * Are interested in full-time work (40 hours a week) About the role A Peer Recovery Specialist (PRS) is a person who uses their direct or indirect experience of recovery from mental illness, substance use disorders, and/or significant trauma, combined with skills learned in formal training, to deliver peer-based recovery support services with a focus on improving overall health and well-being, and quality of life. Success in this role Patient Support - 60% * Conduct patient engagement in accordance with Boulder Peer Recovery Specialist policies and procedures * Assist patients in identifying barriers to achieving sustained recovery and support by empowering them in the recovery management process * Assess patient progress, functioning, and willingness to engage peer services in collaboration with patients and Care Team members, identifying options for short/long-term whole-health goals, and recovery plans * Educate on and liaise for patients available community resources, and the Boulder Care program components * Facilitate placement for higher levels of care as needed while maintaining contact with patients to enable continuity and streamline care transitions * Escalate any crisis situations involving patients and ethical breaches involving staff to appropriate personnel/agencies in a timely manner in accordance with Boulder policies & procedures * Assume primary role in providing social/emotional support and non-emergency-based, external, recovery-relevant resources to patients * Maintain clear and proactive follow-up communication with patients and providers, delivering patient outcomes reports to Care Team members * Report situations to appropriate person/s that fall under Mandatory Reporting, Duty to Warn, and the U.S. Drug Enforcement Agency's purviews (i.e. when patient reports they are not using any of their medicine prescribed by Boulder personnel) * Represent and advocate for the patient population in company matters affecting current and prospective Boulder patients, their families, and their communities Community Resources & Continuing Education- 20% * Maintain a working knowledge of appropriate services and resources (e.g., housing, transportation, community-based recovery resources) to reduce the likelihood of health setbacks and promote improved health and well being; share resources with PRS teammates and other company personnel * Assist with managing patients' appointments and care-related tasks with Care Team members and referrals outside of Boulder Care * Participate in continuing education to further advance the practice of peer-assisted recovery as a profession Administrative Responsibilities - 20% * Prioritize self-and-mutual-care * Attend weekly 1:1 and monthly group supervision sessions * Attend team meetings and trainings as requested/ scheduled * Regularly review general patient status with other members of patient's Care Team; maintain confidence & trust w/ patients by only documenting and disclosing sensitive patient information with patients' permission, except in cases of imminent harm or when patient discloses they are not using any of their Boulder-prescribed medication Requirements for the role * 2+ years of documented, professional experience working in peer support (required) * 1+ years experience navigating adjunctive OUD treatment resources and referral processes * Peer certification in state of residence - active and in good standing where available - is required * Certification as a National Certified Peer Recovery Support Specialist (NCPRSS) through NAADAC, the Association for Addiction Professionals, is expected within 9 months of hire * Must have a minimum two years of recovery from lived-experience in substance use and/or co-occurring mental health disorders (self-attested) * Strong preference for individuals utilizing underrepresented pathways/modes of substance use and/or mental illness recovery, and those with direct experience of marginalization from systems of care for mental health and/or substance use recovery (personal identification with any illness/recovery not required) * A high degree of trustworthiness, integrity and professionalism and a relentless focus on patient confidentiality through compliance with HIPAA, 42 CFR Part II, the Boulder Care Code of Conduct and Code of Ethics, Boulder Care Standard Operating Procedures * Ability to reach out to local and regional resources or recovery centers and help individuals leverage those resources * Exceptional written and verbal communication * Team-focused; effective collaboration. Serves both the team and the customer at a consistently high level * Demonstrates problem-solving and analytical skills appropriate for the position * Demonstrates high ethical standards of behavior * Maintains composure under pressure * Regularly demonstrates Boulder's core values Nice to have but not required * Familiarity with medicaid billing in Oregon and/or Washington State Work environment * This is a fully remote role but we are currently only hiring candidates who reside in: AL, AK, AZ, CA, CO, FL, GA, KS, ID, IN, MD, MI, NM, NY, NC, NV, OH, OR, PA, TN, TX, WA, and WY * Employees are required to have a dedicated, private workspace with a lockable door and high-speed internet to maintain a secure, distraction-free environment, ensuring compliance with HIPAA and confidentiality standards Expected hours of work This is a full-time non-exempt position expected to work 40 hours a week, Mon-Fri 9:00am-6:00pm Pacific Time/Eastern Time depending on your state of residence. Team members may work with their managers to adjust work hours to suit the needs of the position. Team members may be asked to work additional days as work demands require. Compensation The starting pay range for this position is $24.52 - $28.32 an hour, commensurate with experience, and is eligible for our comprehensive benefits package below. Hiring Process * First Interview (30-min phone) * Panel Interview (60-min video) * Employment Offer, Background Check, and Reference Checks * NOTE: As part of our hiring process, all final candidates will be required to undergo background checks and provide professional references. By applying, you acknowledge and consent to these checks, which may include employment history, criminal records, education/licensing verification, and professional references. We are committed to transparency and confidentiality throughout this process and will inform you in advance should any further information be required. Some of Boulder's amazing benefits for regular, full-time employees * Medical coverage through Regence * Dental, Vision and Short Term Disability coverage through Metlife and VSP * 4 weeks of PTO accrued per calendar year with a tenured increase to 5 weeks at 2 years of employment * Sick leave accrued at 1 hr for every 30 hrs worked * Mental Health Services via Regence, Doctors on Demand, and EAP for continuous care * Supplemental mental health services through Talkspace for care needed following tough patient visits * 9 Paid Holidays per year * 12 weeks of 100% paid parental leave for the birth or adoption of a child (eligible after 6 months of employment) * 401(k) retirement savings * Remote friendly with hardware provided to complete your work duties Our mission * Based in science: Boulder care teams provide comprehensive, evidence-based treatment that is tailored to each individual's unique needs and goals. * Breaking down barriers: Boulder's proprietary technology suite makes care accessible, and convenient through secure video, phone, and messaging. We're reaching rural communities of the country, where more than 80% of people have little to no access to buprenorphine (Suboxone) prescribers. Boulder provides low-threshold care that is inclusive, empowering, and heavily influenced by participants' stated preferences and goals. Wherever our patients wish to go, we're grateful to go there together. * Grounded in empathy: Our care is science-based and rooted in harm reduction. Patients, peer recovery specialists, and clinicians make important decisions together. Boulder Care believes the people who manage our product and team should be representative of those who use the platform. This includes people from backgrounds that are historically underrepresented in the industry. We celebrate differences and are committed to equal employment opportunities regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, citizenship, marital status, disability, gender identity or veteran status. If you are a qualified person with a passion for what we do, please apply!

Come join our amazing team and work remote from home! The Claims Recovery & Loss Analysis Specialist is responsible for performing financial reconciliation on all liquidated loans. Identify additional recovery opportunities to mitigate losses for both Carrington Mortgage Services and its clients. Research incurred losses on liquidated loans, determining responsibility and identifying bill back opportunities. Determine the root cause for all avoidable losses, work under general direction analyzing multiple data elements in order to apply the proper decision rationale and attaching evidentiary information to accurate written summaries. Perform all duties in accordance with the company's policies and procedures, all US state and federal laws and regulations, wherein the company operates. The target pay range for this position is $22.50/hr - $25.00/hr. What you'll do: Reconcile all loan advances once the GSE or Government Mortgage Insured “expense” claim has been paid. Maintain updates in LoanServ and input the assign and completion tasks upon the date the action occurs. Respond to and make all corrections identified during the Quality Review Process within 24 hours of receipt. Responsible for learning new skills and expand job knowledge to better perform assigned duties. Maintain monthly performance in alignment with quality expectations. Analyze multiple data elements in order to apply the proper decision rationale and provide evidentiary support to complete accurate written summaries. Research incurred losses, using analytical skills and subject matter knowledge to determine responsibility and identify bill back opportunities. Complete ad hoc Loss Analysis as required. Responsible for staying abreast of relevant changes to GSE or Government Mortgage Insured guidelines, industry standards and client expectations. Ensure timely completion of projects and tasks when assigned. If unable to meet a deadline, the deadline must be renegotiated prior to the initial deadline date. Look for opportunities to improve the department's processes and procedures, to reduce costs and eliminate non-essential and manual processes and activities. Keep Team Lead and Supervisor informed of all trends and problems including, but not limited to, claim denials/curtailments and claim payment offsets. Moderate working knowledge of all Default Servicing processes up to and including Loss Mitigation, Bankruptcy, Foreclosure, Conveyance and Claims in addition to mortgage servicing state, federal and agency guidelines and timelines. Moderate background in financial and loss analysis including ability to determine: all funds/advances due CMS have been recovered. Moderate Accounting Background--Must possess the ability to complete financial reconciliations. Moderate computer skills with MS Word, Excel. Strong attention to details and excellent time management and organizational skills. Comprehensive writing skills, including proper punctuation and grammar, organization, and formatting. Ability to work under general direction to accomplish department goals and reduce/mitigate financial loss to CMS and its Clients. Ability to substantiate facts and properly document them. Ability to work effectively and develop rapport with all levels of staff, management, Investors/Insurers and 3rd parties. Ability to make decisions that have moderate impact to immediate work unit. Ability to identify urgent matters requiring immediate action and properly escalating them. Ability to handle multiple tasks under pressure and changing priorities. What you'll need: High School diploma required; Associate/Bachelor Degree in accounting or other related field preferred. One (1) or more years' mortgage servicing default experience. One (1) or more years' Loan Servicing platform experience for all default related activities such as Foreclosure, Bankruptcy, Default MI Claims, Loss Mitigation, etc. Previous FHA, VA, USDA and PMI claims experience preferred Our Company: Carrington Mortgage Services is part of The Carrington Companies, which provide integrated, full-lifecycle mortgage loan servicing assistance to borrowers and investors, delivering exceptional customer care and programs that support borrowers and their homeownership experience. We hope you'll consider joining our growing team of uniquely talented professionals as we transform residential real estate. To read more visit: *************************** What We Offer: Comprehensive healthcare plans for you and your family. Plus, a discretionary 401(k) match of 50% of the first 4% of pay contributed. Access to several fitness, restaurant, retail (and more!) discounts through our employee portal. Customized training programs to help you advance your career. Employee referral bonuses so you'll get paid to help Carrington and Vylla grow. Educational Reimbursement. Carrington Charitable Foundation contributes to the community through causes that reflect the interests of Carrington Associates. For more information about Carrington Charitable Foundation, and the organizations and programs, it supports through specific fundraising efforts, please visit: carringtoncf.org. Notice to all applicants: Carrington does not do interviews or make offers via text or chat. #LI-SY1

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 $22.45 - $24.70/hr based on experience The Sr. Revenue Recovery Specialist will be responsible for working with a team of associates that research and analyze accounts to ensure that underpayments are identified and recovered. The Specialist will determine the appropriate action needed to recover the underpayment, complete the action, and follow up on the underpayment through recovery of the outstanding monies. Duties include identifying and recovering underpayments on patient accounts. The Specialist will develop a strong working relationship with the client team and counterparts in Contract Management and will work reports and assigned tasked as they are assigned. The Specialist will have the ability to find underpayments through both prediction rules and special assignments as required by leadership. The position will require the ability to multitask within the client team. Essential Job Functions: Communicate directly with payors to follow up on outstanding underpayments, file underpayment appeals with payors, resolve account variance and ensure timely and accurate recovery of underpayments. Identify root cause of underpayments, denials, and delayed payments to clients. Work with the client team to identify, document, and address root causes of issues in the A/R with minimal direction. Maintain a thorough understanding of applicable state and federal insurance regulations as well as payor specific requirements, taking actions on underpayments accordingly. Document all activity accurately with all pertinent information in the client's host system, Ensemble IQ, or other appropriate tracking system. Demonstrate initiative and resourcefulness by making recommendations and communicating trends and issues to management. Operate as a strong problem solver and critical thinker to resolve underpayments, independently solving problems. Meet all productivity and quality standards as established by Ensemble and Identify underpayments through both automated and manual means. Multitask within the client team. Job Experience: Three (3) to five (5) years of experience in the physician insurance industry or elsewhere in the revenue cycle, required. Desired Education Level: High school diploma or GED. Preferred Knowledge, Skills: Excellent verbal and written communication skills. Profession presence. Exceptional customer service. Ability to adapt to multiple client host systems. Integrity and honesty. Internal drive to succeed. Experience with and ability to operate in Microsoft Office suite of programs. #LI-J #LI-JW #LI-Remote 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

We are seeking a Certified Peer Recovery/Support Specialist to support our members in Tennessee. This position requires some travel within the community as needed, but mostly work from home. We would love to speak with you about joining us if: You are caring and compassionate, and would enjoy helping individuals facing substance-exposed living make positive changes in their lives. If you have strong organizational skills and a talent for problem-solving. If you are a Peer Recovery Specialist or Peer Support Specialist and have successfully participated in a recovery program, then Mindoula wants you to join our team! Peer Recovery Specialists serve as role models for individuals facing substance-exposed living and are in varying phases of recovery. In this role, you would follow the Substance Use Disorder Program division of Mindoula's guidelines in planning care, assessing client needs, and completing screenings. You also would refer clients to resources as needed, and coordinate with the Substance Use Disorder Program team, primary care providers, managed care organizations, and community agencies to provide quality care for our clients. Comprehensive Benefits Package includes: Medical, Dental and Vision Insurance Supplemental Life Insurance Short Term and Long Term Insurance paid by Mindoula 401k, with a company match 3 weeks paid vacation each year, 4 mental wellness days and 11 holidays Parental Leave: 8 weeks of paid parental leave Personal Development Program: $500 credit reimbursement per calendar year Some of the responsibilities include: Identifying individual member needs and documenting interventions based on relationships and assessments. Providing support to members through a variety of settings and assisting with support groups, as needed. Contributing to case management meetings to ensure a team approach is delivered for each member. Completing documentation for member contacts, touches, cancellations and care plans based on organizational policies. Communicating professionally with members, families, physicians, community agencies, agency leadership and office staff. Following chain of command in communicating concerns or recommendations. Responsible for achieving set goals/Key Performance Indicators (KPI's). Representing and promoting Mindoula and the Substance Use Disorder program through participation and interaction with community, professional organizations and community outreach efforts. Participating in timely conflict resolution and treating people fairly and with respect. Supporting all members of the team in performance of their duties. Participating in any performance improvement processes and initiatives. Promoting responsible and ethical stewardship of Mindoula's resources. Maintaining excellent punctuality and attendance during work hours. Partnering with the enrollment team to grow the member census and identifying eligible members to enroll in program. Other duties as assigned Apply for our Peer Recovery Specialist position today for the opportunity to join a team of professionals who are proactive in making a difference in others' lives! We launched Mindoula because each of us has had personal experience with mental illness, either directly or through a loved one. We realized that the behavioral health system was broken and decided to take it upon ourselves to fix it by focusing on the people we serve, not their diagnoses or symptom sets. Each of us, and everyone we serve, is a person first, and a set of challenges second. Come be part of the solution!

Who We Are: Santé Group Companies prides itself in being a leader in community-based behavioral and mental health services. Our track record of innovation and growth reflects our ability to deliver diverse and highly individualized services. We have a passion for providing empathetic and potentially life-saving care to help individuals heal, recover, and thrive, as well as live their lives in a manner that allows them to fully integrate in the community. The Santé Group aspires to create an organization that places value on collaboration, innovation, creativity, and inclusiveness. To achieve this success, it is essential that all members of our organization feel secure, welcome, and respected. All members of our organization have a responsibility to uphold these values. What We're Looking For: Santé is seeking a Weekend Peer Recovery Specialist (in office) to join our frontline crisis intervention team in Easton, MD. The available shift is weekends, 8:00am to 8:00pm. As a Peer Recovery Specialist, you will assess, evaluate, and perform crisis intervention techniques, and will develop a crisis plan for continuation of services related to individual clients. He or she will be responsible for all incident documentation and will be the on-site resource for any relevant clinical information, as well as the liaison for collaboration with other involved parties including families, friends, and other community providers (all under clinical supervision of an LCSW-C/LCPC). NOT A REMOTE POSITION. IN PERSON ONLY. What You'll Do: * Assist in performing a danger assessment, a crisis assessment, an environmental assessment upon entry to the community situation and lethality assessment * Assist in performing an on-scene assessment and treatment plan * Effectively perform crisis intervention including de-escalation, crisis planning and implementation * Design appropriate referral recommendations using available community resources * Address population of child, adolescent, adult, dual-diagnosis, co-occurring and elderly * Work with families and involved persons to de-escalate the situation, make a crisis plan, and enlist cooperation with recommended treatment * Document interactions using CRS procedures * Must be able to work with first responders and be aware of first responder culture * Must familiarize oneself with police codes and language * Participate in and complete all required trainings * Provide education in the community about the agency and all components of CRS when needed * Check work e-mail at the beginning and end of each shift * Provide mentoring to interns and new staff * Other duties as assigned What We Require: * Peer recovery certification or willingness to be certified. At least 2 years in full recovery and 5 years lived experience. Some college preferred. * High School Diploma or equivalent and at least one (1) year professional experience (experience working with children and families in a community-based program preferred). * While performing the duties of this job, the employee is regularly required to drive a company vehicle. The employee must possess a valid Driver's License, proof of current automobile insurance and may not have more than two (2) points on their driving record. What You'll Get: * Pay Ranges: * Uncertified: $17.75-20.50 per hour * Certified: $20.50-$24.50 per hour * Available shift * weekends, 8:00am to 8:00pm. * Financial assistance for Peer Recovery certification fees. * Opportunities for career growth, training and development, flexible work schedules and shifts. * Company-wide wellness program. * Paid parental leave. We believe that diversity of background and experience makes for better problem-solving and collaboration, which is why we are dedicated to adding new perspectives to the team. Even more important than your resume is a positive attitude, a passion for making an impact, a personal desire to grow, and the ability to help individuals heal, recover, and thrive. Disclaimers: The Santé Group aspires to create an organization that places value on collaboration, innovation, creativity, and inclusiveness. To achieve this success, it is essential that all members of our organization feel secure, welcome, and respected. All members of our organization have a responsibility to uphold these values. The Santé Group is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, protected veteran status, or disability status. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of this job. The Santé Group participates in E-Verify. ****************************************************************

Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider compliance. Collaborates with health plans and vendors to facilitate recovery of outstanding overpayments. Monitors and controls backlog and workflow of claims and ensures that claims are settled in a timely fashion and in accordance with cost-control standards. **Essential Job Duties** - Prepares written provider overpayment notifications and provides supporting documentation such as explanation of benefits (EOBs), claims and attachments. - Maintains and reconciles department reports for outstanding payments collected, past-due overpayments, uncollectible claims and autopayment recoveries. - Prepares and provides write-off documents that are deemed uncollectible, and ensures collections efforts are exhausted for write-off approval. - Researches simple to complex claims payments using tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources to validate overpayments made to providers. - Completes basic validation prior to offset to include, eligibility, coordination of benefits (COB), standard of care (SOC) and diagnosis-related group (DRG) requests. - Enters and updates recovery applications and claim systems for multiple states and prepares/creates overpayment notification letters with accuracy; processes claims as a refund or auto debit in claim systems and in recovery application. - Follows department processing policies and procedures including, claims processing (claim reversals and adjustments), claim recovery (refund request letters, refund checks, claim reversals), and reporting and documentation of recovery as explained in departmental Standard Operating Procedures (SOPs). - Responds to provider correspondence related to claims recovery requests and provider remittances where recovery has occurred. - Collaborates with finance to complete accurate and timely posting of provider and vendor refund checks and manual check requests to reimburse providers. - Supports claims department initiatives to improve overall claims function efficiency. - Meets claims department quality and production standards. - Completes basic claims projects as assigned. **Required Qualifications** - At least 1 year of experience in a clerical role in a claims, and/or customer service setting - preferably in managed care, or equivalent combination of relevant education and experience. - Research and data entry skills. - Organizational skills and attention to detail. - Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Customer service experience. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software programs proficiency. **Preferred Qualifications** - Claims recovery experience. - Health insurance experience in a managed care setting. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $34.88 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Boulder Care is hiring a Peer Recovery Specialist for a 100% remote, full-time position. We are looking for individuals who: Reside in one of the following states: AL, AK, AZ, CA, CO, FL, GA, KS, ID, IN, MD, MI, NM, NY, NC, NV, OH, OR, PA, TN, TX, WA, and WY Have a peer certification active and in good standing in your state of residence Have a minimum of 2 years of documented, professional experience working in peer support (this is a hard requirement; applications without this experience clearly shown on the resume will not be considered) 1 or more years experience navigating adjunctive OUD treatment resources and referral processes Have a minimum two years of recovery from lived-experience in substance use and/or co-occurring mental health disorders (self-attested) Are interested in full-time work (40 hours a week) About the role A Peer Recovery Specialist (PRS) is a person who uses their direct or indirect experience of recovery from mental illness, substance use disorders, and/or significant trauma, combined with skills learned in formal training, to deliver peer-based recovery support services with a focus on improving overall health and well-being, and quality of life. Success in this role Patient Support - 60% Conduct patient engagement in accordance with Boulder Peer Recovery Specialist policies and procedures Assist patients in identifying barriers to achieving sustained recovery and support by empowering them in the recovery management process Assess patient progress, functioning, and willingness to engage peer services in collaboration with patients and Care Team members, identifying options for short/long-term whole-health goals, and recovery plans Educate on and liaise for patients available community resources, and the Boulder Care program components Facilitate placement for higher levels of care as needed while maintaining contact with patients to enable continuity and streamline care transitions Escalate any crisis situations involving patients and ethical breaches involving staff to appropriate personnel/agencies in a timely manner in accordance with Boulder policies & procedures Assume primary role in providing social/emotional support and non-emergency-based, external, recovery-relevant resources to patients Maintain clear and proactive follow-up communication with patients and providers, delivering patient outcomes reports to Care Team members Report situations to appropriate person/s that fall under Mandatory Reporting, Duty to Warn, and the U.S. Drug Enforcement Agency's purviews (i.e. when patient reports they are not using any of their medicine prescribed by Boulder personnel) Represent and advocate for the patient population in company matters affecting current and prospective Boulder patients, their families, and their communities Community Resources & Continuing Education- 20% Maintain a working knowledge of appropriate services and resources (e.g., housing, transportation, community-based recovery resources) to reduce the likelihood of health setbacks and promote improved health and well being; share resources with PRS teammates and other company personnel Assist with managing patients' appointments and care-related tasks with Care Team members and referrals outside of Boulder Care Participate in continuing education to further advance the practice of peer-assisted recovery as a profession Administrative Responsibilities - 20% Prioritize self-and-mutual-care Attend weekly 1:1 and monthly group supervision sessions Attend team meetings and trainings as requested/ scheduled Regularly review general patient status with other members of patient's Care Team; maintain confidence & trust w/ patients by only documenting and disclosing sensitive patient information with patients' permission, except in cases of imminent harm or when patient discloses they are not using any of their Boulder-prescribed medication Requirements for the role 2+ years of documented, professional experience working in peer support (required) 1+ years experience navigating adjunctive OUD treatment resources and referral processes Peer certification in state of residence - active and in good standing where available - is required Certification as a National Certified Peer Recovery Support Specialist (NCPRSS) through NAADAC, the Association for Addiction Professionals, is expected within 9 months of hire Must have a minimum two years of recovery from lived-experience in substance use and/or co-occurring mental health disorders (self-attested) Strong preference for individuals utilizing underrepresented pathways/modes of substance use and/or mental illness recovery, and those with direct experience of marginalization from systems of care for mental health and/or substance use recovery (personal identification with any illness/recovery not required) A high degree of trustworthiness, integrity and professionalism and a relentless focus on patient confidentiality through compliance with HIPAA, 42 CFR Part II, the Boulder Care Code of Conduct and Code of Ethics, Boulder Care Standard Operating Procedures Ability to reach out to local and regional resources or recovery centers and help individuals leverage those resources Exceptional written and verbal communication Team-focused; effective collaboration. Serves both the team and the customer at a consistently high level Demonstrates problem-solving and analytical skills appropriate for the position Demonstrates high ethical standards of behavior Maintains composure under pressure Regularly demonstrates Boulder's core values Nice to have but not required Familiarity with medicaid billing in Oregon and/or Washington State Work environment This is a fully remote role but we are currently only hiring candidates who reside in: AL, AK, AZ, CA, CO, FL, GA, KS, ID, IN, MD, MI, NM, NY, NC, NV, OH, OR, PA, TN, TX, WA, and WY Employees are required to have a dedicated, private workspace with a lockable door and high-speed internet to maintain a secure, distraction-free environment, ensuring compliance with HIPAA and confidentiality standards Expected hours of work This is a full-time non-exempt position expected to work 40 hours a week, Mon-Fri 9:00am-6:00pm Pacific Time/Eastern Time depending on your state of residence. Team members may work with their managers to adjust work hours to suit the needs of the position. Team members may be asked to work additional days as work demands require. Compensation The starting pay range for this position is $24.52 - $28.32 an hour, commensurate with experience, and is eligible for our comprehensive benefits package below. Hiring Process First Interview (30-min phone) Panel Interview (60-min video) Employment Offer, Background Check, and Reference Checks NOTE: As part of our hiring process, all final candidates will be required to undergo background checks and provide professional references. By applying, you acknowledge and consent to these checks, which may include employment history, criminal records, education/licensing verification, and professional references. We are committed to transparency and confidentiality throughout this process and will inform you in advance should any further information be required. Some of Boulder's amazing benefits for regular, full-time employees Medical coverage through Regence Dental, Vision and Short Term Disability coverage through Metlife and VSP 4 weeks of PTO accrued per calendar year with a tenured increase to 5 weeks at 2 years of employment Sick leave accrued at 1 hr for every 30 hrs worked Mental Health Services via Regence, Doctors on Demand, and EAP for continuous care Supplemental mental health services through Talkspace for care needed following tough patient visits 9 Paid Holidays per year 12 weeks of 100% paid parental leave for the birth or adoption of a child (eligible after 6 months of employment) 401(k) retirement savings Remote friendly with hardware provided to complete your work duties Our mission Based in science: Boulder care teams provide comprehensive, evidence-based treatment that is tailored to each individual's unique needs and goals. Breaking down barriers: Boulder's proprietary technology suite makes care accessible, and convenient through secure video, phone, and messaging. We're reaching rural communities of the country, where more than 80% of people have little to no access to buprenorphine (Suboxone) prescribers. Boulder provides low-threshold care that is inclusive, empowering, and heavily influenced by participants' stated preferences and goals. Wherever our patients wish to go, we're grateful to go there together. Grounded in empathy: Our care is science-based and rooted in harm reduction. Patients, peer recovery specialists, and clinicians make important decisions together. Boulder Care believes the people who manage our product and team should be representative of those who use the platform. This includes people from backgrounds that are historically underrepresented in the industry. We celebrate differences and are committed to equal employment opportunities regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, citizenship, marital status, disability, gender identity or veteran status. If you are a qualified person with a passion for what we do, please apply!

Come join our amazing team and work remote from home! The Claims Recovery & Loss Analysis Specialist is responsible for performing financial reconciliation on all liquidated loans. Identify additional recovery opportunities to mitigate losses for both Carrington Mortgage Services and its clients. Research incurred losses on liquidated loans, determining responsibility and identifying bill back opportunities. Determine the root cause for all avoidable losses, work under general direction analyzing multiple data elements in order to apply the proper decision rationale and attaching evidentiary information to accurate written summaries. Perform all duties in accordance with the company's policies and procedures, all US state and federal laws and regulations, wherein the company operates. The target pay range for this position is $22.50/hr - $25.00/hr. What you'll do: Reconcile all loan advances once the GSE or Government Mortgage Insured “expense” claim has been paid. Maintain updates in LoanServ and input the assign and completion tasks upon the date the action occurs. Respond to and make all corrections identified during the Quality Review Process within 24 hours of receipt. Responsible for learning new skills and expand job knowledge to better perform assigned duties. Maintain monthly performance in alignment with quality expectations. Analyze multiple data elements in order to apply the proper decision rationale and provide evidentiary support to complete accurate written summaries. Research incurred losses, using analytical skills and subject matter knowledge to determine responsibility and identify bill back opportunities. Complete ad hoc Loss Analysis as required. Responsible for staying abreast of relevant changes to GSE or Government Mortgage Insured guidelines, industry standards and client expectations. Ensure timely completion of projects and tasks when assigned. If unable to meet a deadline, the deadline must be renegotiated prior to the initial deadline date. Look for opportunities to improve the department's processes and procedures, to reduce costs and eliminate non-essential and manual processes and activities. Keep Team Lead and Supervisor informed of all trends and problems including, but not limited to, claim denials/curtailments and claim payment offsets. Moderate working knowledge of all Default Servicing processes up to and including Loss Mitigation, Bankruptcy, Foreclosure, Conveyance and Claims in addition to mortgage servicing state, federal and agency guidelines and timelines. Moderate background in financial and loss analysis including ability to determine: all funds/advances due CMS have been recovered. Moderate Accounting Background--Must possess the ability to complete financial reconciliations. Moderate computer skills with MS Word, Excel. Strong attention to details and excellent time management and organizational skills. Comprehensive writing skills, including proper punctuation and grammar, organization, and formatting. Ability to work under general direction to accomplish department goals and reduce/mitigate financial loss to CMS and its Clients. Ability to substantiate facts and properly document them. Ability to work effectively and develop rapport with all levels of staff, management, Investors/Insurers and 3rd parties. Ability to make decisions that have moderate impact to immediate work unit. Ability to identify urgent matters requiring immediate action and properly escalating them. Ability to handle multiple tasks under pressure and changing priorities. What you'll need: High School diploma required; Associate/Bachelor Degree in accounting or other related field preferred. One (1) or more years' mortgage servicing default experience. One (1) or more years' Loan Servicing platform experience for all default related activities such as Foreclosure, Bankruptcy, Default MI Claims, Loss Mitigation, etc. Previous FHA, VA, USDA and PMI claims experience preferred Our Company: Carrington Mortgage Services is part of The Carrington Companies, which provide integrated, full-lifecycle mortgage loan servicing assistance to borrowers and investors, delivering exceptional customer care and programs that support borrowers and their homeownership experience. We hope you'll consider joining our growing team of uniquely talented professionals as we transform residential real estate. To read more visit: *************************** What We Offer: Comprehensive healthcare plans for you and your family. Plus, a discretionary 401(k) match of 50% of the first 4% of pay contributed. Access to several fitness, restaurant, retail (and more!) discounts through our employee portal. Customized training programs to help you advance your career. Employee referral bonuses so you'll get paid to help Carrington and Vylla grow. Educational Reimbursement. Carrington Charitable Foundation contributes to the community through causes that reflect the interests of Carrington Associates. For more information about Carrington Charitable Foundation, and the organizations and programs, it supports through specific fundraising efforts, please visit: carringtoncf.org. Notice to all applicants: Carrington does not do interviews or make offers via text or chat. #LI-SY1

Who We Are: Santé Group Companies prides itself in being a leader in community-based behavioral and mental health services. Our track record of innovation and growth reflects our ability to deliver diverse and highly individualized services. We have a passion for providing empathetic and potentially life-saving care to help individuals heal, recover, and thrive, as well as live their lives in a manner that allows them to fully integrate in the community. The Santé Group aspires to create an organization that places value on collaboration, innovation, creativity, and inclusiveness. To achieve this success, it is essential that all members of our organization feel secure, welcome, and respected. All members of our organization have a responsibility to uphold these values. What We're Looking For: Santé is seeking a Weekend Peer Recovery Specialist (in office) to join our frontline crisis intervention team in Easton, MD. The available shift is weekends, 8:00am to 8:00pm. As a Peer Recovery Specialist, you will assess, evaluate, and perform crisis intervention techniques, and will develop a crisis plan for continuation of services related to individual clients. He or she will be responsible for all incident documentation and will be the on-site resource for any relevant clinical information, as well as the liaison for collaboration with other involved parties including families, friends, and other community providers (all under clinical supervision of an LCSW-C/LCPC). NOT A REMOTE POSITION. IN PERSON ONLY. What You'll Do: Assist in performing a danger assessment, a crisis assessment, an environmental assessment upon entry to the community situation and lethality assessment Assist in performing an on-scene assessment and treatment plan Effectively perform crisis intervention including de-escalation, crisis planning and implementation Design appropriate referral recommendations using available community resources Address population of child, adolescent, adult, dual-diagnosis, co-occurring and elderly Work with families and involved persons to de-escalate the situation, make a crisis plan, and enlist cooperation with recommended treatment Document interactions using CRS procedures Must be able to work with first responders and be aware of first responder culture Must familiarize oneself with police codes and language Participate in and complete all required trainings Provide education in the community about the agency and all components of CRS when needed Check work e-mail at the beginning and end of each shift Provide mentoring to interns and new staff Other duties as assigned What We Require: Peer recovery certification or willingness to be certified. At least 2 years in full recovery and 5 years lived experience. Some college preferred. High School Diploma or equivalent and at least one (1) year professional experience (experience working with children and families in a community-based program preferred). While performing the duties of this job, the employee is regularly required to drive a company vehicle. The employee must possess a valid Driver's License, proof of current automobile insurance and may not have more than two (2) points on their driving record. What You'll Get: Pay Ranges: Uncertified: $17.75-20.50 per hour Certified: $20.50-$24.50 per hour Available shift weekends, 8:00am to 8:00pm. Financial assistance for Peer Recovery certification fees. Opportunities for career growth, training and development, flexible work schedules and shifts. Company-wide wellness program. Paid parental leave. We believe that diversity of background and experience makes for better problem-solving and collaboration, which is why we are dedicated to adding new perspectives to the team. Even more important than your resume is a positive attitude, a passion for making an impact, a personal desire to grow, and the ability to help individuals heal, recover, and thrive. Disclaimers: The Santé Group aspires to create an organization that places value on collaboration, innovation, creativity, and inclusiveness. To achieve this success, it is essential that all members of our organization feel secure, welcome, and respected. All members of our organization have a responsibility to uphold these values. The Santé Group is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, protected veteran status, or disability status. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of this job. The Santé Group participates in E-Verify. ****************************************************************

Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider compliance. Collaborates with health plans and vendors to facilitate recovery of outstanding overpayments. Monitors and controls backlog and workflow of claims and ensures that claims are settled in a timely fashion and in accordance with cost-control standards. **Essential Job Duties** - Prepares written provider overpayment notifications and provides supporting documentation such as explanation of benefits (EOBs), claims and attachments. - Maintains and reconciles department reports for outstanding payments collected, past-due overpayments, uncollectible claims and autopayment recoveries. - Prepares and provides write-off documents that are deemed uncollectible, and ensures collections efforts are exhausted for write-off approval. - Researches simple to complex claims payments using tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources to validate overpayments made to providers. - Completes basic validation prior to offset to include, eligibility, coordination of benefits (COB), standard of care (SOC) and diagnosis-related group (DRG) requests. - Enters and updates recovery applications and claim systems for multiple states and prepares/creates overpayment notification letters with accuracy; processes claims as a refund or auto debit in claim systems and in recovery application. - Follows department processing policies and procedures including, claims processing (claim reversals and adjustments), claim recovery (refund request letters, refund checks, claim reversals), and reporting and documentation of recovery as explained in departmental Standard Operating Procedures (SOPs). - Responds to provider correspondence related to claims recovery requests and provider remittances where recovery has occurred. - Collaborates with finance to complete accurate and timely posting of provider and vendor refund checks and manual check requests to reimburse providers. - Supports claims department initiatives to improve overall claims function efficiency. - Meets claims department quality and production standards. - Completes basic claims projects as assigned. **Required Qualifications** - At least 1 year of experience in a clerical role in a claims, and/or customer service setting - preferably in managed care, or equivalent combination of relevant education and experience. - Research and data entry skills. - Organizational skills and attention to detail. - Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Customer service experience. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software programs proficiency. **Preferred Qualifications** - Claims recovery experience. - Health insurance experience in a managed care setting. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $34.88 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Boulder Care is hiring a Peer Recovery Specialist for a 100% remote, full-time position. We are looking for individuals who: Reside in one of the following states: AL, AK, AZ, CA, CO, FL, GA, KS, ID, IN, MD, MI, NM, NY, NC, NV, OH, OR, PA, TN, TX, WA, and WY Have a peer certification active and in good standing in your state of residence Have a minimum of 2 years of documented, professional experience working in peer support (this is a hard requirement; applications without this experience clearly shown on the resume will not be considered) 1 or more years experience navigating adjunctive OUD treatment resources and referral processes Have a minimum two years of recovery from lived-experience in substance use and/or co-occurring mental health disorders (self-attested) Are interested in full-time work (40 hours a week) About the role A Peer Recovery Specialist (PRS) is a person who uses their direct or indirect experience of recovery from mental illness, substance use disorders, and/or significant trauma, combined with skills learned in formal training, to deliver peer-based recovery support services with a focus on improving overall health and well-being, and quality of life. Success in this role Patient Support - 60% Conduct patient engagement in accordance with Boulder Peer Recovery Specialist policies and procedures Assist patients in identifying barriers to achieving sustained recovery and support by empowering them in the recovery management process Assess patient progress, functioning, and willingness to engage peer services in collaboration with patients and Care Team members, identifying options for short/long-term whole-health goals, and recovery plans Educate on and liaise for patients available community resources, and the Boulder Care program components Facilitate placement for higher levels of care as needed while maintaining contact with patients to enable continuity and streamline care transitions Escalate any crisis situations involving patients and ethical breaches involving staff to appropriate personnel/agencies in a timely manner in accordance with Boulder policies & procedures Assume primary role in providing social/emotional support and non-emergency-based, external, recovery-relevant resources to patients Maintain clear and proactive follow-up communication with patients and providers, delivering patient outcomes reports to Care Team members Report situations to appropriate person/s that fall under Mandatory Reporting, Duty to Warn, and the U.S. Drug Enforcement Agency's purviews (i.e. when patient reports they are not using any of their medicine prescribed by Boulder personnel) Represent and advocate for the patient population in company matters affecting current and prospective Boulder patients, their families, and their communities Community Resources & Continuing Education- 20% Maintain a working knowledge of appropriate services and resources (e.g., housing, transportation, community-based recovery resources) to reduce the likelihood of health setbacks and promote improved health and well being; share resources with PRS teammates and other company personnel Assist with managing patients' appointments and care-related tasks with Care Team members and referrals outside of Boulder Care Participate in continuing education to further advance the practice of peer-assisted recovery as a profession Administrative Responsibilities - 20% Prioritize self-and-mutual-care Attend weekly 1:1 and monthly group supervision sessions Attend team meetings and trainings as requested/ scheduled Regularly review general patient status with other members of patient's Care Team; maintain confidence & trust w/ patients by only documenting and disclosing sensitive patient information with patients' permission, except in cases of imminent harm or when patient discloses they are not using any of their Boulder-prescribed medication Requirements for the role 2+ years of documented, professional experience working in peer support (required) 1+ years experience navigating adjunctive OUD treatment resources and referral processes Peer certification in state of residence - active and in good standing where available - is required Certification as a National Certified Peer Recovery Support Specialist (NCPRSS) through NAADAC, the Association for Addiction Professionals, is expected within 9 months of hire Must have a minimum two years of recovery from lived-experience in substance use and/or co-occurring mental health disorders (self-attested) Strong preference for individuals utilizing underrepresented pathways/modes of substance use and/or mental illness recovery, and those with direct experience of marginalization from systems of care for mental health and/or substance use recovery (personal identification with any illness/recovery not required) A high degree of trustworthiness, integrity and professionalism and a relentless focus on patient confidentiality through compliance with HIPAA, 42 CFR Part II, the Boulder Care Code of Conduct and Code of Ethics, Boulder Care Standard Operating Procedures Ability to reach out to local and regional resources or recovery centers and help individuals leverage those resources Exceptional written and verbal communication Team-focused; effective collaboration. Serves both the team and the customer at a consistently high level Demonstrates problem-solving and analytical skills appropriate for the position Demonstrates high ethical standards of behavior Maintains composure under pressure Regularly demonstrates Boulder's core values Nice to have but not required Familiarity with medicaid billing in Oregon and/or Washington State Work environment This is a fully remote role but we are currently only hiring candidates who reside in: AL, AK, AZ, CA, CO, FL, GA, KS, ID, IN, MD, MI, NM, NY, NC, NV, OH, OR, PA, TN, TX, WA, and WY Employees are required to have a dedicated, private workspace with a lockable door and high-speed internet to maintain a secure, distraction-free environment, ensuring compliance with HIPAA and confidentiality standards Expected hours of work This is a full-time non-exempt position expected to work 40 hours a week, Mon-Fri 9:00am-6:00pm Pacific Time/Eastern Time depending on your state of residence. Team members may work with their managers to adjust work hours to suit the needs of the position. Team members may be asked to work additional days as work demands require. Compensation The starting pay range for this position is $24.52 - $28.32 an hour, commensurate with experience, and is eligible for our comprehensive benefits package below. Hiring Process First Interview (30-min phone) Panel Interview (60-min video) Employment Offer, Background Check, and Reference Checks NOTE: As part of our hiring process, all final candidates will be required to undergo background checks and provide professional references. By applying, you acknowledge and consent to these checks, which may include employment history, criminal records, education/licensing verification, and professional references. We are committed to transparency and confidentiality throughout this process and will inform you in advance should any further information be required. Some of Boulder's amazing benefits for regular, full-time employees Medical coverage through Regence Dental, Vision and Short Term Disability coverage through Metlife and VSP 4 weeks of PTO accrued per calendar year with a tenured increase to 5 weeks at 2 years of employment Sick leave accrued at 1 hr for every 30 hrs worked Mental Health Services via Regence, Doctors on Demand, and EAP for continuous care Supplemental mental health services through Talkspace for care needed following tough patient visits 9 Paid Holidays per year 12 weeks of 100% paid parental leave for the birth or adoption of a child (eligible after 6 months of employment) 401(k) retirement savings Remote friendly with hardware provided to complete your work duties Our mission Based in science: Boulder care teams provide comprehensive, evidence-based treatment that is tailored to each individual's unique needs and goals. Breaking down barriers: Boulder's proprietary technology suite makes care accessible, and convenient through secure video, phone, and messaging. We're reaching rural communities of the country, where more than 80% of people have little to no access to buprenorphine (Suboxone) prescribers. Boulder provides low-threshold care that is inclusive, empowering, and heavily influenced by participants' stated preferences and goals. Wherever our patients wish to go, we're grateful to go there together. Grounded in empathy: Our care is science-based and rooted in harm reduction. Patients, peer recovery specialists, and clinicians make important decisions together. Boulder Care believes the people who manage our product and team should be representative of those who use the platform. This includes people from backgrounds that are historically underrepresented in the industry. We celebrate differences and are committed to equal employment opportunities regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, citizenship, marital status, disability, gender identity or veteran status. If you are a qualified person with a passion for what we do, please apply!

**Come join our amazing team and work remote from home!** The Claims Recovery & Loss Analysis Specialist is responsible for performing financial reconciliation on all liquidated loans. Identify additional recovery opportunities to mitigate losses for both Carrington Mortgage Services and its clients. Research incurred losses on liquidated loans, determining responsibility and identifying bill back opportunities. Determine the root cause for all avoidable losses, work under general direction analyzing multiple data elements in order to apply the proper decision rationale and attaching evidentiary information to accurate written summaries. Perform all duties in accordance with the company's policies and procedures, all US state and federal laws and regulations, wherein the company operates. The target pay range for this position is $22.50/hr - $25.00/hr. **What you'll do:** + Reconcile all loan advances once the GSE or Government Mortgage Insured "expense" claim has been paid. + Maintain updates in LoanServ and input the assign and completion tasks upon the date the action occurs. + Respond to and make all corrections identified during the Quality Review Process within 24 hours of receipt. + Responsible for learning new skills and expand job knowledge to better perform assigned duties. + Maintain monthly performance in alignment with quality expectations. + Analyze multiple data elements in order to apply the proper decision rationale and provide evidentiary support to complete accurate written summaries. + Research incurred losses, using analytical skills and subject matter knowledge to determine responsibility and identify bill back opportunities. + Complete ad hoc Loss Analysis as required. + Responsible for staying abreast of relevant changes to GSE or Government Mortgage Insured guidelines, industry standards and client expectations. + Ensure timely completion of projects and tasks when assigned. If unable to meet a deadline, the deadline must be renegotiated prior to the initial deadline date. + Look for opportunities to improve the department's processes and procedures, to reduce costs and eliminate non-essential and manual processes and activities. + Keep Team Lead and Supervisor informed of all trends and problems including, but not limited to, claim denials/curtailments and claim payment offsets. + Moderate working knowledge of all Default Servicing processes up to and including Loss Mitigation, Bankruptcy, Foreclosure, Conveyance and Claims in addition to mortgage servicing state, federal and agency guidelines and timelines. + Moderate background in financial and loss analysis including ability to determine: all funds/advances due CMS have been recovered. + Moderate Accounting Background--Must possess the ability to complete financial reconciliations. + Moderate computer skills with MS Word, Excel. + Strong attention to details and excellent time management and organizational skills. + Comprehensive writing skills, including proper punctuation and grammar, organization, and formatting. + Ability to work under general direction to accomplish department goals and reduce/mitigate financial loss to CMS and its Clients. + Ability to substantiate facts and properly document them. + Ability to work effectively and develop rapport with all levels of staff, management, Investors/Insurers and 3rd parties. + Ability to make decisions that have moderate impact to immediate work unit. + Ability to identify urgent matters requiring immediate action and properly escalating them. + Ability to handle multiple tasks under pressure and changing priorities. **What you'll need:** + High School diploma required; Associate/Bachelor Degree in accounting or other related field preferred. + One (1) or more years' mortgage servicing default experience. + One (1) or more years' Loan Servicing platform experience for all default related activities such as Foreclosure, Bankruptcy, Default MI Claims, Loss Mitigation, etc. + Previous FHA, VA, USDA and PMI claims experience preferred **Our Company:** Carrington Mortgage Services is part of The Carrington Companies, which provide integrated, full-lifecycle mortgage loan servicing assistance to borrowers and investors, delivering exceptional customer care and programs that support borrowers and their homeownership experience. We hope you'll consider joining our growing team of uniquely talented professionals as we transform residential real estate. To read more visit: ************************** . **What We Offer:** + Comprehensive healthcare plans for you and your family. Plus, a discretionary 401(k) match of 50% of the first 4% of pay contributed. + Access to several fitness, restaurant, retail (and more!) discounts through our employee portal. + Customized training programs to help you advance your career. + Employee referral bonuses so you'll get paid to help Carrington and Vylla grow. + Educational Reimbursement. + Carrington Charitable Foundation contributes to the community through causes that reflect the interests of Carrington Associates. For more information about Carrington Charitable Foundation, and the organizations and programs, it supports through specific fundraising efforts, please visit: carringtoncf.org. **Notice to all applicants: Carrington does not do interviews or make offers via text or chat.** \#LI-SY1 Carrington is an equal opportunity employer. It is the policy of the company that applicants be considered for positions for which they qualify without regard to race, color, religion, sex, gender identity, national origin, ancestry, age, marital status, sexual orientation, protected veterans status, physical or mental disability or any other legally protected category. Carrington will make reasonable accommodations for known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the company.

Job Description Who We Are: Santé Group Companies prides itself in being a leader in community-based behavioral and mental health services. Our track record of innovation and growth reflects our ability to deliver diverse and highly individualized services. We have a passion for providing empathetic and potentially life-saving care to help individuals heal, recover, and thrive, as well as live their lives in a manner that allows them to fully integrate in the community. The Santé Group aspires to create an organization that places value on collaboration, innovation, creativity, and inclusiveness. To achieve this success, it is essential that all members of our organization feel secure, welcome, and respected. All members of our organization have a responsibility to uphold these values. What We're Looking For: Santé is seeking a Weekend Peer Recovery Specialist (in office) to join our frontline crisis intervention team in Easton, MD. The available shift is weekends, 8:00am to 8:00pm. As a Peer Recovery Specialist, you will assess, evaluate, and perform crisis intervention techniques, and will develop a crisis plan for continuation of services related to individual clients. He or she will be responsible for all incident documentation and will be the on-site resource for any relevant clinical information, as well as the liaison for collaboration with other involved parties including families, friends, and other community providers (all under clinical supervision of an LCSW-C/LCPC). NOT A REMOTE POSITION. IN PERSON ONLY. What You'll Do: Assist in performing a danger assessment, a crisis assessment, an environmental assessment upon entry to the community situation and lethality assessment Assist in performing an on-scene assessment and treatment plan Effectively perform crisis intervention including de-escalation, crisis planning and implementation Design appropriate referral recommendations using available community resources Address population of child, adolescent, adult, dual-diagnosis, co-occurring and elderly Work with families and involved persons to de-escalate the situation, make a crisis plan, and enlist cooperation with recommended treatment Document interactions using CRS procedures Must be able to work with first responders and be aware of first responder culture Must familiarize oneself with police codes and language Participate in and complete all required trainings Provide education in the community about the agency and all components of CRS when needed Check work e-mail at the beginning and end of each shift Provide mentoring to interns and new staff Other duties as assigned What We Require: Peer recovery certification or willingness to be certified. At least 2 years in full recovery and 5 years lived experience. Some college preferred. High School Diploma or equivalent and at least one (1) year professional experience (experience working with children and families in a community-based program preferred). While performing the duties of this job, the employee is regularly required to drive a company vehicle. The employee must possess a valid Driver's License, proof of current automobile insurance and may not have more than two (2) points on their driving record. What You'll Get: Pay Ranges: Uncertified: $17.75-20.50 per hour Certified: $20.50-$24.50 per hour Available shift weekends, 8:00am to 8:00pm. Financial assistance for Peer Recovery certification fees. Opportunities for career growth, training and development, flexible work schedules and shifts. Company-wide wellness program. Paid parental leave. We believe that diversity of background and experience makes for better problem-solving and collaboration, which is why we are dedicated to adding new perspectives to the team. Even more important than your resume is a positive attitude, a passion for making an impact, a personal desire to grow, and the ability to help individuals heal, recover, and thrive. Disclaimers: The Santé Group aspires to create an organization that places value on collaboration, innovation, creativity, and inclusiveness. To achieve this success, it is essential that all members of our organization feel secure, welcome, and respected. All members of our organization have a responsibility to uphold these values. The Santé Group is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, protected veteran status, or disability status. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of this job. The Santé Group participates in E-Verify. ****************************************************************

Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider compliance. Collaborates with health plans and vendors to facilitate recovery of outstanding overpayments. Monitors and controls backlog and workflow of claims and ensures that claims are settled in a timely fashion and in accordance with cost-control standards. **Essential Job Duties** - Prepares written provider overpayment notifications and provides supporting documentation such as explanation of benefits (EOBs), claims and attachments. - Maintains and reconciles department reports for outstanding payments collected, past-due overpayments, uncollectible claims and autopayment recoveries. - Prepares and provides write-off documents that are deemed uncollectible, and ensures collections efforts are exhausted for write-off approval. - Researches simple to complex claims payments using tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources to validate overpayments made to providers. - Completes basic validation prior to offset to include, eligibility, coordination of benefits (COB), standard of care (SOC) and diagnosis-related group (DRG) requests. - Enters and updates recovery applications and claim systems for multiple states and prepares/creates overpayment notification letters with accuracy; processes claims as a refund or auto debit in claim systems and in recovery application. - Follows department processing policies and procedures including, claims processing (claim reversals and adjustments), claim recovery (refund request letters, refund checks, claim reversals), and reporting and documentation of recovery as explained in departmental Standard Operating Procedures (SOPs). - Responds to provider correspondence related to claims recovery requests and provider remittances where recovery has occurred. - Collaborates with finance to complete accurate and timely posting of provider and vendor refund checks and manual check requests to reimburse providers. - Supports claims department initiatives to improve overall claims function efficiency. - Meets claims department quality and production standards. - Completes basic claims projects as assigned. **Required Qualifications** - At least 1 year of experience in a clerical role in a claims, and/or customer service setting - preferably in managed care, or equivalent combination of relevant education and experience. - Research and data entry skills. - Organizational skills and attention to detail. - Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Customer service experience. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software programs proficiency. **Preferred Qualifications** - Claims recovery experience. - Health insurance experience in a managed care setting. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $34.88 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Who We Are: Santé Group Companies prides itself in being a leader in community-based behavioral and mental health services. Our track record of innovation and growth reflects our ability to deliver diverse and highly individualized services. We have a passion for providing empathetic and potentially life-saving care to help individuals heal, recover, and thrive, as well as live their lives in a manner that allows them to fully integrate in the community. The Santé Group aspires to create an organization that places value on collaboration, innovation, creativity, and inclusiveness. To achieve this success, it is essential that all members of our organization feel secure, welcome, and respected. All members of our organization have a responsibility to uphold these values. What We're Looking For: Santé is seeking a Full-Time Peer Recovery Specialists (in office) to join our frontline crisis intervention team in Centreville, MD. The available shift is 4:00pm to 12:00am. As a Peer Recovery Specialist, you will assess, evaluate, and perform crisis intervention techniques, and will develop a crisis plan for continuation of services related to individual clients. He or she will be responsible for all incident documentation and will be the on-site resource for any relevant clinical information, as well as the liaison for collaboration with other involved parties including families, friends, and other community providers (all under clinical supervision of an LCSW-C/LCPC). NOT A REMOTE POSITION. IN PERSON ONLY. What You'll Do: * Assist in performing a danger assessment, a crisis assessment, an environmental assessment upon entry to the community situation and lethality assessment * Assist in performing an on-scene assessment and treatment plan * Effectively perform crisis intervention including de-escalation, crisis planning and implementation * Design appropriate referral recommendations using available community resources * Address population of child, adolescent, adult, dual-diagnosis, co-occurring and elderly * Work with families and involved persons to de-escalate the situation, make a crisis plan, and enlist cooperation with recommended treatment * Document interactions using CRS procedures * Must be able to work with first responders and be aware of first responder culture * Must familiarize oneself with police codes and language * Participate in and complete all required trainings * Provide education in the community about the agency and all components of CRS when needed * Check work e-mail at the beginning and end of each shift * Provide mentoring to interns and new staff * Other duties as assigned What We Require: * Peer recovery certification or willingness to be certified. At least 2 years in full recovery and 5 years lived experience. Some college preferred. * High School Diploma or equivalent and at least one (1) year professional experience (experience working with children and families in a community-based program preferred). * While performing the duties of this job, the employee is regularly required to drive a company vehicle. The employee must possess a valid Driver's License, proof of current automobile insurance and may not have more than two (2) points on their driving record. What You'll Get: * Pay Ranges: * Uncertified: $17.75-20.50 per hour * Certified: $20.50-$24.50 per hour * Work Schedule: 4:00pm to 12:00am, Full Time * Financial assistance for certification fees. * No cost supervision for Peer Recovery certification. * Opportunities for career growth, training and development, flexible work schedules and shifts. * Company-wide wellness program. * Paid parental leave. We believe that diversity of background and experience makes for better problem-solving and collaboration, which is why we are dedicated to adding new perspectives to the team. Even more important than your resume is a positive attitude, a passion for making an impact, a personal desire to grow, and the ability to help individuals heal, recover, and thrive. Disclaimers: The Santé Group aspires to create an organization that places value on collaboration, innovation, creativity, and inclusiveness. To achieve this success, it is essential that all members of our organization feel secure, welcome, and respected. All members of our organization have a responsibility to uphold these values. The Santé Group is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, protected veteran status, or disability status. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of this job. The Santé Group participates in E-Verify. ****************************************************************

Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider compliance. Collaborates with health plans and vendors to facilitate recovery of outstanding overpayments. Monitors and controls backlog and workflow of claims and ensures that claims are settled in a timely fashion and in accordance with cost-control standards. **Essential Job Duties** - Prepares written provider overpayment notifications and provides supporting documentation such as explanation of benefits (EOBs), claims and attachments. - Maintains and reconciles department reports for outstanding payments collected, past-due overpayments, uncollectible claims and autopayment recoveries. - Prepares and provides write-off documents that are deemed uncollectible, and ensures collections efforts are exhausted for write-off approval. - Researches simple to complex claims payments using tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources to validate overpayments made to providers. - Completes basic validation prior to offset to include, eligibility, coordination of benefits (COB), standard of care (SOC) and diagnosis-related group (DRG) requests. - Enters and updates recovery applications and claim systems for multiple states and prepares/creates overpayment notification letters with accuracy; processes claims as a refund or auto debit in claim systems and in recovery application. - Follows department processing policies and procedures including, claims processing (claim reversals and adjustments), claim recovery (refund request letters, refund checks, claim reversals), and reporting and documentation of recovery as explained in departmental Standard Operating Procedures (SOPs). - Responds to provider correspondence related to claims recovery requests and provider remittances where recovery has occurred. - Collaborates with finance to complete accurate and timely posting of provider and vendor refund checks and manual check requests to reimburse providers. - Supports claims department initiatives to improve overall claims function efficiency. - Meets claims department quality and production standards. - Completes basic claims projects as assigned. **Required Qualifications** - At least 1 year of experience in a clerical role in a claims, and/or customer service setting - preferably in managed care, or equivalent combination of relevant education and experience. - Research and data entry skills. - Organizational skills and attention to detail. - Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Customer service experience. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software programs proficiency. **Preferred Qualifications** - Claims recovery experience. - Health insurance experience in a managed care setting. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.16 - $34.88 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.