A community recreation center in Denver is seeking a tumbling program instructor responsible for designing and implementing classes for children aged 5-12. The ideal candidate will have a high school diploma, relevant experience in tumbling or gymnastics, and excellent communication skills. The role involves instructing participants in tumbling techniques and ensuring safety during classes. A CPR certification is preferred and must be obtained within 30 days of hire. This position offers the chance to work in a vibrant environment focused on children's development.
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$93k-125k yearly est. 4d ago
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OnSite Specialist - Mansfield, OH
Stryker Corporation 4.7
Specialist job at Stryker
Work Flexibility: Field-based · Utilizes a wide array of knowledge, technical skills and critical thinking abilities to facilitate job functions during surgical procedures as well as preoperative and postoperative equipment management. · Essential duties & responsibilities: (detailed description) · Provides clinical surgical support by managing all relevant equipment. · Anticipates related device needs of the O.R. staff and surgeon during surgical procedures. · Is responsible for trouble-shooting and maintaining Stryker equipment and or other related devices. · Works with surgeons, O.R. personnel, central processing, biomedical and all other related personnel. · Maintains knowledge base of equipment and disposable products through Stryker education training programs. · Provide physicians and OR personnel with information on new and current products. · Must be able to accurately and honestly record and report data metrics related to all specific job functions on a monthly basis. · Responsible for maintaining up-to-date account information to ensure continuous high levels of service at the account; including all vendor credentialing required by the account. · Accurately records and reports all surgical procedure information. · Adheres to all Stryker and medical facility policies, standards and procedures. · Analyze and resolve both routine and non-routine product issues expediently using independent judgment. · Maintain professional appearance, work ethic, and attitude required by Stryker and the medical facility. · Adhere to (HIPAA) and other related patient confidentiality policies and procedures. · Provide support/coverage on all shifts at your assigned account, as well as provide support/coverage at other account in and outside your region; other shifts might include on-call, overnight, and weekends; other accounts might require overnight travel. o Note: Assigned shifts may change without notice based on account/business needs, this may include a rotating shift (which is a shift that has rotating/changing days of the week AND start and end time)
Education & special trainings: · Bachelor's Degree, Associate's Degree or equivalent certifications preferred. · Applicable for Specialists working in Sterile Processing Department: HSPA CRCST Certification within 6 months of start date and on time yearly renewal
Qualifications & experience: · Operating Room experience and demonstrated knowledge of anatomy, surgical procedures and techniques preferred. · Basic computer skills including Microsoft Office, strong verbal and written communication, interpersonal, and organizational skills are essential. · The ability to quickly, efficiently, and effectively troubleshoot issues in the moment in demanding, high stress situations. · The ability to provide support/coverage, not only at your assigned account during your assigned shift, but also on other shifts that need additional support. Note: Assigned shifts may change without notice based on account/business needs, this may include a rotating shift (which is a shift that has rotating/changing days of the week AND start and end time) · The ability to provide on-call services as required by the hospital/account, which may include overnight and weekends. If the account contract includes on-call services, you must be within 45 minutes driving distance from the account. · The ability to provide support/coverage at other accounts in other regions, which may include overnight travel.
Scope of Work Summary (Sterile Processing Department - SPD):
Responsible for reprocessing and managing surgical instrumentation per IFU, HSPA/AAMI standards, and hospital policy.
Works alongside SPD staff to ensure timely, compliant reprocessing of Stryker and hospital-owned instruments.
Core Responsibilities:
* Decontaminate and assemble rigid scopes, cameras, light cords, and power instrumentation.
* Perform in-line function testing (leak, sharpness, insulation, or power checks).
* Wrap and containerize sets for sterilization per IFU.
* Maintain and update Stryker-managed instrumentation lists in collaboration with SPD leadership.
* Facilitate repairs, replacements, and instrument tracking per hospital protocols.
* Communicate with SPD and OR leaders regarding equipment readiness and process improvements.
Certifications:
* CRCST required within 6 months of hire (per Stryker and state legislation).
* Ongoing annual continuing education required.
Travel Percentage: 10%
Stryker Corporation is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, sexual orientation, national origin, disability, or protected veteran status. Stryker is an EO employer - M/F/Veteran/Disability.
Stryker Corporation will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information.
Stryker is driven to work together with our customers to make healthcare better. Employees and new hires in sales and field roles that require access to customer accounts as a function of the job may be required, depending on customer requirements, to obtain the COVID-19 vaccination as an essential function of their role.
$69k-96k yearly est. Auto-Apply 6d ago
Senior Nursing Professional Development Specialist - Primary Care
Akron Children's Hospital 4.8
Akron, OH jobs
Part-time, 24 hours/week
Onsite, travel required to all primary care locations
The Senior Nursing Professional Development (NPD) Specialist is a highly experienced educator responsible for advancing nursing practice through leadership in education, professional development, evidence-based practice, and strategic initiatives. This role mentors other professional development staff and plays a critical role in developing and implementing system-wide educational strategies. The Senior NPD Specialist supports the onboarding, orientation, and ongoing competency of nursing staff while cultivating a culture of continuous learning and excellence in practice.
Responsibilities:
The Senior NPD specialist advances the profession by contributing to the professional development of others, supporting collaborative relationships and supporting life-long learning.
Uses the educational design process to bridge the knowledge, skills and practice gaps identified through needs assessment.
Influences the inter-professional practice and learning environments, the NPD specialty, and the profession of nursing and healthcare through collaboration with leadership in planning and decision making to achieve desired results.
Actively works to transform processes at all levels through inspiration, initiation, adoption and sustainment of and adaptation to change using project management and improvement processes.
Promotes the generation and dissemination of new knowledge and the use of evidence to advance NPD practice, guide clinical practice and improve patient care.
Actively supports, promotes, and demonstrates nursing professional development as a nursing practice specialty through promotion of research, EBP, and QI.
Supports the transitions of nurses and other healthcare team members across learning and practice environments, roles and professional stages.
Other duties as required.
Other information:
Technical Expertise
Experience in project management with interdisciplinary team is required.
Experience in data analysis and presentations is required.
Experience working with all levels within an organization is required.
Experience in healthcare is preferred.
Proficiency in MS Office [Outlook, Excel, Word] or similar software is required.
Education and Experience
Education: BSN required. Master's degree in nursing or related field required.
Certification: Registered Nurse licensure is required; BLS certification is required; PALS certification may be required by area of service. Professional nursing certification required.
Years of relevant experience: Minimum 4 years required.
Years of experience supervising: None.
Part Time
FTE: 0.600000
Status: Onsite
$43k-65k yearly est. 9d ago
Nursing Professional Development Specialist NEX
Akron Children's Hospital 4.8
Akron, OH jobs
Covering Pain Center, Sedation, and Radiology Part Time 20 hours/week Dayshift onsite NPD coverage of procedural areas: Pain Center, Sedation and Radiology (including Vascular Access and Interventional Radiology)
The Nursing Professional Development (NPD) Specialist is responsible for enhancing the professional growth and development of nursing staff through educational programs, training sessions, and continuous learning opportunities. The NPD Specialist will collaborate with nursing leadership to identify educational needs, develop curricula, and implement strategies to improve nursing practice and patient care outcomes.
Responsibilities:
• The NPD specialist advances the profession by contributing to the professional development of others, supporting collaborative relationships and supporting life-long learning.
• Uses the educational design process to bridge the knowledge, skills and practice gaps identified through needs assessment.
• Influences the inter-professional practice and learning environments, the NPD specialty, and the profession of nursing and healthcare through collaboration with leadership in planning and decision making to achieve desired results.
• Actively works to transform processes at all levels through inspiration, initiation, adoption and sustainment of and adaptation to change using project management and improvement processes.
• Promotes the generation and dissemination of new knowledge and the use of evidence to advance NPD practice, guide clinical practice and improve patient care.
• Actively supports, promotes, and demonstrates nursing professional development as a nursing practice specialty through promotion of research, EBP, and QI.
• Supports the transitions of nurses and other healthcare team members across learning and practice environments, roles and professional stages.
• Other duties as required.
Other information:
Technical Expertise
Experience in project management with interdisciplinary team is preferred.
Experience in data analysis and presentations is preferred.
Experience working with all levels within an organization is required.
Experience in healthcare is required.
Proficiency in MS Office [Outlook, Excel, Word] or similar software is required.
Education and Experience
Education: Master's degree in nursing or related field or BSN and in process of attaining master's degree in nursing or related field. Completion of Nurse Education track of MSN program is preferred.
Certification: Registered Nurse licensure is required; BLS certification is required; PALS certification may be required by area of service. Professional Nursing certification preferred.
Years of relevant experience: Minimum 3 years required.
Years of experience supervising: None.
Part Time
FTE: 0.500000
Status: Onsite
The Applied Genomics, Computation & Translational Core is looking for a Biomedical Specialist to join the team!
The Cedars-Sinai Applied Genomics, Computation, and Translational Core (AGCT Core) is a fully equipped, state-of-the-art genomics facility offering data generation and interpretation for basic science and translational research in next-generation sequencing technologies, including single cell omics, spatial transcriptomics, and bulk cell omics. We specialize in single cell omics and spatial transcriptomics via the 10x Genomics, Parse Biosciences, Mission Bio, and NanoString platforms. Our R&D team offers sample preparation for single cell assays, such as nuclei isolation from frozen tissue or single cell isolation from fresh tissue dissociation. The AGCT Core also offers comprehensive services for standard bulk cell sequencing in genomics, transcriptomics, epigenomics, and metagenomics. To learn more please visit Applied Genomics, Computation & Translational Core | Cedars-Sinai.
Are you ready to be a part of breakthrough research?
The Genomics Core Biomedical Specialist is responsible for carrying out wet lab procedures involving DNA/RNA isolation from various sources such as cells, tissue, FFPE curls and scrapes, and blood. In addition, they possess expertise in the complete Next-Generation Sequencing (NGS) workflow, which includes DNA/RNA quantification and quality control (QC) analysis, manual library preparation, library quantification and QC analysis, sequencing on the Illumina platform, and analysis of sequencing metrics.
As part of their duties, the Biomedical Specialist will ensure accurate and up-to-date electronic documentation using an electronic lab notebook, project management software, and laboratory information management system. They will also manually prepare libraries for bulk cell, single cell, and spatial omics, covering transcriptomics (RNA-Seq), genomics (WGS/WES), epigenomics (WGBS, ATAC-Seq), and metagenomics (16S/ITS amplicon sequencing, shotgun).
Overall, this position involves hands-on work in a wet lab environment, focusing on DNA/RNA isolation and various aspects of the NGS workflow, as well as documentation and library preparation for different omics applications.
Primary Duties and Responsibilities:
Train, guide, and supervise a team of junior associates.
Train and supervise junior associates on Next-Generation Sequencing experiments, procedures, and day-to-day service request fulfillment and lab operations.
Effectively communicate needs and requirements to junior associates as required for the management of service requests and day-to-day lab operations.
Manage junior associate performance, mentor and coach, and seek opportunities to help them grow and become their best.
Assign service requests to junior associates and ensure their proper execution and successful completion.
Ensure the availability of all required resources for the execution of service requests.
Liaise with investigators regarding service requests.
Participate in the planning, execution, and troubleshooting of service requests.
Provide research and input on new technologies and assays for testing to possibly develop and implement new service offerings.
Execute or manage the execution of projects testing new technologies, assays, or kits.
Analyze, summarize, and present findings at monthly R&D meetings.
Assist with the implementation of new technologies, assays, or kits into new service offerings by writing and reviewing standard operating procedures, service guidelines, and staff training guides, and training junior associates.
Receive, store, and document samples.
Attend meetings and seminars/webinars as assigned.
Qualifications
Education:
Bachelor of Sciences in Genetics, Genomics, Molecular Biology, or Biological Sciences is required. Master's degree is preferred.
Experience & Skills:
Two (2) years of laboratory experience are required. Five (5) years is preferred.
Minimum 3 years of experience performing NGS library preparation in bulk cell genomics, transcriptomics, and metagenomics.
Minimum 2 years of experience in the operation of Illumina sequencers and Agilent Technologies fragment analyzers.
Minimum 1 year of supervisory and training experience.
Experience in single cell NGS assays and cell biology is preferred.
Critical analysis, problem-solving, troubleshooting, multitasking, time management, following through tasks with details, working independently with minimal supervision.
Interact with professionalism with teammates, peers, researchers, investigators, and support staff of diverse backgrounds and educational levels.
Respond to rapidly changing priorities and exceptionally diverse demands through constant interruptions in a fast-paced laboratory environment.
Must be self-motivated, take initiative, enjoy learning, and willing to take on new challenges while independently executing new or unusual and complex technical procedures and protocols.
Work cooperatively with other personnel as part of a team to accomplish daily and weekly goals.
Proficient in PC (or Mac) skills as well as demonstrated proficiency in Microsoft Word, Excel, and PowerPoint.
About UsCedars-Sinai is a leader in providing high-quality healthcare encompassing primary care, specialized medicine and research. Since 1902, Cedars-Sinai has evolved to meet the needs of one of the most diverse regions in the nation, setting standards in quality and innovative patient care, research, teaching and community service. Today, Cedars- Sinai is known for its national leadership in transforming healthcare for the benefit of patients. Cedars-Sinai impacts the future of healthcare by developing new approaches to treatment and educating tomorrow's health professionals. Additionally, Cedars-Sinai demonstrates a commitment to the community through programs that improve the health of its most vulnerable residents.
About the TeamCedars-Sinai is one of the largest nonprofit academic medical centers in the U.S., with 886 licensed beds, 2,100 physicians, 2,800 nurses and thousands of other healthcare professionals and staff. Choose this if you want to work in a fast-paced environment that offers the highest level of care to people in the Los Angeles that need our care the most.
Req ID : 10395
Working Title : Biomedical Specialist - Applied Genomics, Computation & Translational Core
Department : Research - BMS - Bioinfo and Func Genomics
Business Entity : Cedars-Sinai Medical Center
Job Category : Academic / Research
Job Specialty : Biomanufacturing
Overtime Status : EXEMPT
Primary Shift : Day
Shift Duration : 8 hour
Base Pay : $75,524.80 - $117,062.40
$75.5k-117.1k yearly 8h ago
Receiving Specialist
Coxhealth 4.7
Springfield, MO jobs
:The Supply Chain Receiving Specialist II is responsible for performing an array of functions that may include but not limited to the following: Receiving and inspecting deliveries of medical supplies, pharmaceuticals, and equipment to ensure proper quantity and quality.
Processing and verifying incoming shipment contents against packing lists and purchase orders, noting discrepancies or damages.
Document all received items in the hospital's software system.
Delivery of merchandise from Warehouse trucks, Carriers, or LTL.
In addition, must demonstrate a working knowledge of all department locations for correct and timely routing (and signatures) for merchandise throughout the Healthcare System.
Cross training at other System Locations.
â—¦ Education â–ª Required: High School Diploma or Equivalent â—¦ Experience â–ª Required: None â—¦ Skills â–ª Proficient Materials Management procurement system (Lawson) including mobile supply chain hand held devices.
â–ª Understanding and management with compliance of regulatory processes as it pertains to the Warehouse â—¦ Licensure/Certification/Registration â–ª Required: None
$28k-32k yearly est. 6d ago
Prior Authorization Specialist
Methodist Le Bonheur Healthcare 4.2
Memphis, TN jobs
If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One!
We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow their career caring for others. For over a century, we've served the health care needs of the people of Memphis and the Mid-South.
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.
Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence.
A Brief Overview
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.
What you will do
Responsible for precertification of eligible prescription medications for inpatient and outpatient services based on medical plan documents and medical necessity. Ensures medical documentation is sufficient to meet insurer guidelines for medical necessity documentation and procedure payment.
Reviews clinical information submitted by medical providers to evaluate the necessity, appropriateness and efficiency of the use of prescription medications.
Assists with patient assistance and grant coordination for Patients for outpatient pharmacies from designated areas.
Proactively analyzes information submitted by providers to make timely medical necessity review determinations based on appropriate criteria and standards guidelines. Verifies physician orders are accurate. Determines CPT, HCPCS and ICD-10 codes for proper Prior Authorization.
Contacts insurance companies and third party administrators to gather information and organize work-flow based on the requested procedure.
Collects, reads and interprets medical documentation to determine if the appropriate clinical information has been provided for insurance reimbursement and proper charge capture.
Serves as primary contact with physicians/physician offices to collect clinical documentation consistent with insurer reimbursement guidelines. Establishes and maintains rapport with providers as well as ongoing education of providers concerning protocols for pre-certification.
Communicates information and acts as a resource to Patient Access, Case Management, and others in regard to contract guidelines and pre-certification requirements.
Performs research regarding denials or problematic accounts as necessary. Works to identify trends and root cause of issues and recommend resolutions for future processes.
Education/Formal Training Requirements
High School Diploma or Equivalent
Work Experience Requirements
3-5 years Pharmacy (clinical, hospital, outpatient, or specialty)
Licenses and Certifications Requirements
See Additional Job Description.
Knowledge, Skills and Abilities
Basic understanding of prescription processing flow. Expertise in utiliizing EMRs to document clinical critieria required for third party approval.
Knowledgeable of medical terminology, drug nomenclature, symbols and abbreviations associated with pharmacy practice.
Strong attention to detail and critical thinking skills.
Ability to speak and communicate effectively with patients, associates, and other health professionals.
Ability to diagnose a situation and make recommendations on how to resolve problems.
Experience with a computerized healthcare information system required. Familiarity with fundamental Microsoft Word software.
Excellent verbal and written communication skills.
Supervision Provided by this Position
There are no lead or supervisory responsibilities assigned to this position.
Physical Demands
The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
Must have good balance and coordination.
The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative.
Our Associates are passionate about what they do, the service they provide and the patients they serve. We value family, team and a Power of One culture that requires commitment to the highest standards of care and unity.
Boasting one of the South's largest medical centers, Memphis blends a friendly community, a thriving and growing downtown, and a low cost of living. We see each day as a new opportunity to make a difference in the lives of the people in our community.
$24k-28k yearly est. Auto-Apply 1d ago
TechOps Analyst - Hybrid IT Support & Automation
Persona 4.3
San Francisco, CA jobs
A leading technology company in San Francisco is seeking a TechOps Analyst who will provide essential support for IT operations. The ideal candidate should have 4-6+ years of experience and a strong passion for technology and problem-solving. They will assist employees with technical issues, manage onboarding processes, and contribute to improving internal efficiencies. This role offers a hybrid work model, with benefits including medical and wellness offerings.
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$42k-87k yearly est. 3d ago
Associate Spine Specialist (Boston, MA)
Globus Medical 4.5
Boston, MA jobs
Associate Spine Specialist (Boston, MA) page is loaded## Associate Spine Specialist (Boston, MA)locations: Massachusettstime type: Full timeposted on: Posted 25 Days Agojob requisition id: JR104911At Globus Medical, we move with a sense of urgency to deliver innovations that improve the quality of life of patients with musculoskeletal disorders. Our team is inspired by the needs of these patients, and the surgeons and healthcare providers who treat them. We embrace a culture of exceptional response by partnering with researchers and educators to transform clinical insights into tangible solutions. Our solutions improve the techniques and outcomes of surgery so patients can resume their lives as quickly as possible The Associate Spine Specialist will work together with the Spine Territory Manager and will have territory coverage, inventory management, and limited sales responsibilities. The Associate Spine Specialist will represent the company in accordance with the company's quality policy and procedures.**Essential Functions****:*** Gains and consistently increases product knowledge through formal sales training; surgeon speaker programs, attends surgeries/operating room visits, and industry research* Meeting or exceeds all sales goals and objectives assigned* Conducts sales calls to promote, sells, and services Globus Medical products and services to existing and competitive customers based on a strategic plan* Assists the Spine Territory Manager on field calls for assigned geography and address and problems that arise on the account* Performs field ride along with the Area Director and Spine Territory Manager on a regular basis* Develops and increases customer base and continually enhances Globus product market share within assigned territory* Provides feedback regularly on topics such as product development opportunities, new target accounts, sales performance, and market feedback* Maintains conduct that is aligned with company quality policy and procedures, and protects confidentiality with proprietary information* Stays current with all compliance training requirements* Adheres to the letter and spirit of the company Code of Conduct, the AdvaMed Code, MedTech Code, and all other company policies.* Ensures Compliance with applicable governmental laws, rules, and regulations, both in the United States and internationally, by completing introductory and annual training and maintaining knowledge of compliance as it applies to your role* Represents the company in a professional manner and uphold the highest standards of ethical business practices and socially responsible conduct in all interactions with other employees, customers, suppliers, and other third parties*Reasonable accommodations may be made to enable individuals with disabilities to perform these* essential *functions.***Qualifications****:*** 1-2 years' successful spine sales experience preferred, may consider other healthcare related sales and or business to business sales experience* Bachelor's degree in Science or Business* Exemplary ability to listen, communicate and influence* Ability to travel as necessary, which may include nights and/or weekends* Strong understanding of spinal anatomy* Ability to make sales presentations with positive results**Physical Demands****:**The physical demands listed here are representative of those that must be met by and employee to successfully perform the essential functions of this job.* Required to sit; climb or balance; and stoop, kneel, crouch or crawl* Required to regularly lift and/or move up to 10 pounds, and occasionally lift and/or move up to 25 pounds* Required to possess specific visons abilities, including: close vision, distance vision, color vision, peripheral vision, depth perception and capacity to adjust focus.**Our Values:**Our Life Moves Us philosophy is built on four values: Passionate About Innovation, Customer Focused, Teamwork, and Driven.* **Passionate about Innovation**: Improving patient care by delivering advanced technology to our customers is at the core of what we do. We are passionate in our role in improving the lives of patients by continuously developing better solutions.* **Customer Focused**: We listen to our customers' needs and respond with a sense of urgency.* **Teamwork**: Working together, anything is possible. We value every person on our team and treat each other with respect. We are accountable to one another and support each other. Together, we make each other stronger.* **Driven**: We pursue our mission with energy and passion. We are nimble, results-oriented and decisive. We overcome obstacles that arise in our quest to deliver solutions that will improve the lives of our customers and patients. **Equal Employment Opportunity:**Globus Medical is an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, age, disability, marital status, pregnancy, national origin or citizenship. We are committed to a diverse workforce. We value all employees' talents and support an environment that is inclusive and respectful. **Other Duties:**Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
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$75k-86k yearly est. 2d ago
Program Specialist I
Can Community Health 4.3
Miami, FL jobs
CAN Community Health is now hiring a Program Specialist I
Standard clinic hours are Monday-Thursday 8:00 am-5:30pm Friday 8:00 am-12:30 pm. This position requires hours of work outside normal operating hours including nights and weekends.
Are you passionate about patient care and ready to make a difference every day? We are looking for someone who is passionate about serving the needs of individuals impacted by HIV, Hepatitis C, STI's, and other infectious diseases. You will become part of our professional team that drives home our Company's Mission and Values.
We have received recognition for more than six (6) years NPT's Best Non-Profit to Work for Award.
Salary: Starting at $21-$24 per hour based on education and experience.
Must be able to pass a Level I background check (a Level II background may also be required).
********************************
CAN Community Health, Inc. is an equal opportunity employer that is committed to diversity and values the ways in which we are different. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Why You'll Love It Here
Competitive pay
Generous paid PTO and Sick time
11 Paid Company Holidays
Paid training and certification support
Health, dental, vision, with generous company contribution, paid life and disability plans & retirement plan with generous match of up to 8% of your contribution additional match of 1%.
Tuition Reimbursement Plan
Other voluntary plans are available to support you and your family
Career growth opportunities in a supportive environment
What You'll Do
The Program Specialist I is an entry-level position within CAN Community Health's Education & Prevention Team. This role requires a basic understanding of HIV, Prevention, and Treatment pathways. The provisions of this role include but are not limited to HIV/STI Testing, Health Education, Risk Reduction Counseling, PrEP/HIV and Hep C Linkage and community outreach.
Provides HIV/STI/Hepatitis C testing and risk reduction counseling in community-based settings and in clinic settings when applicable, including phlebotomy.
Provides education on Pre-exposure Prophylaxis to clients and community members and links clients to the Pre-exposure Prophylaxis program.
Ensures client confidentiality 100% of the time by conforming to HIPAA laws and CAN Community Health Policies and Procedures.
Accurately documents the provision of testing in the electronic medical record, state reporting systems and on paper as required.
Fosters and assists in developing new community partnerships through the establishment of BRTA/FRTA agreements, other informal agreements, as well as formal agreements, including Memorandums of Agreement/Understanding and Business Associate Agreements under the supervision of the HIV Prevention Program Manager and Prevention Team Lead.
Serves as a representative of CAN Community Health and conducts community-based outreach in various settings including but not limited to shelters, bars, inpatient centers, resource centers, parks etc. Assist in the planning and execution of events including testing, tabling and provides health education as appropriate.
Distribute condoms and other promotional materials to community members and partner organizations.
Accurately documents and maintains all records as related to prevention data collection efforts.
Represents CAN Community Health at local, state, and national conferences and meetings, as deemed necessary.
Collaborates with other disciplines internally and externally to coordinate client/patient services and community needs.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of an employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Requirements:
Education/Professional:
High school diploma required
Minimum 1 year of experience in a related field preferred, relevant college-level coursework may substitute for experience.
Must be able to operate a motor vehicle and have valid insurance and driver's license.
PI7a743e8aa831-37***********1
$21-24 hourly 2d ago
Maternity Care Authorization Specialist (Hybrid Potential)
Christian Healthcare Ministries 4.1
Barberton, OH jobs
This role plays a key part in ensuring maternity care bills are processed accurately and members receive timely support during an important season of life. The specialist serves as a detail-oriented professional who upholds CHM's commitment to excellence, compassion, and integrity.
WHAT WE OFFER
Compensation based on experience.
Faith and purpose-based career opportunity!
Fully paid health benefits
Retirement and Life Insurance
12 paid holidays PLUS birthday
Lunch is provided DAILY.
Professional Development
Paid Training
ESSENTIAL JOB FUNCTIONS
Compile, verify, and organize information according to priorities to prepare data for entry
Check for duplicate records before processing
Accurately enter medical billing information into the company's software system
Research and correct documents submitted with incomplete or inaccurate details
Verify member information such as enrollment date, participation level, coverage status, and date of service before processing medical bills
Review data for accuracy and completeness
Uphold the values and culture of the organization
Follow company policies, procedures, and guidelines
Verify eligibility in accordance with established policies and definitions
Identify and escalate concerns to leadership as appropriate
Maintain daily productivity standards
Demonstrate eagerness and initiative to learn and take on a variety of tasks
Support the overall mission and culture of the organization
Perform other duties as assigned by management
SKILLS & COMPETENCIES
Core strengths like problem-solving, attention to detail, adaptability, collaboration, and time management.
Soft skills such as empathy (especially important in maternity care), professionalism, and being able to handle sensitive information with care.
EXPERIENCE REQUIREMENTS
Required: High school diploma or passage of a high school equivalency exam
Medical background preferred but not required.
Capacity to maintain confidentiality.
Ability to recognize, research and maintain accuracy.
Excellent communication skills both written and verbal.
Able to operate a PC, including working with information systems/applications.
Previous experience with Microsoft Office programs (I.e., Outlook, Word, Excel & Access)
Experience operating routine office equipment (i.e., faxes, copy machines, printers, multi-line telephones, etc.)
About Christian Healthcare Ministries
Founded in 1981, Christian Healthcare Ministries (CHM) is a health care sharing ministry for Christians. CHM is a nonprofit, voluntary cost-sharing ministry through which participating Christians meet each other's medical bills. The mission of CHM is to glorify God, show Christian love, and experience God's presence as Christians share each other's medical bills.
$31k-35k yearly est. 3d ago
Mobility Specialist - Physical Therapy - Full Time
Guthrie 3.3
Sayre, PA jobs
In collaboration with Rehabilitation and Nursing, and under the direction of Rehabilitation, the Mobility Specialist provides mobility to promote maximum function based on AM-PAC Mobility Score and Johns Hopkins Highest Level of Mobility (JH-HLM) goal score.
Education, License, & Cert:
High school Graduate/GED and must be knowledgeable in use of computers.
Prefer successful completion of a CNA training course or currently enrolled in a licensed nurse program or successfully completed a fundamentals of nursing course, or has had experience in the field of Therapy or previously completed internal training for a care partner role or mobility specialist
Experience:
Experience desired but not necessary
Licenses & Certifications:
None required
School Education:
High School Grad or Equivalent
Essential functions:
Participates in the mobility of all patients based on AM-PAC Mobility Score and JH-HLM Goal Score
Openly communicates individual patient progress so all members of the healthcare team are involved and aware of the patient's level of function
Collaborate with RN staff prior to mobilizing patient to ensure patient is medically stable for activity.
Incorporates proper safe patient handling skills such as body mechanics for safe lifting, turning and positioning of patients
Ensure all appropriate patients are out of bed daily utilizing the necessary equipment based on the patients current level of function
Assist therapy team as a second set of hands during sessions when warranted
Other Duties:
Maintain a clean and safe environment for mobilization of the patient
Demonstrate the ability to accept other non-routine work assignments as appropriate
Maintain PAR level of Safe Patient Handling Equipment on the nursing unit
Attend Monthly Rehab staff meetings as appropriate
About Us
Joining the Guthrie team allows you to become a part of a tradition of excellence in health care. In all areas and at all levels of Guthrie, you'll find staff members who have committed themselves to serving the community.
The Guthrie Clinic is an Equal Opportunity Employer.
The Guthrie Clinic is a non-profit, integrated, practicing physician-led organization in the Twin Tiers of New York and Pennsylvania. Our multi-specialty group practice of more than 500 physicians and 302 advanced practice providers offers 47 specialties through a regional office network providing primary and specialty care in 22 communities. Guthrie Medical Education Programs include General Surgery, Internal Medicine, Emergency Medicine, Family Medicine, Anesthesiology and Orthopedic Surgery Residency, as well as Cardiovascular, Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine.
$98k-122k yearly est. 4d ago
Senior Neurosurgery Scheduling Specialist
Houston Methodist 4.5
Houston, TX jobs
A leading healthcare provider in Houston is seeking a Senior Scheduler to manage appointment scheduling for complex services. The role involves clear communication with patients and medical staff, ensuring timely access to healthcare services, and training new staff members. Candidates should have a high school diploma and relevant experience in medical scheduling or a call center environment. This position offers opportunities for personal growth and a dynamic team environment.
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$28k-32k yearly est. 3d ago
Family Engagement Specialist
Lifegift 3.7
Houston, TX jobs
Would You Like a Life-Changing Career with LifeGift
Where You Can Grow as a Family Engagement Specialist I?
Kick-start the career of a lifetime where you can be a part of our mission of hope, working with an incredible team saving lives while modeling our values of Passion, Compassion, and Professionalism to the LifeGift community.
LifeGift is currently looking for a
Family Engagement Specialist I
in Houston
who serves as a critical link between LifeGift and the families whose loved ones are considering or have opted for organ donation. This role encompasses providing emotional support, education about the donation process, and facilitating meaningful conversations between families and healthcare personnel. The Family Engagement Specialist will work collaboratively with medical professionals, social workers, and bereavement coordinators to ensure families receive comprehensive and compassionate care during emotionally challenging times.
Do you possess the attributes to be a successful Family Engagement Specialist I and perform the following essential functions?
Provide compassionate support to families during the organ donation process, addressing their questions and concerns with empathy and understanding.
Educate families on the process of organ donation, including the medical, ethical, and emotional aspects, to help them make informed decisions.
Act as a liaison between families and medical providers, ensuring effective communication and clarity regarding the donation process.
Offer immediate support and resources to families in crisis, assisting them in navigating complex emotions and providing grief counseling as necessary.
Collaborate with the Family Engagement Manager to develop and refine educational materials, resources, and training programs to enhance family engagement strategies.
Maintain accurate records and documentation of family interactions, ensuring confidentiality and compliance with all regulatory standards.
Participate in community outreach initiatives to promote organ donation awareness and educate the public about LifeGift's mission and the importance of donor families.
Work closely with multidisciplinary teams to advocate for families' needs and ensure their voices are heard in policy and operational discussions.
Do you have the education and experience to be a Family Engagement Specialist I?
Bachelor's degree in Social Work, Nursing, Psychology, Public Health, Human Services, Communications, Counseling, Education, or a related field; Master's degree preferred.
Minimum of 2-3 years' experience in family support, grief counseling, or a related field, preferably in healthcare or organ donation settings.
Backgrounds that demonstrate advanced interpersonal communication, conflict resolution, and the ability to guide individuals through complex, emotionally charged decisions
Knowledge of the organ donation process and relevant regulatory frameworks is highly desirable.
Ability to navigate sensitive and complex situations with professionalism and poise.
Proficient in Microsoft Office Suite and experience with data management systems.
Bilingual (English/Spanish) is a plus.
This is
NOT
a remote position.
This role requires frequent travel and ability to commute to different hospital partners within our service area.
As a condition of employment, you must be able to attain Hospital Badge and EMR Access from all of the LifeGift Hospital Partners, as well as the availability to work 12-hour shifts, including nights, weekends and holidays.
The Heart of Our Culture
Established in 1987, LifeGift offers hope to the thousands of people in Texas and beyond who need lifesaving organ and tissue transplants. Our organization is diverse by nature, and inclusive by choice. LifeGift strives to reflect the communities where we live and work, and our multi-cultural and diverse team contributes an abundance of talent, abilities, and innovation that have continued to elevate our success.
Rewards and Benefits for Your Career and Well-Being
LifeGift values its team members and offers a variety of highly competitive benefits. Full-time team members have the opportunity to enroll in the following insurance plans: medical, dental, and vision, as well as life insurance, LTD and STD, and FSAs and HSAs that are pre-tax and to which LifeGift contributes. LifeGift also offers an exceptional retirement package that includes 403(b) and 401(a) retirement plans with the opportunity for a generous match. Additionally, LifeGift offers a tuition reimbursement program to encourage team members to expand their knowledge and further their education. LifeGift recognizes the importance of a work-life balance and encourages team members to take advantage of a generous vacation and sick leave plan.
LifeGift is an equal opportunity employer!
If you are qualified and want to be considered for a career that is life-changing, has purpose, and where you can be a part of an organization that cares about its employees, we encourage you to apply by completing the application at *************************
LifeGift is a drug-free workplace.
$31k-41k yearly est. 1d ago
CMM Specialist 2nd shift
Quest Global 4.4
Windsor Locks, CT jobs
Who We Are:
Quest Global delivers world-class end-to-end engineering solutions by leveraging our deep industry knowledge and digital expertise. By bringing together technologies and industries, alongside the contributions of diverse individuals and their areas of expertise, we are able to solve problems better, faster. This multi-dimensional approach enables us to solve the most critical and large-scale challenges across the aerospace & defense, automotive, energy, hi-tech, healthcare, medical devices, rail and semiconductor industries.
We are looking for humble geniuses, who believe that engineering has the potential to make the impossible possible; innovators, who are not only inspired by technology and innovation, but also perpetually driven to design, develop, and test as a trusted partner for Fortune 500 customers. As a team of remarkably diverse engineers, we recognize that what we are really engineering is a brighter future for us all. If you want to contribute to meaningful work and be part of an organization that truly believes when you win, we all win, and when you fail, we all learn, then we're eager to hear from you.
The achievers and courageous challenge-crushers we seek, have the following characteristics and skills:
What You Will Do:
Analyze the current state of CMM programs
Write CMM programs to support operations
Develop CMM inspection strategies for high-precision aerospace components to ensure compliance with engineering requirements
Create new and modify existing CMM programs using off-line systems. Preferably utilizing PC-DMIS, open to multiple programming language
Output new and edit existing code to run articulated automatic CMM machines
Organize and plan work effectively to produce output according to budget and schedule constraints
Troubleshoot programming result errors and work holding issues with production personnel to optimize automated inspection results
Employment is contingent on passing a customer administered certification course on CMM programming and GD&T
What You Will Bring:
2-7 years' experience in CMM setup, inspection, and programming techniques
Competency using CMM software. PC-DMIS software preferred
Competency with machines and tools required to fabricate and manufacture sheet metal
Understanding of Manufacturing Engineering core processes (e.g. process planning, inspection planning, tooling, creation of operator instructions)
Ability to characterize various tools, gages, and fixtures
Knowledge of GD&T and can integrate it within a production process. A keen understanding of blueprint interpretation is desired as well
Solid background in manufacturing
Knowledge of Siemens NX solids and NX CMM or other CAD/ CAM, DEMIS, and MODUS tools
Proficient in reading and interpreting blueprints
Understanding of GD&T
Excellent communication and teamwork skills
Must be able to communicate effectively with manufacturing engineering, precision inspection personnel, and shop floor employees
Must be able to pass a customer administered certification course on CMM programming and GD&T.
Pay Range: $90,000-$110,000 a year
Compensation decisions are made based on factors including experience, skills, education, and other job-related factors, in accordance with our internal pay structure. We also offer a comprehensive benefits package, including health insurance, paid time off, and retirement plan.
Work Requirements: This role is considered an on-site position located in Windsor Locks, CT.
You must be able to commute to and from the location with your own transportation arrangements to meet the required working hours.
Shop floor environment, which may include but not limited to extensive walking, and ability to lift up to 40 lbs.
Typical 8-hour days plus lunch / 40-hour weeks / hours are 3 PM to 11:30 PM for 2nd Shift
Travel Requirements: Due to the nature of the work, no travel is required
Citizenship Requirement: Due to the nature of the work, U.S. citizenship is required.
Benefits:
401(k)
401(k) matching
Dental insurance
Health insurance
Life insurance
Paid time off
Referral program
Vision insurance
Short/Long Term Disability
$90k-110k yearly 11h ago
Patient Relations Support Specialist
NYC Health + Hospitals/Correctional Health Services 4.7
New York, NY jobs
NYC Health + Hospitals is the largest public health care system in the nation. We are a network of 11 hospitals, trauma centers, neighborhood health centers, nursing homes, post-acute care centers, and correctional health services. We are a home care agency and a health plan, MetroPlus. Our health system provides essential services to 1.4 million New Yorkers every year in more than 70 locations across the city's five boroughs. Our diverse workforce of more than 42,000 employees are uniquely focused on empowering New Yorkers.
NYC Health + Hospitals/Correctional Health Services is one of the nation's leading correctional health care systems in quality of and innovations to care, and access from pre-arraignment through compassionate release. In-jail services include medical, nursing, mental health, substance use treatment, social work, dental and vision care, discharge planning, and reentry support. In addition to providing direct patient care in the jails, CHS leverages the resources of the nation's largest municipal health care system to help discharged patients successfully return to their communities. CHS is also a pivotal partner in New York City's criminal justice reform efforts.
NYC Health + Hospitals/Correctional Health Services is one of the nation's leading correctional health care systems in quality of, and innovations and access to care. In-jail services include medical, mental health, nursing, substance use treatment, social work, dental and vision care, discharge planning, and reentry support. In addition to providing direct patient care in the jails, CHS conducts enhanced pre-arraignment screening and forensic psychiatric examinations; and leverages the resources of the Health + Hospitals system to help discharged patients successfully return to their communities. CHS is also a pivotal partner in New York City's criminal justice reform efforts. Our workforce is comprised of more than 1,500 dedicated professionals, with locations in all five boroughs and on Rikers Island.
Under the direction of the Director and/or Deputy Director of Patient Relations, the Assistant Coordinating Manager will be responsible for documenting, managing incoming phone calls and emails, maintaining accurate records, updating the databases and coordinating complaints and requests relating to health care provided in the City's jails.
Examples of work:
Review dashboard on a daily basis, notify emergency contact for patients with specific serious injuries, hospitalizations and enter into database.
Assist in coordinating the bi-monthly QIC meetings by recording meeting minutes and updating the database with relevant outcomes and follow-up action items.
Answer incoming calls, compose email identifying case as a complaint and/or request.
Review voicemails, transcribing messages and email.
Enter and update new cases into the Patient Relations database.
Monitor and maintain the Patient Relations email in-box for all correspondences received and appropriately handle according to standardized procedures and policies.
Complete day-end reconciliation of inquiries received, assigned and sent.
Perform additional tasks as assigned.
Minimum Qualifications:
1. A Baccalaureate Degree from an accredited college or university in Business Administration, Community Health, Psychology or related discipline with one year of full-time experience in a supervisory or administrative capacity in business management systems, general administration, health care and medical/patient systems administration; or,
2. A satisfactory combination of education, training and experience.
NYC Health and Hospitals offers a competitive benefits package that includes:
Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
Retirement Savings and Pension Plans
Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
Loan Forgiveness Programs for eligible employees
College tuition discounts and professional development opportunities
College Savings Program
Union Benefits for eligible titles
Multiple employee discounts programs
Commuter Benefits Programs
$40k-61k yearly est. 11h ago
RCM OPEX Specialist
Femwell Group Health 4.1
Miami, FL jobs
The RCM OPEX Specialist plays a critical role in optimizing the financial performance of healthcare organizations by ensuring that revenue cycle management processes are efficient and compliant with industry regulations. This position requires detail-oriented professionals who can navigate complex insurance claims and reimbursement processes.
Essential Job Functions
Manage internal and external customer communications to maximize collections and reimbursements.
Analyze revenue cycle data to identify trends and proactively remediate suboptimal processes.
Maintain fee schedule uploads in financial and practice operating systems.
Review and resolve escalations on denied and unpaid claims.
Collaborate with healthcare providers, payors, and business partners to ensure revenue best practices are promoted.
Monitor accounts receivable and expedite the recovery of outstanding payments.
Prepare regular reports on refunds, under/over payments.
Stay updated on changes in healthcare regulations and coding guidelines.
*NOTE: The list of tasks is illustrative only and is not a comprehensive list of all functions and tasks performed by this position.
Other Essential Tasks/Responsibilities/Abilities
Must be consistent with Femwell's core values.
Excellent verbal and written communication skills.
Professional and tactful interpersonal skills with the ability to interact with a variety of personalities.
Excellent organizational skills and attention to detail.
Excellent time management skills with proven ability to meet deadlines and work under pressure.
Ability to manage and prioritize multiple projects and tasks efficiently.
Must demonstrate commitment to high professional ethical standards and a diverse workplace.
Must have excellent listening skills.
Must have the ability to maintain reasonably regular, punctual attendance consistent with the ADA, FMLA, and other federal, state, and local standards and organization attendance policies and procedures.
Must maintain compliance with all personnel policies and procedures.
Must be self-disciplined, organized, and able to effectively coordinate and collaborate with team members.
Extremely proficient with Microsoft Office Suite or related software; as well as Excel, PPT, Internet, Cloud, Forums, Google, and other business tools required for this position.
Education, Experience, Skills, and Requirements
Bachelor's degree preferred.
Minimum of 2 years of experience in medical billing, coding, revenue cycle or practice management.
Strong knowledge of healthcare regulations and insurance processes.
Knowledgeable in change control.
Proficiency with healthcare billing software and electronic health records (EHR).
Knowledge of HIPAA Security preferred.
Hybrid rotation schedule and/or onsite as needed.
Medical coding (ICD-10, CPT, HCPCS)
Claims management (X12)
Revenue cycle management
Denials management
Insurance verification
Data analysis
Compliance knowledge
Comprehensive understanding of provider reimbursement methodologies
Billing software proficiency
$34k-49k yearly est. 1d ago
Billing Specialist
Spooner Medical Administrators, Inc. 2.7
Westlake, OH jobs
Spooner Medical Administrators, Incorporated (SMAI) is a family owned and operated company that offers rewarding career opportunities for motivated individuals who are passionate about excellence and growth. Since 1997, SMAI's proactive philosophy and best practices have set the standard in workers' compensation by continuously improving the delivery of case management, utilization review and billing services to help facilitate a successful return to work for the injured worker.
The Billing Specialist is primarily responsible for reviewing, auditing and data entry of bills submitted by medical providers for compliance with proper billing practices.
Essential Functions
Review bills to determine if the information needed to process the bill has been received and contact the medical provider for any missing information.
Perform fee bill audits according to established procedures and guidelines.
Data enter fee fills accurately for electronic transmission.
Adhere to established billing performance requirements.
Review electronic response to transmitted bills and make modifications accordingly.
Respond to telephone inquiries from customers regarding bill payment status.
Participate in continuous improvement activities and other duties as assigned.
Supervision Received
Reports to the Billing Supervisor
Experience and Education Required
Medical billing certification or at least 2 years of experience working in the medical billing field
Data entry experience
Additional Skills Needed
Effective written and verbal communication
Detail oriented
Strong organizational ability
Basic computer literacy skills
Working Environment
The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of the job. While performing the duties of this job, the employee typically works in a normal office environment. The noise level in the work environment is usually quiet.
$28k-33k yearly est. 4d ago
RCM Specialist
Aspen Dental 4.0
East Syracuse, NY jobs
The Aspen Group (TAG) is one of the largest and most trusted retail healthcare business support organizations in the U.S., supporting 15,000 healthcare professionals and team members at more than 1,000 health and wellness offices across 47 states in three distinct categories: Dental care, urgent care, and medical aesthetics. Working in partnership with independent practice owners and clinicians, the team is united by a single purpose: to prove that healthcare can be better and smarter for everyone. TAG provides a comprehensive suite of centralized business support services that power the impact of five consumer-facing businesses: Aspen Dental, ClearChoice Dental Implant Centers, WellNow Urgent Care, Lovet Pet Health Care and Chapter Aesthetic Studio. Each brand has access to a deep community of experts, tools and resources to grow their practices, and an unwavering commitment to delivering high-quality consumer healthcare experiences at scale.
As a reflection of our current needs and planned growth we are very pleased to offer a new opportunity to join our dedicated team as Revenue Cycle Management Specialist based in our East Syracuse, NY office.
Essential Responsibilities:
RCM Specialists care for the people who care for our patients by performing insurance adjudication, customer service, and patient collection job functions that require superior service and attention to detail.
Bring better care to the front lines by supporting the execution and achievement of functional areas and company goals.
Partners with internal departments to resolve issues related to all tasks and assignments supporting the business.
Point of contact for internal and external customer inquiries, which entails contacting insurance companies and/or addressing patient inquiries.
Uses software and company systems to source, obtain, process, audit and analyze standard data reporting and presenting.
Plans, organizes, and executes tasks and activities with urgency and in accordance with managers' delegated assignments.
Responds to and resolves issues related to claim adjudication, patient and billing inquiries, while seeking managers guidance for non-routine inquiries or escalated concerns.
May be required to meet position related productivity and quality standards.
Other duties as assigned.
Requirements/Qualifications:
Education Level: High School diploma or equivalent.
Job related/Industry experience preferred.
Excellent verbal and written communication skills.
Excellent organizational and time management skills.
Excellent problem solving/analysis collaboration.
Self-motivated individual with strong attention to detail.
Leadership experience preferred.
Additional Details:
Base Pay Range: $17.00 - 21.00 per hour (Actual pay may vary based on experience, performance, and qualifications.)
This position will be based on-site in our East Syracuse, NY office working a hybrid schedule of 4 days/week and 1 day remote.
A generous benefits package that includes paid time off, health, dental, vision, and 401(k) savings plan with match.
$17-21 hourly 1d ago
Grievance & Appeals Specialist II (Must live in Indiana)
Caresource 4.9
Indianapolis, IN jobs
The Grievance & Appeals Specialist II reviews appeals submitted by Medicaid and Medicare providers and all future providers contracted with CareSource. Must live in Indiana.
.
Essential Functions:
Prepare the appeals for clinical review and be responsible for recording and tracking on a regular basis
Review submitted appeals daily for validation of the appeal
Identify appropriate claim problem within the appeal
Prepare all clinical edit appeals for review by computer research, print claim from Facets system, and print off all the code descriptions to assist the reviewer in decision making for committee meetings
Attend and participate in Appeals Committee meetings as needed
Maintain spreadsheet of all appeals reviewed with the outcomes resulting from the Appeals Committee Meetings
Document within Facets the detailed information as to the outcome of the claim appeal
Identify System changes, log the ticket and track the resolution
Complete claim appeal through claim adjustments or letters of denials
Review claim appeals for possible fraud and abuse and report to SIU
Research and release claim appeals with other health insurance, notifying the COB unit when there is other insurance
Process a variety of appeals, including but not limited to: dental appeals, low difficulty appeals, non-clinical appeals - (i.e. tobacco surcharge, etc.), medically frail appeals, RCP appeals, member and provider appeals
Resolve assigned appeals within regulatory timeframes, achieve departmental quality expectations, and meet daily production requirements
Identify and log any related issues
Perform UAT testing when necessary
Perform any other job related instructions, as requested
Education and Experience:
High school diploma or equivalent is required
Associates Degree or equivalent years of relevant work experience preferred
Minimum of two (2) years of healthcare customer service, claims, compliance or related experience is required
Competencies, Knowledge and Skills:
Technical writing skills
Intermediate level skills in Microsoft Word & Excel with Access skills a plus
Communication skills (written, oral and interpersonal)
Multitasking ability
Able to work independently and within a team environment
Familiarity of the Healthcare field
Knowledge of Medicaid
Time Management
Decision-making and/or problem solving skills
Proper grammar skills
Phone etiquette skills
Licensure and Certification:
None
Working Conditions:
General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$41,200.00 - $66,000.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type:
Hourly
Competencies:
- Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
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