• Perform ongoing demands analysis to adapt and optimize insurance coverage. • Negotiate terms and conditions with insurance providers to secure the best coverage and rates. • Provide expert advice on insurance-related clauses. • Assess clients’ insurance needs and recommend appropriate coverage options. • Assist internally with the application process and ensure documentation is completed accurately. • Handle insurance claims from initial reporting to final settlement. • Stay updated on industry trends and regulatory changes. • Conduct risk assessments and provide recommendations for risk management strategies. • Prepare and present detailed reports on insurance coverage, claims status, and risk management activities to senior management.

• Responsible for all collection functions for hospital and physician services • Account resolution, which includes reviewing accounts • Following up with Medi-Cal and various insurance companies on claim status • Gathering and submitting any missing information • Rebilling, appeals, and billing out secondary electronic or paper claims • Provide customer service to various healthcare contract customers • Prepare, research and collect from Medi-Cal and various contracted health insurance payers • Research remits and Explanation of Benefits (EOBs) for complete accurate payments or denials • Provide or arrange for additional information when needed • Submit corrected claims or appeals • Request appropriate adjustments, when required • Identify items that require client assistance • Gather payor trends and provide feedback • Other duties as assigned

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are seeking a motivated and results-driven Life Insurance Sales Team Manager to lead and grow a high-performing remote sales team. This role combines hands-on sales production with team leadership, recruitment, and performance management. - Recruit, onboard, and develop a team of life insurance sales professionals - Provide ongoing coaching, mentorship, and performance feedback - Foster a collaborative, accountability-driven team culture - Implement and execute sales strategies to exceed individual and team targets - Analyze performance metrics to identify trends, opportunities, and areas for improvement - Lead by example by actively engaging with clients and closing sales - Ensure a high standard of service and professionalism across all client interactions - Support team members in managing complex sales scenarios - Drive repeat business and long-term relationships through consistent follow-up - Conduct regular training sessions on sales techniques and best practices - Keep the team informed of product updates, regulatory requirements, and policy changes - Identify skill gaps and deliver targeted coaching to improve performance Qualifications - Proven leadership experience managing and mentoring sales teams - Strong background in life insurance sales or a closely related field - Excellent communication, coaching, and interpersonal skills - Goal-oriented mindset with a track record of exceeding sales targets - Strategic and analytical approach to performance management - Highly organized and self-motivated with the ability to lead remotely Requirements - Must be legally authorized to work in the United States - Candidates residing in New York or Massachusetts are not eligible for this role Benefits - 100% Remote: Lead your team from anywhere in the U.S. (excluding NY & MA) - Comprehensive Training & Support: Ongoing resources to support your success and your team’s growth - Flexible Schedule: Balance leadership responsibilities with work-life flexibility - Competitive Commission Structure: Earnings tied to both individual and team performance - Career Advancement: Opportunity to grow into senior or executive leadership roles - Purpose-Driven Work: Help individuals and families secure long-term financial protection

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Do you have a meticulous eye for detail and a passion for helping patients access the care they need? Are you experienced in navigating insurance guidelines, prior authorizations, and the specialized world of wound care? If so, NIVA Health invites you to apply for our Remote Insurance Verification Specialist position! As a key member of our authorization coordination team, you will play a pivotal role in ensuring patients receive timely, necessary treatment, all while exemplifying our Core Values of Teamwork, Resilience, Open-Mindedness, Ownership, and Positivity. - Submit and manage prior authorization requests for wound care treatments, ensuring that all documentation meets payer requirements. - Handle PCP referrals/authorizations and follow up to facilitate smooth patient care. - Prepare and track Single Case Agreements/GAP exceptions for out-of-network cases. - Communicate with insurance providers to clarify coverage, resolve denials, and facilitate appeals. - Maintain precise records of authorizations, denials, appeals, and corresponding documentation. - Stay up to date with insurance policies, coding changes, and criteria for wound care procedures. - Collaborate with healthcare providers, nurses, and admin staff to gather complete, accurate documentation for submissions. - Serve as a patient advocate, keeping patients informed about the status of their authorizations and potential out-of-pocket expenses. - Conduct your work with utmost discretion, diplomacy, and tact during all patient and staff interactions. - Contribute to other duties of similar complexity as assigned by your supervisor. Qualifications - Possess at least 1 year of experience in prior authorization management, specifically within wound care services. - Demonstrate a strong work ethic, self-motivation, and a “can-do” attitude. - Communicate clearly, empathetically, and professionally with patients, staff, and payers. - Understand the intricacies of insurance processes, medical terminology, and healthcare systems. - Are proficient with electronic medical records (EMR) and case management software. - Excel at collaborating with multidisciplinary healthcare teams and solving complex problems. - Embody NIVA Health’s Core Values in every interaction with patients and colleagues. Requirements - Bonus Points If You: - Are experienced in handling appeals, denials, and single case agreements. - Bring innovative approaches to patient advocacy and insurance coordination. - Stay informed about industry trends, especially in advanced wound care and insurance policy changes. Benefits At NIVA Health, your efforts are instrumental in ensuring that patients receive the life-changing care they deserve. We celebrate our team’s achievements, invest in personal and professional growth, and provide meaningful work in a values-driven, supportive environment. Join us and help shape a brighter, healthier future for all—one successful authorization at a time! Company Description - Pay: $1,300 per month (Up to R20,553.78 per month) - Work Schedule: US Timezone (East Coast) - Job Type: Full-time - Work Location: Remote