This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Fabric is looking for a Managed Care Coordinator to join us on a contract basis and serve as a critical link between our clinical teams, healthcare payers, and finance department. In this role, you will own the end-to-end provider enrollment and credentialing process while supporting claims management and denial resolution — ensuring our providers are properly networked and that revenue flows without unnecessary delays. This is a detail-oriented, process-driven role that sits at the heart of our revenue cycle operations. You will be the go-to person for payer relationships, provider data accuracy, and compliance documentation — playing a direct role in keeping our clinical and financial operations running smoothly. What You'll Do - Manage the complete provider enrollment and re-credentialing process with all relevant payers, including Medicare and Medicaid, and maintain up-to-date CAQH profiles and TIN information. - Oversee the claims queue, analyze denied claims and underpayments, and resolve issues in a timely manner. - Maintain meticulous accuracy of provider data — including NPIs, tax IDs, professional licenses, and addresses — across internal and payer-specific databases. - Ensure all MCO compliance documentation and provider data meet regulatory standards set by bodies such as NCQA and URAC. - Serve as the primary point of contact with healthcare payers on network participation status, enrollment, and reimbursement inquiries. - Identify and report on trends in claim denials and outstanding A/R balances to support ongoing improvements in revenue cycle efficiency. Qualifications - 1–3 years of experience in provider credentialing, enrollment, or managed care, preferably within a hospital or insurance setting. - Demonstrated proficiency with payer portals such as Availity, PECOS, and eMedNY, and experience with credentialing software. - Solid understanding of medical billing, coding, and claims adjudication processes. - Strong analytical and critical thinking skills, with the ability to resolve complex enrollment issues under time pressure. - Excellent written and verbal communication skills. - High school diploma or GED required; Bachelor's degree preferred. - Preferred certifications: CPCS, CPMSM, CPB, CBCS, and/or CMRS. - Prior experience with virtual care platforms is a plus. Requirements - You take pride in keeping data clean and processes airtight — small errors in this work have real downstream consequences and you understand that. - You are comfortable navigating payer portals and credentialing systems and are not intimidated by the administrative complexity of managed care. - You are a clear, confident communicator who can work effectively with both internal teams and external payer contacts to resolve issues quickly. - You enjoy having ownership over a defined set of processes and finding ways to make them more efficient over time. This Might Not Be The Right Fit If... - You prefer variety and ambiguity over structured, process-driven work — this role requires consistency, precision, and attention to detail every day. - You are not comfortable working across multiple payer portals and databases simultaneously or managing competing deadlines. - You are looking for a primarily strategic or client-facing role — the core of this work is operational and detail-oriented. Benefits - The national pay range for this role is $22.00 – $35.00 per hour. - Actual compensation will be determined by factors such as the candidate's geographic market, experience, skills, and qualifications. - If your compensation requirement is greater than our posted range, please still consider applying; a determination can be made based on unique qualifications. - Expected compensation ranges for this role may change over time.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner. This candidate should have a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment. - Effectively follow-up on claim submission and remittance review for insurance collections. - Create and pursue disputed balances from both government and non-government entities. - Work as part of a dynamic team and adapt to changing work assignments. - Work independently and closely with management to resolve accounts. - Interact professionally with insurance plans, patients, physicians, attorneys, and team members. - Utilize basic computer skills to navigate various system applications. - Access payer websites to resolve accounts and document actions taken. - Maintain department daily productivity goals while meeting quality standards. - Identify and communicate issues related to system access and payor behavior. - Provide support for team members that may be absent or backlogged. Qualifications - Thorough understanding of the revenue cycle process. - Intermediate skill in Microsoft Office (Word, Excel). - Ability to learn hospital systems quickly and fluently. - Strong oral and written communication skills. - Strong interpersonal skills and analytical thinking skills. - Full understanding of Commercial, Managed Care, Medicare, and Medicaid collections. - Familiarity with terms such as HMO, PPO, IPA, and Capitation. - Intermediate understanding of EOB and hospital billing form requirements. - Ability to problem solve, prioritize duties, and follow through with tasks. Requirements - High School diploma or equivalent; some college coursework in business administration or accounting preferred. - 1-4 years of medical claims and/or hospital collections experience. - Minimum typing requirement of 45 wpm. Benefits - Pay: $15.80 - $23.70 per hour, depending on location, qualifications, and experience. - Potential signing bonus for qualified new hires. - Conifer observed holidays receive time and a half. - Medical, dental, vision, disability, and life insurance. - Paid time off (min of 12 days per year, accruing at approximately 1.84 hours per 40 hours worked). - 401k with up to 6% employer match. - 10 paid holidays per year. - Health savings accounts and flexible spending accounts. - Employee Assistance program and Employee discount program. - Voluntary benefits including pet insurance and legal insurance. - Paid leave for Colorado employees in accordance with Colorado’s Healthy Families and Workplaces Act.

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible for: • Processing of Professional claim forms files by provider • Reviewing the policies and benefits • Comply with company regulations regarding HIPAA, confidentiality, and PHI • Abide with the timelines to complete compliance training of NTT Data/Client • Work independently to research, review and act on the claims • Prioritize work and adjudicate claims as per turnaround time/SLAs • Ensure claims are adjudicated as per clients defined workflows, guidelines • Sustaining and meeting the client productivity/quality targets to avoid penalties • Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. • Timely response and resolution of claims received via emails as priority work • Correctly calculate claims payable amount using applicable methodology/ fee schedule Requirements: • 3 year(s) hands-on experience in Healthcare Claims Processing • 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools • High school diploma or GED. • Previously performing – in P&Q work environment; work from queue; remotely • Key board skills and computer familiarity – o Toggling back and forth between screens/can you navigate multiple systems. o Working knowledge of MS office products – Outlook, MS Word and MS-Excel. Preferred Skills & Experiences: • Amisys • Ability to communicate (oral/written) effectively in a professional office setting • Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities • Time management with the ability to cope in a complex, changing environment

The Material Damage Claims Specialist (MDS) is primarily responsible for the timely completion of internal estimates, appraisals, and valuations for the REPO Plus department. They serve as the physical damage experts/SMEs within the department and will routinely complete audits of outside insurance carrier (OIC) estimates/appraisals. Additionally, they are tasked with both initial and evergreen training related to automobile physical damage. Job Duties and Responsibilities:​ Physical Damage Estimate/Appraisal Production - Will complete internal estimates, appraisals, and valuations on REPO Plus claim files. - This may include desk estimates of damaged vehicles, total loss valuations, and reviews or audit of externally supplied material. - Work is generated from internal REPO Plus claim files as well as via request from lender clients. - Required to meet production goals set by REPO Plus management. - Required to meet QA goals set by REPO Plus management. Physical Damage Subject Matter Expert - Will field questions and provide answers to REPO Plus Adjusters and Analysts as needed such as: - Estimate Review - Total Loss valuations audit - Written responses to OIC appraisers - Will be involved in all testing necessary to validate new workflows/processes and system integrations or applications within the REPO Plus department (ex. Integrating the CCC platform with PEGA for REPO Plus). Physical Damage Training - Provide initial physical damage training for the REPO Plus department including the following: - Condition Report review training for incoming REPO Plus Processors - Physical damage/Estimate training for incoming REPO Plus Adjusters and Analysts - Evergreen training related to physical damage including updates to state regulations, industry standards, etc. Qualifications (Education, Experience, Certifications & KSA): - High school diploma or GED. - 8-10 years of work-related experience. - Required to maintain all applicable licensing (if required) and continuing education/training necessary to complete the above work in all 50 states. This may include: - State licensing - Training specific to changes within the automobile physical damage field (ICAR, etc.) The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with a job. #LI-SJ1 #LI-Remote We offer our employees a robust compensation package! Our comprehensive benefits include: medical, dental and vision insurance coverage; 100% company-paid life and disability coverage, 401k options with company match, three weeks PTO by the end of the first year and much more. Allied proudly promotes from within as part of a strong commitment to providing career growth opportunities for employees of all levels. Our diverse business portfolio allows employees broad career options with the advantage of staying with the same organization. All qualified candidates will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law. To view our privacy statement click here To view our terms and conditions click here