This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description As a Medical Insurance Billing Specialist, you play a vital role in ensuring the financial accuracy and efficiency of our cardiology billing operations. This role focuses on: - Insurance claim management - Denial resolution - Tracking reimbursement patterns to ensure claims are processed correctly and promptly You will work closely with: - Insurance companies - Internal departments - The broader business office team to resolve billing issues Your work directly supports the financial sustainability of our clinics and helps ensure patients receive uninterrupted care. Qualifications - High School Diploma or GED - Minimum 1 year of healthcare experience - Minimum 1 year of experience processing health insurance claims Requirements - Understanding of CMS-1500 claim forms, coordination of benefits (COB), PHI, and medical terminology - Experience using insurance payer websites to verify eligibility and claim status - Strong organizational and time-management skills - Detail-oriented with a high commitment to accuracy - Strong communication skills for working with insurance companies and internal teams Benefits - Medical, dental, and vision coverage - Retirement benefits - Paid time off - Competitive compensation - Tuition Assistance Company Description Cardiac Study Center (CSC) partners with Pulse Heart Institute to deliver trusted outpatient cardiology care across the Puget Sound region for over 50 years. In 2016, CSC joined with MultiCare Health System to form Pulse Heart Institute—bringing together clinical excellence, innovation, research, and education to improve heart health in our communities. Through this partnership, CSC provides essential operational and revenue cycle support that allows Pulse to focus on delivering exceptional cardiovascular care. Our billing and business office teams play a critical role in ensuring the financial health of the organization while supporting a seamless patient care experience.

The Opportunity As a First Party Medical Manager, you will be responsible for the results of a team of adjusters handling Personal Injury Protection (PIP) claims with emphasis on: Coverage Review, Medical Treatment Analysis including Mechanism of Injury and Causation as well as educating your adjusters on all exposures and the importance of transferring exposures timely. This role is vital to Root’s success as we continue to grow the scale and scope of our Claims team. Salary Range: $81,600 - $102,000 Root is a “work where it works best” company. This means we will support you working in whatever location that works best for you across the US. How You Will Make an Impact - Leads a team of PIP/MPC Claims Adjusters who are responsible for the handling of first-party medical claims. - Help train and educate leaders and adjusters on New Jersey PIP claim handling best practices. - Ensures adherence to state regulations and applicable policy language. - Oversees adjuster review of medical bills and works with vendor(s) to properly handle 1st party injury claims. - Reviews and approves payments over adjuster authority. - Acts as a coach to promote understanding of MOI, causation and medical management. - Create and execute talent development strategies for claims personnel, while recognizing the outsized impact that people have on the performance of the organization. - Measure, evaluate and communicate individual and team performance results in relation to overall organizational objectives. - Drive pace in a scalable manner, resulting in best-in-class LAE while maintaining high employee and customer satisfaction. - Interacts and communicates effectively with claims leadership, business partners, and teammates. - Understand and leverage analytics, process automation, and technology to improve efficiency and quality within claims operations. - Drive process innovation with a high degree of discernment between true differentiators and superficial features. - Engages in learning opportunities to build knowledge of personal lines claims, court decisions impacting the claims function, current guidelines in claims function, and policy changes and modifications. - Recruits, retains and develops a highly motivated and accountable team of experienced and developing claim liability professionals. - Always advocates for talent and builds capabilities to ensure strong leadership and technical talent bench strength What You Will Need to Succeed - New Jersey PIP adjusting and leadership experience (three years minimum) - Insurance licenses or professional insurance designations preferred - Strong understanding and application of laws, statutes, and regulations specific to PIP/MPC handling - Ability to coach to and drive medical management - Ability to interpret insurance policy language and apply coverage correctly to claim decisions - Communicates and collaborates effectively - High sense of professionalism while remaining empathetic - Familiarity with claims best practices required - Curious in nature - Great attention to detail - Self-starter and ability to work independently and effectively prioritize work - Ability to handle ambiguity and quickly adapt when changes occur - Strong written and oral communication skills - Ability to approach problems with an open mind - Ability to obtain and maintain insurance licenses in several states (including Texas) within three months of start date As part of Root's interview process, we kindly ask that all candidates be on camera for virtual interviews. This helps us create a more personal and engaging experience for both you and our interviewers. Being on camera is a standard requirement for our process and part of how we assess fit and communication style, so we do require it to move forward with any applicant's candidacy. If you have any concerns, feel free to let us know once you are contacted. We’re happy to talk it through. Please see our Privacy Notice available HERE for more information on how we process your personal data. Consistent with the Americans with Disabilities Act (ADA) and the Civil Rights Act of 1964, it is the policy of Root to provide reasonable accommodation when requested by a qualified applicant or candidate with a disability, unless such accommodation would cause an undue hardship for Root. The policy regarding requests for reasonable accommodation applies to all aspects of the hiring process. If reasonable accommodation is needed, please contact recruiting@joinroot.com

CMSAt ZOLL, we're passionate about improving patient outcomes and helping save lives. We provide innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and treat patients suffering from serious cardiopulmonary and respiratory conditions. ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies designed to deliver better insights and better outcomes. On any given day, clinicians utilize these ZOLL products for tens of thousands of cardiac patients around the world: - LifeVest, the world's first wearable defibrillator, has been trusted to protect more than 1M patients at risk of sudden cardiac death. - HFMS (Heart Failure Management system) is a non-invasive, patch-based device that monitors pulmonary fluid levels and has been shown to reduce heart failure readmissions rates by 38 percent. - TherOx Super Saturated Oxygen (SSO2) Therapy is the first FDA-approved therapy since the stent 20+ years ago to reduce infarct size in patients with the most severe heart attacks. Heart disease is the leading cause of death for both men and women in the U.S. At ZOLL, your work will help to ensure cardiac patients get the life-saving therapy they need. ZOLL has been Pittsburgh's Manufacturer of the Year, one of Western PA's Healthiest Employers, and even one of Pittsburgh's Coolest Offices. But it's our unique opportunity to impact people's lives that makes ZOLL the ideal place to build your career. Job Summary Responsible for reviewing and editing home sleep apnea tests for accuracy and completeness and for supporting patients who are prescribed a WatchPAT Home Sleep Apnea test. Essential Functions - Follow all ZOLL Laboratory Services policies and procedures. - Review scored clinical events (such as respiratory events) utilizing American Academy of Sleep Medicine (AASM) standards. - Upload final home sleep apnea test results to ZOLL Patient Management portal. - Contact (usually by phone) patients regarding pending home sleep kit arrival. - Explain the procedure and orient the patient to home sleep testing (HST). - Provide age-appropriate patient education. - Identify artifact, inadequate signals, and equipment failures and generate an accurate report. - Comply with applicable laws, regulations, guidelines, and standards regarding safety and infection control issues. - Perform routine equipment care and maintenance and inventory evaluation. - Maintain current CPR or BLS certification. - Adheres to all ZOLL policies and procedures. - Complete annual ZOLL training as required. - Comply with HIPAA regulations. - Works with other members of the IDTF as necessary to provide excellent patient care. - Interface with Supervising Physician as necessary. - Adhere to IDTF policies related to quality assurance. - Comply with professional standards of conduct. - Obtain/maintain sleep credentials as needed to perform job duties. - Supervise, train and coach Sleep Technicians as needed. Required/Preferred Education and Experience - High School Diploma or GED required - Minimum of 1 year Sleep center/IDTF experience required - Maintain current CPR or BLS certification - Current RPSGT certification or Respiratory Therapist with Sleep Disorder Specialist (SDS) credential. Knowledge, Skills and Abilities - Working knowledge of Microsoft Office suite (particularly Excel and PowerPoint). - Strong oral and written communication skills. - Operates efficiently as an individual or the member of a team. - High stress tolerance. - Strong analytical, critical thinking and creative problem-solving skills. - Ability to work efficiently independently or as a member of a team. - Ability to multi-task and stay organized. - Superior phone communication and customer service skills. - Effective written and verbal communication skills. - Ability to handle multiple tasks simultaneously under stringent deadlines. - Willing and able to work a flexible schedule. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. - Standing - Occasionally - Walking - Occasionally - Sitting - Constantly - Talking - Occasionally - Hearing - Occasionally - Repetitive Motions - Frequently ZOLL is a fast-growing company that operates in more than 140 countries around the world. Our employees are inspired by a commitment to make a difference in patients' lives, and our culture values innovation, self-motivation and an entrepreneurial spirit. Join us in our efforts to improve outcomes for underserved patients suffering from critical cardiopulmonary conditions and help save more lives. The hourly pay rate for this position is: $33.50 to $40.00 Factors which may affect this rate include shift, geography, skills, education, experience, and other qualifications of the successful candidate. Details of ZOLL's comprehensive benefits plans can be found at www.zollbenefits.com. Applications will be accepted on an ongoing basis until this position is filled. For fully remote positions, compensation will comply with all applicable federal, state, and local wage laws, including minimum wage requirements, based on the employee’s primary work location. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, disability, or status as a protected veteran. ADA: The employer will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990.

About the role Are you ready for your next career adventure?! Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Sr Review Coordinator to join our healthcare consulting practice. The role is fully remote within the US. We are proud of our national presence, and excited to offer great career opportunities within the organization. What you'll do - Perform utilization review/medical management including prospective, concurrent, and retrospective review for Long Term Care and Hospice services. - Review the complex plans of service and act as a resource for non-clinical reviewers. - Act as a resource for non-clinical reviewers. - Provide independent review decisions for behavioral health services and the appropriateness of quality of care based on contract, state or URAC requirements. - Screen situations according to specific criteria to determine if care is appropriate. - Refer cases that fail to meet criteria to peer reviewers. - Ensure review is conducted thoroughly and within specified timeframes. - Serve as liaison among peer reviewers, providers, facilities, and/or subscribers. - Document medical information supporting decisions into the workflow documentation system, ensuring data is entered accurately and timely. Required Qualifications - Compact RN License in Maryland - 3 – 5 years of recent experience working in a clinical environment - Long Term Care experience - Good written and oral communication skills - Typing and data entry skills, familiarity with computer systems, and use of multiple monitor work systems - Because of the nature and immediacy of the work, the ability to maintain regular and predictable attendance is essential Preferred Qualifications - Knowledge of medical coding and billing - Hospice experience What we offer: In addition to a rewarding career, IMS offers a wide range of benefits to its employees, including: - 401(k) Retirement Plan - Medical, Rx, Dental & Vision Insurance - Personal and Family Sick Time - 11 Company Paid Holidays - Medical & Dependent Care Flexible Spending Accounts - Group Life & Accidental Death & Dismemberment (AD&D) Insurance - Group Short Term Disability Insurance - Voluntary Life Insurance, Long Term Disability Insurance, Accident Insurance, Critical Illness Insurance, and Hospital Indemnity Insurance - Personal Development & Learning Opportunities - Skills Development & Certifications - Employee Referral Program - Corporate Sponsored Events & Community Outreach - Position may be eligible for a discretionary variable incentive bonus Integrated Management Strategies is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, gender identity, national origin, disability, pregnancy, status as a protected veteran, or any other protected characteristic as outlined by federal, state, or local laws. If you are an individual with a disability and would like to request a reasonable accommodation for the employment process, please email your request to hr@im-strat.com E-Verify® is a registered trademark of the U.S. Department of Homeland Security. This business uses E-Verify in its hiring practices to achieve a lawful workforce. www.dhs.gov/E-Verify The salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary rate for this position will be determined by a number of factors, including, scope, complexity, and location of the role; the skills, education, training, credentials, and experience of the candidate, and other conditions of employment.