Overview FULL-TIME (REMOTE) CORPORATE DENIALS & APPEALS SPECIALIST MUST HAVE HEALTHCARE BILLING/COLLECTIONS EXPERIENCE W/CONCENTRATION ON DENIALS / APPEALS At Powerback, we're on a mission to improve lives. As the leader in physical, occupational, speech, and respiratory therapies, we help older adults stay active and thrive while providing essential therapy for children at home and in school. With over 38 years of trusted service, our reach spans skilled nursing centers, assisted and independent living facilities, outpatient clinics, and home-based care. We're proud to deliver personalized care exactly where and when it's needed most. Join an industry-leading team that restores hope and makes a lasting impact. If you're passionate about making a meaningful difference and want to be part of the future of rehabilitation and wellness, Powerback is the place for you. Why Powerback? - Benefits: We offer Medical, Dental, and Vision plans to Full-Time team members. We offer Dental and Vision to Part-Time team members. - Paid Time Off: We offer generous paid time off to Full-Time and Part-Time team members. - Support for New Grads: Our Powerback Clinical Mentorship Program kicks off on day one, helping you learn from the best in the field. - Continuing Education: Keep growing with free CEUs through Medbridge. - H-1B Visa & Relocation Assistance: We support Visa or Green Card sponsorships, plus our Journey Travel Program lets you work across the U.S. with the security of a full-time role. - Perks at Powerback: Enjoy exclusive discounts on Wireless/TV, Home/Auto/Renters and Pet Insurance, Childcare, Eldercare, and more. Earn rewards through our PowerZone Employee Recognition Program, and expand your expertise with our Clinicians in Action professional development program Responsibilities The Denials and Appeals Specialist is responsible for the follow up of denied claims from all commercial and contracted payers. The follow up includes initial assessment of the denials received to determine the appropriate process. Once determined, established policy and procedure will be followed for appeal submission. Reviews assigned accounts that have a payer denial based on the response from the payer and takes appropriate action, including appeals, based on the type of denial. Documents all necessary elements; reason for denial/audit, denial status, and action taken in the electronic medical record per denial management policy. Provides missing or additional information if necessary, to expedite the resolution of the denied claim. This may include writing detailed appeal letters supporting the claim and reimbursement. Performs all appeals and denials recovery procedures needed to appropriately and accurately resolve denied claims. This includes working with internal and external customers. Consistently meets productivity and quality standards established by management, recommending new approaches for enhancing performance and productivity when appropriate. Keeps Supervisor/Manager informed of any problems or issues related to the appeal process and/or current appeals. Performs other duties as assigned. Qualifications * High School diploma or equivalent education and experience required. College degree preferred. * Must be proficient using MS Office or Google Suite applications. * Strong analytical skills. * Minimum of 1 - 2 years of previous revenue cycle management experience. Posted Salary Range USD $20.00 - USD $20.00 /Hr.

Role Description The Claims Processing Specialist is responsible for: - Data entry related to processing claims - Reviewing claim submissions - Insurance verification - Determining denial reasons - Processing insurance payments - Working with clinical staff, administrative staff, and payer representatives to ensure timely and accurate claims - Actively following up with claim status Must have attention to detail, be highly motivated, multi-task, and complete tasks in a specified time frame to meet production and quality standards. Shifts/Days and Work Hours: Monday through Friday; 8:00 am - 4:30 pm. Qualifications - High School/GED - Billing experience (REQUIRED) Company Description

Role Description K2 Claims Services, LLC ("K2 Claims") is actively seeking a motivated General Liability Adjuster with experience handling both commercial and personal lines’ liability claims. As a third-party administrator (TPA), K2 Claims services specialty programs across property, general liability, auto, professional liability, and workers’ compensation. This is an opportunity to join a well-established, growing company and contribute to building a world-class TPA. - Claim Handling: Manage claims in strict accordance with state-specific insurance regulations and K2 Claims' Best Practices. - Investigation: Verify facts of loss by obtaining statements, analyzing documents, and evaluating damages. - Diverse Caseload: Manage a broad spectrum of claims ranging from low exposure to complex losses, including dog bites, slip/falls, wrongful evictions, and general business disputes. - Litigation Management: Oversee litigated cases, including referring to counsel, establishing litigation plans and budgets, and providing settlement authority. - Coverage Analysis: Analyze policy coverage and draft detailed reservation of rights and/or coverage declination letters. - Large Loss Reporting: Prepare comprehensive reports for senior management and clients regarding claim status, recommended reserves, and strategic plans of action. - Negotiation: Effectively negotiate settlements within assigned authority. - Risk Evaluation: Analyze risk transfer options and determine insurance priority. - Referrals: Identify and refer appropriate claims to subrogation or the Special Investigation Unit (SIU). Qualifications - Experience: 8+ years of commercial and personal lines liability experience is ideal, with a minimum requirement of 5+ years in commercial and homeowner liability claims. - Industry Background: Previous experience in a TPA or insurance carrier environment handling diverse programs. - Licensing: Ability to obtain and maintain all required state adjuster licenses. A California adjuster’s license is preferred. - Education: Bachelor’s Degree is preferred. - Technical Proficiency: Skilled in Microsoft Word, Excel, and Outlook. - Communication: Excellent verbal and written communication skills with a dedicated focus on customer service. - Travel: Must be flexible for occasional business travel for training, mediations, and/or trials. Benefits - Medical, dental, and vision coverage with no waiting period. - Competitive base salary plus a bonus plan. - 401(k) with employer match. - Generous paid time off, available starting in your first year. - A collaborative team environment within a growing company.

Overview This position is primarily remote work, but candidate must reside within the state of Utah for this one. Top candidates will also have some prior working experience in Prior Authorizations. As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA This position is responsible to secure outpatient accounts by performing insurance verification, obtaining benefit information, calculating patient estimates, and obtaining prior authorization before services are rendered. This position works with physicians, nurses, clinic managers, and financial advocates to resolve issues that arise during the prior authorizations process. This position is not responsible for providing care to patients. Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes. Responsibilities - Verifies insurance eligibility, benefits, network status, and creates pre-service liability estimate. - Ensures accurate ICD, CPT codes and related medical records are submitted in the authorization request. - Secures prior authorizations for outpatient imaging and in office scheduled services. - Acts as a liaison between the payer and clinic schedulers/medical support staff. - Follows up on delayed or denied authorization requests and escalates for resolution. - Creates detailed documentation and maintains/stores the authorization paper trail. - May work to resolve claims denials related to the prior authorization. Knowledge / Skills / Abilities - Basic knowledge of accounting, word processing, and spreadsheets. - Demonstrated critical thinking and ability to analyze information and problem solve. - Demonstrated professional verbal/written communication skills. - Ability to work independently within a team setting. - Ability to adapt to a dynamic work environment. - Demonstrated ability to prioritize and manage a large workload in stressful situations. - Ability to multitask. - Familiarity with human anatomy and medical terminology. - Demonstrated ability to complete work with a high level of detail and accuracy. - Ability to meet process time standards. - Ability to provide professional and courteous service in all interactions with internal and external customers. - Ability to navigate through various hospital software applications, including Epic ADT/Prelude, Cadence, Epicare, Referrals and Auth/Cert applications. - Ability to navigate and maneuver through multiple web sites. Qualifications Qualifications Required - Two years of experience in a health care financial setting, or the equivalency. Qualifications (Preferred) Preferred - Previous experience with medical insurance and prior-authorizations. - ICD/CPT coding experience. - Outpatient or Radiology prior authorizations experience. Working Conditions and Physical Demands Employee must be able to meet the following requirements with or without an accommodation. - This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull, or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. Physical Requirements Listening, Sitting, Speaking