Role Description This REMOTE position will help to support billing edit resolution activities for the Laboratory, Pathology, and Blood Bank service lines. - Responsible for charge capture analysis, workflow, and maintenance of related work queues in assigned service lines. - Works designated work queues to resolve claim edits prior to billing by analyzing medical record documentation and application of payer guidelines. - Evaluates and provides guidance related to billing and/or clearinghouse system edits. - May complete focused charge review assessments for assigned clinical departments and/or service lines to ensure that charges are generated in accordance with established policies and timeframes. - Advises service line leaders and their staff on proper usage of charge codes. - Identifies opportunities for capturing additional revenue in accordance with payer guidelines. - Develops specifications to modify existing charge capture applications to reduce charge-related claim edits/rejections. Qualifications - H.S. Diploma or General Education Degree (GED) Required - Associate’s Degree in HIM/HIT Preferred - Bachelor’s Degree in HIM/HIT Preferred - 3 years of related healthcare experience focused in one or more of the following areas: - charge integrity Required - charge capture/reconciliation Required - healthcare compliance Required - charge auditing Required - CDM management Required - coding and/or hospital billing procedures Required - Experience working with Epic Required - Licenses and Certifications: - AHIMA certification (e.g. RHIA, CCS, RHIT) Upon Hire Required - RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure RN licensure Upon Hire Required - certified healthcare provider (e.g. MT, RT) Upon Hire Required Business Unit Piedmont Healthcare Corporate

Role Description As a key member of the Amazon One Medical Revenue Cycle team, the Medical Auditor will be responsible for supporting Amazon One Medical Clinical and Revenue Cycle teams in managing and optimizing compliant healthcare revenue cycle operations. This role reports into the Coding Compliance Auditing Manager, Revenue Cycle. Key job responsibilities: - Conduct regular audits to verify accuracy of ICD-10-CM, CPT, HCPCS, and modifier medical codes - Review documentation to verify appropriate code assignment - Ensure coding reflects clinical documentation and meets medical necessity requirements - Identify coding inaccuracies and opportunities for improvement - Track and report coding errors and findings - Maintain detailed records of audit findings - Ensure adherence to coding guidelines and regulatory requirements - Follow established policies and procedures, and surface and escalate compliance concerns as appropriate - Experience using data to drive root cause elimination and process improvement Qualifications - 3+ years of data analysis and formula creation in Microsoft Excel experience - CPC certification through AAPC or CCS certification through AHIMA - 3+ years of coding/auditing experience in the professional fee and/or risk adjustment setting working with Medicare, Medicare Advantage, and Commercial payers required - Knowledge of industry standard code sets and associated guidelines (ICD-10-CM, CPT, HCPCS) - Advanced knowledge and understanding of HCC Risk Adjustment, coding and documentation requirements - Strong written and verbal communication with attention to detail - Strong organizational, analytical, problem solving, and time management skills - Experience with end-to-end project management - Experience prioritizing and handling multiple assignments at any given time while maintaining commitment to deadlines, or experience in a fast-paced, high-tech company - Bachelor’s Degree in healthcare related field - Demonstrated ability to identify and communicate trends in coding and documentation Requirements - Ability to adhere to company policies - Exercise sound judgment - Effectively manage stress and work safely and respectfully with others - Exhibit trustworthiness and professionalism - Safeguard business operations and the Company’s reputation Benefits - Comprehensive health insurance (medical, dental, vision, prescription) - Basic Life & AD&D insurance and option for Supplemental life plans - EAP, Mental Health Support, Medical Advice Line - Flexible Spending Accounts - Adoption and Surrogacy Reimbursement coverage - 401(k) matching - Paid time off - Parental leave

Overview The Opportunity Premium Audit Associate – Remote Opportunity (must be located in FL, GA, SC, or PA) Pay starting at $21.00 per hour We are seeking to add an Insurance Premium Audit Associate to our team! This is an entry-level, fully remote opportunity; however, candidates must reside in Florida, Georgia, South Carolina, or Pennsylvania. Our Premium Audits team plays a very important role in auditing the policy premium collected. As a Premium Audit Associate, job duties include processing all audit endorsements received by companies, including follow-up reminders with agents. They also ensure compliance with company guidelines for payment or return of audit endorsements. This position is ideal for someone who is detail-oriented, organized, and comfortable working in a fast-paced, high-volume environment. Benefits: - Paid Time Off - 10 Paid Holidays - 401(k) with company match up - Medical, Dental, & Vision insurance - Supplemental benefits including company paid long-term disability and life insurance. Responsibilities Responsibilities include: - Manage a high volume of email correspondence, ensuring timely, accurate, and professional responses - Review and process audit documentation received from carriers - Bill audit endorsements and set up installment plans in accordance with carrier guidelines - Prepare and send communications to agents regarding audit results and payment terms - Process direct bill taxes accurately and in a timely manner - Monitor outstanding audits and ensure all unpaid audits are returned within each carrier’s required timeframes - Support the Manager with additional tasks and team needs as assigned Qualifications Job Requirements: - High School Diploma or General Education Diploma (G.E.D.) - Excellent attention to detail & organization skills - Strong customer orientation, excellent interpersonal and communication skills - Team player with a commitment to company values Who We Are Bass Underwriters, Inc. is a leading Managing General Agency for commercial property and casualty insurance. We focus on risks that fit outside the box and play a pivotal role between agents and insurance carriers. Our relationships are driven by our commitment to our independent agents, and that translates into every team here are Bass Underwriters. -

Introduction At Gallagher Benefit Services, you’re a trusted partner to organizations navigating some of their most important people decisions. We help clients build better workplaces, where people feel supported, empowered, and inspired to thrive. Whether it’s shaping benefit strategies, designing wellbeing programs, or advising on workforce challenges, the work you do here creates meaningful change for businesses and the people who power them. We’re a community of bold explorers, trusted experts, and compassionate partners; working side by side to solve problems, and shape the future of work. Here, curiosity is encouraged, collaboration is second nature, and your ideas have room to grow. If you’re looking for a place where your contribution matters and where you can help build a better world of work; think of Gallagher. Overview The Pharmacy Auditor is an integral part of the Pharmacy Audit Team and is responsible for performing and supporting Prescription Drug Claim Audits (claims, rebates, operational, Medicare, pre/post-implementation, etc.) to validate that the coverage of a prescription drug claim, and the payment of such claim, comply with the contractual, regulatory, and custom plan guidelines. Additionally, certain audits validate the proper reimbursement of prescription rebates from a Pharmacy Benefits Manager (PBM) to a client per the contractual arrangement. This position is client-facing and requires an individual who can effectively manage client expectations as well as the ability to manage multiple projects without compromise of accuracy or timeliness. How you'll make an impact - Project management of Prescription Drug Claim Audits from implementation through closure. - Manage and perform audits of prescription drug claim payment data to validate conformance with contractual requirements and plan specifications as assigned. - Review and evaluate Administrative Services Agreement between the employer and PBM. - Work with dedicated data analytics team to define and translate plan provisions for testing purposes, ensuring that scope aligns with the statement of work and client commitments. Review client-specific documentation, Summary Plan Description(s), and other documentation such as copay grids, plan literals, set-up grids, etc., to develop the audit test filters. - Complete the contract summary, or assist with completion of contract summaries, as assigned. - Evaluate the results of the initial claim data tests and determine valid audit samples for review and response by the PBM. - Prepare PBM communications regarding test results, response expectations, and clarifications to questions. - Work collaboratively with PBM to resolve exceptions, review supporting documentation, and make final claim error determination. - Ensure audit timeline is adhered to and deliver high level of service to clients. - Perform Prescription Drug Claim Rebate audits as assigned. - Occasional travel to the PBM is required; 10-20% travel is possible. - Prepare and present detailed audit reports which clearly articulate audit findings and recommendations to PBM and client. - Maintain audit project work papers to support audit findings. - Work collaboratively within the audit team, as well as with internal and external customers. - Participate in team meetings, conference calls, Microsoft Teams meetings, etc. remotely with PBMs and audit team as necessary. - Assist with claims data analysis and quality assurance as requested. - Interact directly with clients and respond to client requests. Develop strong relationships with clients. - Assist in supporting other auditors, Directors, and Practice Leader as requested. - Perform special projects or assignments, as instructed by Manager/Director. About You - College degree (experience may be considered to waive the degree requirement) - 5+ years’ experience in pharmacy auditing, consulting, or other applicable pharmacy industry experience - Previous PBM experience is a plus but not required - Must demonstrate a high level of pharmacy benefit, claim, or benefit administration knowledge - Medicare benefits experience is a strong plus - Proficient in the use of Microsoft Office Suite of programs (Word, Excel, PowerPoint, Outlook, Teams) - Excellent oral and written communication skills are required - Excellent organizational and time management skills - Personable communication style, positive outlook, and self-confidence - Ability to multi-task and acclimate to changing priorities without losing focus - Attention to detail and ability to clearly explain thought process in reaching documented conclusions - Self-directed individuals who require little supervision and can manage multiple projects effectively to ensure deadlines are met - Team player with a strong work ethic Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave Other benefits include: - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.