• Maintain site specifics for assigned clients • Be able to verify the correct contract rate is applied to the billing • Work billing rejections in clearinghouses: Waystar • Communicate and supply documentation to coding and billing department including Op notes, implant logs, pathology reports • Be the go between providing document management between coding team, billing team and client to effectively bill claim • Provide feedback, guidance, and training support to billers to correct and prevent charge posting errors. • Monitor quality of charge entry and claim submission • Ensure timely filing of claims via electronic submission or paper submission • Resolve and reconcile submissions, rejections and edits daily • Must have a clear understanding of the insurance collection process • Ability to solve problems associated with tasks • Enter charge corrections provided by AR Specialists and rebill to payers as needed • Correct and resend rejected claims • Generate EOM unbilled reporting • Familiar with CPT codes, ICD and modifiers • Calculate pricing for implants and supplies accurately based on site specifics • Communicate professionally with internal and/or external clients • Pull case documents for audits as needed • Posting for Clients with offshore restrictions as needed • Perform other assigned duties

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. ***POSITION IS REMOTE BUT CANDIDATE MUST RESIDE IN STATE OF MISSOURI*** ***IDEAL CANDIDATE WILL HAVE DISCHARGE PLANNING EXPERIENCE*** Position Purpose: Supports care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Interacts with members by performing member outreach telephonically or through home-visits and documents the plan for care/services of activities. - Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate - Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed - Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plan - Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care/service - May support performing service assessments/screenings for members and documenting the member’s care needs - Supports documenting and maintaining member records in accordance with state and regulatory requirements and distribution to providers as needed - Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards - Ability to identify needs and make referrals to Care Manager, community based organizations, and Disease Manager - Provide education on benefits and resources available - Performs other duties as assigned. - Complies with all policies and standards. Education/Experience: Requires a High School diploma or GED. Requires 1 – 2 years of related experience Pay Range: $17.84 - $28.02 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Working at QVC Group means joining a live social shopping company with incredible teams, ambitious projects and amazing careers. QVC Group, Inc. is a Fortune 500 company with six leading retail brands - QVC®, HSN®, Ballard Designs®, Frontgate®, Garnet Hill® and Grandin Road.Your Opportunity, Your Team Our Customer Service Specialist supports QVC, and help answer our inbound customer calls. Working from home, our Specialists not only assist customers by problem-solving and de-escalating unique situations but also promote products and improve sales while maintaining a high-paced call volume. Where You'll Work - This role is remote; job seekers must reside in the greater Boise, ID area to be considered. You will work from home. What You'll Do - Busy day handling a high volume of our inbound customer inquiries. - Offer additional products on each customer interaction. - Assist customers with questions while personalizing the experience for each caller. - Calls may include confirming refunds, taking payments, placing orders, and, analyzing account data. - Opportunity for advancement and upward mobility across the entire QVC Group family of brands. - Report to an assigned Customer Service Supervisor. What You'll Bring - Provide a distraction free work from home environment. - 12 months or more of customer service experience. - Learn and work in a virtual environment. - Communicate with a variety of styles. - Navigate multiple systems and screens. - Follow QVC computer system requirements. - Troubleshoot own technical problems (partner with IT when needed). - Available to work weekends, holidays, and additional hours. This is a remote position. Our Total Rewards package includes benefits you’ll love such as competitive compensation, paid time off, an employee assistance program, parental leave, paid volunteer hours, and amazing company discounts! In our US market, you can also expect health care benefits starting on day 1, 401(k), and tuition reimbursement benefits. QVC Group is committed to inclusion and belonging for all and ensuring that our workplace provides equal employment opportunities for all team members and candidates and complies with all applicable federal, state, and local laws and regulations. As an equal opportunity employer, QVC Group is committed to a barrier-free employment process. If you need reasonable accommodations/support throughout, please contact us at workwithus@qvcgrp.com for assistance. If provided, salary ranges are a general guideline only, and actual salaries will vary and are based on factors such as a candidate's qualifications, skills, experience, and geographic location as well as business and market conditions.

• Customer support (1st and 2nd level) via email, telephone and ticketing system • Order processing • Installation, configuration and maintenance of server systems (Linux, Windows) • Planning and configuration of information and telecommunications systems • Testing of equipment and systematic fault diagnosis and troubleshooting during incidents • Administration and monitoring of server and network infrastructures • Product consultation for new and existing customers • Support and assistance with projects (internal/external)