• Ability to read and understand medical terminology • Review clinical documentation to ensure compliance with Medicare guidelines • Verify payor source and insurance eligibility • Validate ICD-9/10 codes as appropriate for product dispensed • Ability to apply correct modifier and HCPCS to claims • Submit accurate claims utilizing Brightree billing software • Reconcile billing errors on a daily basis • Complete CMS 1500 claim forms as required • Manage account receivables to maintain payments within 90 days • Adhere to monthly closing timeline requirements • Maintain excellent communication with company management and co-workers • Attendance at all meetings, conference calls, etc. at the discretion of your manager • Maintain compliance with all federal, state and local government regulations and agencies • Other duties as assigned by manager

Guide school districts in implementing tailored educational plans, deliver professional development sessions, analyze data to inform strategies, and build relationships with key stakeholders to ensure effective program execution.

Buscamos un VA (Virtual Assistant) especializado en Reddit para la gestión y crecimiento de tráfico hacia nuestras modelos. Trabajamos con varias cuentas y modelos, y necesitamos una persona que entienda en profundidad cómo funciona Reddit, especialmente en subreddits NSFW, y que sea capaz de generar tráfico de forma orgánica, evitando baneos y maximizando el engagement. No buscamos a alguien que haga spam, sino un perfil que entienda la cultura de Reddit, sepa integrarse en las comunidades y aplicar estrategias efectivas a largo plazo. Tareas Identificar y analizar subreddits relevantes según el perfil de cada modelo Publicar contenido adaptado a cada comunidad (títulos, formato, timing) Interactuar con usuarios (comentarios, respuestas, engagement) Gestionar múltiples cuentas de Reddit de forma segura Aplicar estrategias para evitar baneos o restricciones Testear diferentes tipos de posts y optimizar resultados Analizar qué contenido funciona mejor y escalarlo Mantener actividad constante y natural en las cuentas Requisitos Experiencia demostrable trabajando con Reddit (especialmente NSFW) Conocimiento de karma, reglas de subreddits y cultura de la plataforma Capacidad para gestionar múltiples cuentas sin riesgos Mentalidad estratégica orientada a generar tráfico y resultados Perfil proactivo, constante y orientado a crecimiento Experiencia previa trabajando con OnlyFans o tráfico hacia plataformas similares Conocimiento de herramientas o sistemas para escalar cuentas

Employment Type: Full timeShift: Day Shift Description: Authorization Specialist II - FULL TIME- Remote Summary We are looking for a self-starter to join a central team obtaining surgical prior authorizations for all surgical services performed by St Peter's Health Partners physicians. This position is responsible for ensuring appropriate prior authorization for designated specialty. The scope of prior authorizations may include (but is not limited to) consults, diagnostic testing in office procedures and pharmaceuticals including off label drugs, and drugs for clinical trials. The Authorization Specialists will perform all job functions in a courteous and professional manner consistent with the mission and core values of St Peter’s Health Partners Medical Associates. Job Duties - Submit and obtain authorization requests for service line. - Maintain subject matter expertise on authorization requirements by payer and order type to ensure proper authorization obtained pre-procedure. - Review authorization denial trends in partnership with supervisor to identify and address gap areas leading to auth denials within service line. - Confirm appropriate insurance verification as part of auth obtainment responsibilities. - Obtain retro authorizations when necessary. Responsibilities - Obtain and track authorizations/re-authorizations for both new and existing patients in accordance with their insurance policies while following all federal, state, and local medical policy guidelines. - Initiate Peer to Peer’s with payer while working closely with providers and clinical staff to obtain letters of Medical Necessity to support reimbursement. - Monitors all authorization work queue for pending or expiring authorizations. - Scans in approval letters after verifying for accuracy. - Contact the insurance company to check status of authorization submission in a timely manner. - Troubleshoot authorization denials in efforts to overturn payer behavior related denials. Qualifications - Associate degree preferred. - Preferred certification in CCS, CCS-P, CPC, or specialty coding. - Surgical Authorization experience required. - Ortho and Vascular experience highly preferred. - Three or more years’ experience in a health care environment with exposure, preferably to service line of position with knowledge of the patient population and types of services patients receiving. Prior authorization experience involving service line drugs and ancillary testing desirable. - A strong understanding of HIPAA laws and requirements as they relate to review and - reporting of documentation. - Knowledge of managed care and third-party payer benefits designs and reimbursement - requirements. - Knowledge of ICD-9 and ICD-10 coding and documentation requirements. - Proficient in Microsoft Office applications including Outlook, Word, and Excel. Preferred experience in EPIC or comparable EMR system - Strong analytical skills with attention to detail and high degree of accuracy in order to - produce reports, analyses, and other detail as requested - Strong communication skills. Attention to detail. Knowledge of drug regimens and associated regulations/policies/procedures applicable to insurance coverage and the associated payment for and appeal of procedures/billing rejected. - Two years of experience in reviewing medical records for National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) - Demonstrated experience with delivering successful customer service - Demonstrated experience with handling multiple priorities in a deadline driven environment. - Remaining calm under pressure and adaptable with changing priorities - Managing difficult customers respectfully and without confrontation - Previous medical office experience preferred Pay Range:$20.20-$26.93 Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. 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 any other status protected by federal, state, or local law.