***** Experience in Health Insurance, Surgical cases and CPT codes Shift; Days Location: Remote Miami, FL Full-Time Financial Clearance Center (FCC) Summary Authorization & Clearance Specialist plays a critical role in ensuring that medical services provided to patients are covered by the patient's insurance providers. They are responsible for obtaining pre-authorizations, initiating authorizations, extending concurrent authorization, verifying insurance coverage for medical procedures, treatments, hospital stays, initiating retroactive authorization modifications, and discharge notifications as appropriate. Responsibilities Identifies and confirms valid coverage for an episode of care and/or specific service: contacts insurance companies and/or reviews electronic response summary and coverage discovery information to ensure the appropriate coverage coordination are on the patient's record. Initiates authorization with patient insurance by submitting necessary clinical documentation, continues to follow up, obtain and validate authorization/referrals/notifications with appropriate CPT, ICD-10 codes, Tax ID and NPI #s within the appropriate timelines. Works daily work queues according to department directives, to identify patients requiring authorization for services scheduled and non-scheduled appropriately prioritizing work assignments based on scheduled appointment date/time, medical severity, payer assignments, dollar value etc. Verifies that the services the patient is set to receive is a covered benefit, validates benefit package restrictions, and completes quality assurance checks on authorization patient type, facility, etc. Understands patient deductibles, out of network referrals, out of pocket limitations, and lifetime/event caps on liability. Refers patients to appropriate Financial Counselor, Prior Authorization or Billing based on financial coverage, financial situation, employment status, liability and/or patient concern. Uses insurance discovery tools available to attempt to validate any and all insurance coverage, ensure correct insurance coordination of benefits are listed on patient's record, follows up with patient/next of kin/Social Work/Case Management in order to obtain insurance coverage information. Verify all insurance and obtain pre-certification/authorization for services, as warranted, and notifying patient and referring physician in the event of failed eligibility and/or authorization. Follows up with and escalates as appropriate to physician's office/clinical teams/Case Management for any pending clinical documentation, including peer-to-peer requests. Diligently follows up on any pending authorizations to ensure information is processed with the insurance payer within appropriate timelines. Works directly with JHS medical services to ensure procedures, diagnoses, level of care, are sufficient for each case by following CMS and payer guidelines and communicating with medical team for corrections. Maintain knowledge base of all programs offered by JHS for Charity and Financial Assistance and the requirements to qualify, with the process for Charity Care clearance of scheduled procedures and coverage. Calculates patients' financial responsibility based on patient benefits using the estimator tools and includes communication with the patients on the out of pocket due at service. Coordinate Self-pay Package pricing by utilizing tools available and escalating to Managed Care team to obtain appropriate package price amounts not found on list or complex contracts. Receives and processes all patient payments in accordance with JHS Collections Policy and Procedure, issues receipt and maintains the integrity of all payments. Scans/uploads all required documents into the appropriate folder in the documenting imagining system in a timely manner to assure maximum reimbursement and compliance. Assist in supporting go lives of new systems and different department initiatives, including onboarding and training team members. Cross-trained in multiple areas/service lines/payers to substitute all staff positions as needed. Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise). Performs other related job duties as assigned. Experience Generally requires 0 to 3 years of related experience. Financial clearance experience is strongly preferred. Education High school diploma is required. Bachelor's degree in related field is strongly preferred. Skill Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines. Ability to communicate effectively in both oral and written form. Ability to handle difficult and stressful situations with critical thinking and professional composure. Ability to understand and follow instructions. Ability to exercise sound and independent judgment. Knowledge and skill in use of job appropriate technology and software applications. Credentials Valid license or certification is required as needed, based on the job or specialty. Unit Specific Credential Working Conditions Physical Requirements - Job function is sedentary in nature and requires sitting for extended periods of time. Function may require frequent standing or walking. Must be able to lift or carry objects weighing up to 20 pounds. Jobs in this group are required to have close visual acuity to perform activities such as: extended use of computers, preparing and analyzing data and analytics, and other components of a typical office environment. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC). Environmental Conditions - Jobs in this group are required to function in a fast paced environment with occasional high pressure or emergent and stressful situations. Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public. Function is subject to inside environmental conditions, with occasional outdoor exposures. Possible exposure to various environments such as: communicable diseases, toxic substances, medicinal preparations and other conditions common to a hospital and medical office environment. May wear Personal Protective Equipment (PPE) such as gloves or a mask when exposed to hospital environment outside of office. Reasonable accommodations can be made to enable people with disabilities to perform the described essential functions. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).

At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together. Designs and executes high level actuarial processes involving valuation, financial modeling, and management information. Leads and participates on cross-functional teams. Develops and recommends actuarial tools and techniques to manager. Maintains, enhances, and documents actuarial tools and techniques required for project or production work. Assists with training team members on how to use actuarial tools and techniques. Essential Functions: - Leads the analyzing and refining of EMCNL’s financial model by proposing implementing changes and ensuring changes are documented and tested. - Leads the quarterly and annual financial projection project. Gathers information from investment and accounting teams. Enters information into financial model and run a series of projections. Analyzes results of project to make recommendation on necessary amount of additional reserves. - Ensures the completion of financial and Asset Liability Management (ALM) projections using the financial model to project short- and long-term profitability - Collaborates with manager on product development/pricing projects using actuarial modeling software AXIS - Develops highly-automated tools and systems which maintain the data integrity necessary to produce accurate results while also maintaining the flexibility to report data broken down by many factors such as product, gender, underwriting class, face amount, etc. to help with mortality and lapse studies - Develops and evaluates new and existing tools and works on projects to improve the management information capabilities of the actuarial team, such as data reporting. Analyzes data and provides report insights based on results to stakeholders throughout EMCNL. - Makes recommendations based on analysis and communicates them as appropriate to EMCNL teams. - Develops and recommends actuarial tools and techniques that support the actuarial process, such as evaluation and rate study. - Leads and/or participates on cross-functional teams, such as the interest rate team and product implementation team Leads and conducts independent research and analysis and provides input and findings to various teams. Education & Experience: - Bachelor’s degree in actuarial science or math or related field - Five years of actuarial experience - 4-5 exams or equivalent relevant experience - Additional experience, exams or graduate level coursework may be considered in meeting the requirements Knowledge, Skills & Abilities: - Excellent knowledge of statistics, probability and computer programming - Strong ability to perform modeling, pricing, financial reporting and reserving skills - Thorough knowledge of actuarial terminology, concepts and theory - Thorough computer skills, including knowledge of Excel and Word - Thorough knowledge of at least one computer language, such as R, SAS or SQL (SQL is preferred) - Excellent analytical, investigation and problem-solving abilities - Strong ability to effectively lead a team and special projects The hiring salary range for this position will vary based on geographic location, falling within either of the following: $85,799 - $118,545 or $94,826 - $130,394A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs. For information relating to the benefits EMC Team Members receive as part of a comprehensive rewards package, please visit www.emcins.com/careers. Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT **The ideal candidate will reside within the state of WA.** Position Purpose: The Senior Health Equity Specialist is responsible for maintaining compliance with regulations and contractual obligations pertaining to Culturally and Linguistically Appropriate Services (CLAS) and Health Equity within State Health Programs, Commercial and Medicare product lines. The Senior Health Equity Specialist ensures that culturally and linguistically appropriate services are provided to members, including identifying and implementing health equity initiatives, representing the health plan on national, regional and multi-plan initiatives and assessing operations for gaps. The Senior Health Equity Specialist leverages feedback from providers, members, vendors and community based organizations in the development of strategy and implementation and makes recommendations for CLAS and Health Equity efforts as aligned with contractual, accreditation and quality improvement opportunities to senior management. - Implements and manages programs in compliance with contracts and regulations and monitors ongoing program performance to maintain compliance. - Develops strategies and policies to deliver C&L services and maintain compliance with regulatory and contractual obligations. - Develops, interprets and communicates policies, procedures, regulations and standards. - Develops California State Health Programs (Medi-Cal) contract content for C&L services, for Medi-Cal, Healthy Families, and Healthy Kids products. - Prepares P&P’s for committee adoption. - Implements activities to meet regulatory obligations. - Monitors compliance with California regulations and State Health Programs contractual obligations - Assesses operational gaps compared to new standards and makes recommendations to senior management. - Represents Health net to Regulators and Accreditation Agencies, demonstrating the provision of culturally & linguistically appropriate health care services. - Liaisons between community coalitions, California and local regulators, vendors, accrediting bodies and Health Net senior management to increase knowledge of new C&L standards and ensures contract requirements, goals and regulatory are met. - Monitors/evaluates translation services and interpreter services. - Evaluates externally translated materials from vendors and provides recommendations to vendor management/contracting. - Identifies and resolves compliance issues/quality issues related to translating material. - Identifies and resolves compliance issues/quality issues related to the provision of interpreter services. - Reviews the translation process and translated materials for improvement opportunities. - Manages Community Advisory Committees - Develops regional goals, outcomes and objectives for Committees. - Represents and articulates local or regional needs to senior management committees - Develops C&L programs to enhance access to care for members and providers based on geographic, cultural, and linguistic data - Develops teaching to standard modules for associates - Develops teaching to standard modules for providers - Reviews member and provider material for cultural and linguistic appropriateness. - Monitors grievance and appeals processes for C&L issues. - Proactively identifies areas of improvement for the department and participates in development of improvement plans. Education/Experience: Bachelor’s in Cultural Anthropology, Social Work, Medical Anthropology, Public Health or related field required. Masters preferred. 5+ years of experience in government, health, or community programs. Experience in managed care preferred. Pay Range: $70,100.00 - $126,200.00 per year 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

Location: 2727 N Central Ave, Phoenix, Arizona 85004 United States of America U-Haul is looking for an organized, friendly, and motivated call center representative who can work out of our Phoenix office or remote! This position entails helping customers book, edit, reschedule, and/or cancel Moving Help services via phone, chat, and email. To do well in this role, you need to be able to remain calm when customers are frustrated and have experience working with computers. SHIFT SCHEDULE: Part-time and Full Time Available - Days Vary: Monday through Sunday - Hours Vary: 6:00 a.m. - 4:00 p.m. - Initial training hours: Monday-Friday 7:30am–4pm for four weeks. - Holidays Compensation: $15.00/Hr Customer Support Specialist Responsibilities: - Maintaining a positive, empathetic, and professional attitude toward customers at all times. - Responding promptly to customer inquiries. - Communicating with customers through phone calls, chats, and emails. - Acknowledging and resolving customer complaints. - Processing, rebooking, and modifying orders. - Keeping records of customer interactions, transactions, comments, and complaints. - Communicating and coordinating with colleagues and supervisors as necessary. - Providing feedback on the efficiency of the customer service process. - Ensure customer satisfaction and provide professional customer support. Customer Support Specialist Requirements: - High school diploma or GED. - Ability to stay calm when customers are stressed or upset. - Comfortable using computers. - Experience working with customer support. Perks of joining the U-Haul fleet: Get your career moving with a company that empowers team members to be the healthiest version of themselves! We provide robust wellness benefits, events, and resources to help team members become the happiest and healthiest they can be. Here are just some of the programs U-Haul has available: - Full Medical coverage - New indoor fitness gym - Onsite medical clinic for you and your family - Career stability - Opportunities for advancement - Valuable on-the-job training - Prescription plans - Dental & Vision Plans - Business and travel insurance - YouMatter Employee Assistance Program - Paid holidays, vacation, and sick days - Employee Stock Ownership Plan (ESOP) - 401(k) Savings Plan - Life insurance - Critical Illness/Group Accident - 24-hour physician available for kids - Subsidized gym/ membership - MetLaw Legal program - MetLife auto and home insurance - Discounts on cell phone plans, hotels, and more - LifeLock identity Theft - Tuition reimbursement program - Free online courses for personal and professional development at U-Haul University - Savvy consumer wellness programs- from health care tips to financial wellness - U-Haul federal credit union U-Haul Holding Company, and its family of companies including U-Haul International, Inc. (“U-Haul”), continually strives to create a culture of health and wellness. Consistent with applicable state law, U-Haul will not hire or re-hire individuals who use nicotine products. The states in which U-Haul will decline to hire nicotine users are: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Pennsylvania, Texas, Utah, Vermont, Virginia, and Washington. U-Haul has observed this hiring practice since February 1, 2020 as part of our commitment to a healthy work environment for our team. U-Haul is an equal opportunity employer. All applicants for employment will be considered without regard to race, color, religion, sex, national origin, physical or mental disability, veteran status, or any other basis protected by applicable federal, provincial, state or local law. Individual accommodations are available on requests for applicants taking part in all aspects of the selection process. Information obtained during this process will only be shared on a need to know basis.