Role Description Optum WA is seeking a RN Call Assist to join our team in Seattle, WA. As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone. Position in this function is under general supervision; the Staff RN/Consulting Nurse is responsible for providing telephone triage assessment to Primary Care patients by using state-of-the-art telecommunications, information technology, and approved protocols. - Provide excellent customer service. - Utilize clinical expertise and approved protocols to provide health advice to consumers with clinical questions. - Document calls in applicable systems in a timely manner. - Exhibit a willingness to master new work routines and methods. - Document all inquiries according to department standards for legal/statistical purposes. - Problem-solve issues independently and collaborate with teams as needed. - Speak with a pleasant, professional phone voice. - Ensure performance standards are met and accept constructive feedback. Qualifications - Unrestricted WA State or Compact RN license at time of hire. - Apply for OR State RN license within 90 days of hire. - 3+ years of experience in a clinical setting (Med/Surg, critical care, ER, etc.), disease management, home health, discharge planning, utilization review, patient education, and telephonic nursing. - Ability to work 7am-7pm PST on a Flex schedule with availability 7 days per week = 36 hours. Requirements - Bachelor of Science in Nursing (Preferred). - American Academy of Ambulatory Care Nursing (AAACN) (Preferred). - 1+ years of Call Center Nursing experience (Preferred). - Case Management experience (Preferred). Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase. - 401k contribution (subject to eligibility requirements). - Hourly pay range from $28.94 to $51.63 based on full-time employment.

Summary We are currently hiring for a Stop Loss Registered Nurse to join BlueCross BlueShield of South Carolina. In this role as a Stop Loss Registered Nurse, you will evaluate and manage catastrophic episodes of illness for underwriting and claims. Ensures that the insured is receiving the best medical care, but in the most cost-effective manner. Description Location: This position is full-time (40 hours/week) Monday-Friday, from 8:00am – 5:00pm and will be fully remote. What You’ll Do: - Facilitates cost estimates to the underwriters for new and renewal stop loss business. - Consults with the underwriters on catastrophic episodes of illness. - Provides case management oversight of managed care between the TPA and us. - Review potential claim notices and excess claims received to determine setting reserves. - Reviews potential claims notices from TPAs. - Researches as necessary to evaluate cost containment and intervenes with the TPA. To Qualify for This Position, You'll Need the Following: - Required Education: Associates in a job-related field - Degree Equivalency: Graduate of Accredited School of Nursing - Required Work Experience: 10 years, 5 years clinical plus 5 years medical management experience. - Required Skills and Abilities: Working knowledge of word processing software. - Excellent verbal and written communication skills. - Ability to work independently, prioritize effectively, and make sound decisions. - Working knowledge of managed care and various forms of health care delivery systems. - Working knowledge of catastrophic claims cost, medical vendors, case management. - Demonstrated customer service, communication, and organizational skills. - Analytical or critical thinking skills. - Ability to handle confidential or sensitive information with discretion. - Required Software and Tools: Microsoft Office. - Required Licenses and Certificates: Active RN licensure in state hired. What We Prefer You to Have: - Preferred Education: Bachelor's degree-Nursing - Preferred Work Experience: 10+ years as a medical staff nurse, experience working with a stop loss carrier and providing underwriting and claims with medical cost projects. Our Comprehensive Benefits Package Includes the Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. - Subsidized health plans, dental and vision coverage - 401k retirement savings plan with company match - Life Insurance - Paid Time Off (PTO) - On-site cafeterias and fitness centers in major locations - Education Assistance - Service Recognition - National discounts to movies, theaters, zoos, theme parks and more What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. What To Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information.

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities. Job Description Summary: Responsibilities And Duties: The Patient Service Representative I may be expected to perform any of the following and other duties as assigned: Provides exceptional customer service during every encounter with patients, families, visitors and OhioHealth physicians and associates Accept inbound calls within a specific response-to-call timeframe following customer service standards at all time Makes outbound calls with according to the standard work and following customer service standards. Accurately identifies patient in the EMR system. Adhere to the department Standard Work Obtains and enters accurate patient demographic and financial information while maintaining patient confidentiality Uses critical thinking skills to make decisions, resolve issues, or escalate concerns Verifies insurance eligibility using online eligibility system, payer websites or by phone call Processes faxes and transcribes information into the system’s EMR. Follow protocols for directly contacting the care centers regarding urgent patient requests and ensure timely follow up Schedules outpatients appointments Generates, prints, and provides patient estimates utilizing price estimator products Inform patient of any outstanding balance, collect balance and co-payment or provide financial assistance information Answers questions or concerns regarding insurance residuals and self-pay accounts Uses knowledge of CPT codes to accurately select codes from clinical descriptions Identifies and/or determines patient Out of Network acceptance into the organization Explains billing procedures, hospital policies and provides appropriate literature and documentation Update/notate all accounts using appropriate standard work Reviews insurance information and determines need for referrals and/or financial counseling. Educates patients on MyChart, including activation Adhere to policy and procedures Participate in and contribute to development of Lean processes. Complies with all organizational, state and federal laws and regulations related to patient privacy and confidentiality (ie. PHI, HIPAA, etc.) Work collectively in a professional manner Confirms physician's orders/visit purpose Verifies multidisciplinary patient schedules for Outpatient visits to expedite patient processing Obtains Release of Information authorization from patients to release medical records Uses conflict resolution skills and service recovery to handle customer service concerns Resolve patient complaints and concerns and, if unable to resolve, escalate appropriately Provides information to physician offices and other hospital departments when needed Minimum Qualifications: High School or GED (Required) Additional Job Description: Typing of 40 wpm, excellent communication, organization, and basic computer skills. KIND and LENGTH of EXPERIENCE 1-2 years of previous experience in the service industry with a focus on delivering exceptional customer service or 1-2 years previous experience in a Medical Office setting or 1-2 years previous experience in a Call Center or 1-2 years previous experience in Collections Work Shift: Day Scheduled Weekly Hours : 40 Department Patient Contact Center Join us! ... if your passion is to work in a caring environment ... if you believe that learning is a life-long process ... if you strive for excellence and want to be among the best in the healthcare industry Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment Remote Work Disclaimer: Positions marked as remote are only eligible for work from Ohio.

Bilingual Remote Outbound Call Center Representative Life Line Screening | Full-Time | Fully Remote We are looking to add to our bilingual (English/Spanish) call center team! Come be part of a growing, mission-driven healthcare company where your work truly makes a difference. At Life Line Screening, you’ll help individuals take control of their health through preventive screenings — all while working from the comfort of your home. We offer stable full-time schedules, competitive pay with incentives, comprehensive benefits, and long-term career growth in a supportive, performance-driven environment. Compensation & Benefits - Hourly pay: $15/hour + bonus incentives - Paid Time Off & Paid Holidays - Medical, Dental, Vision Insurance - Health Savings Account (HSA) - 401(k) with Employer Match - Professional Development Opportunities - Referral Bonus Program - Courtesy preventive health screenings for you and eligible family/friends - All equipment provided (computer, monitor, phone, headset, etc.) - Paid virtual training Schedule Options Choose the shift that works best for you: - 9:00 AM – 5:30 PM EST - 12:30 PM – 9:00 PM EST (8.5-hour shifts between 9:00 AM – 9:00 PM EST) What We’re Looking For Please review carefully — candidates must meet all requirements to be considered. - Bilingual (English and Spanish) - Desire to work in a fast-paced outbound call center environment - Strong phone presence with exceptional consultative communication skills - Proven job stability (no job-hopping) - Ability to effectively de-escalate conversations - Competitive mindset with a passion for meeting and exceeding goals - High School Diploma or GED required (some college preferred) - Ability to pass a pre-employment drug screen and criminal background check About the Role As a Remote Outbound Representative, you’ll use a compassionate, consultative approach to educate patients about the importance of preventive health screenings. Your conversations directly support early detection and improved quality of life. This role is ideal for individuals who thrive in a fast-paced, goal-oriented call center environment and are motivated by performance and purpose. What You’ll Do - Place 100–150 outbound calls per shift to remind patients to return their screening kits - Educate callers on the benefits of early detection, including prevention of colon disease and colon cancer - Identify and assist with any barriers preventing patients from returning their kits - Use a consultative approach to provide clear, accurate information and encourage successful kit returns - Professionally de-escalate concerns and maintain a positive customer experience Work-From-Home Requirements - Minimum internet speed: 50 Mbps download 10 Mbps upload - Designated, quiet workspace free from distractions - Ability to work independently and remain focused during scheduled shifts Equal Opportunity Employer Life Line Screening is proud to be an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. Life Line Screening is proud to be an equal opportunity employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age disability, protected veteran status, or other characteristics protected by law. Life Line Screening will only employ those who are legally authorized to work in the United States for this opening. Any offer of employment is conditional upon the successful completion of a background check and drug screen. Privacy Notice to California Applicants