🚗 Remote Call Center Representative – Medical Transportation (NEMT) 📍 Remote (Kansas Residents Only)🌎 Supporting Members Nationwide🕒 Full-Time Be the Calm Voice That Helps People Get to Care From your home in Kansas, you'll make a real difference for people across the country. As a Remote Call Center Representative on our Non-Emergency Medical Transportation (NEMT) team, you'll help individuals schedule rides to and from important medical appointments. This is more than a call center job-it's a chance to support people during moments that matter. If you're patient, dependable, and take pride in helping others, you'll thrive here. Why This Role Stands Out - 🏡 Work From Home – Fully remote role (Kansas-based employees only) - 🌎 Nationwide Impact – Help members across the U.S. access healthcare - 💙 Meaningful Work – Every call supports someone's health and well-being - 🤝 Supportive Team – Positive culture with coaching and encouragement - 📚 Paid Training - Learn and grow What You'll Do - Answer inbound calls with empathy, professionalism, and patience - Schedule, confirm, and update medical transportation rides - Assist members nationwide with clear, respectful communication - Verify eligibility and trip details using multiple systems - Accurately document all ride activity (requests, changes, cancellations) - Follow all client policies and procedures, plus local, state, and federal regulations - Stay calm and solution-focused when handling changes or concerns - Meet performance goals for quality, accuracy, and customer experience What We're Looking For - Must live in Kansas and work from a secure home environment - High school diploma or equivalent - Customer service or call center experience preferred - Healthcare, transportation, or scheduling experience is a plus - Strong communication and active listening skills - Detail-oriented with the ability to follow structured processes - Comfortable multitasking across systems while on calls - Reliable, self-motivated, and team-oriented - Bilingual candidates encouraged to apply Make an Impact-Without Leaving Home If you're looking for a stable, work-from-home role where you can help others, stay engaged, and be part of a team that truly cares-this is it. Apply today and help keep healthcare moving-one ride at a time.

Employment Type: Full timeShift: Day Shift Description: POSITION PURPOSE Responsible for scheduling, pre-registering patients for outpatient radiology exams. Electronically verifying insurance eligibility & accurately identifying & collecting patient financial responsibility. This is a key position that begins the overall patient experience and initiates the billing process for any services provided by the hospital. As a mission-driven innovative health organization, we will become the national leader in improving the health of our communities and each person we serve. By demonstrating reverence, commitment to those who are poor, justice, stewardship, and integrity, our organization will continue to provide better health, better care, at lower costs. ESSENTIAL FUNCTIONS Responsible for pre-registration, scheduling, electronically verifying insurance eligibility & accurately identifying & collecting patient financial responsibility. Handles complex scheduled events, including high dollar testing, associated studies & those with study specific instructions & communicates effectively to service delivery areas to maximize patient flow & customer service. Begins the overall patient experience & initiate the billing process for any services provided by the hospital. Analyzes patient insurance(s), identifies the correct insurance plan, selects appropriately from HIS insurance and plan selections and documents correct insurance order. Applies recurring visit processing according to protocol. Verifies patient information with third party payers. Collects insurance referrals and documents within HIS. Communicates with patients and physician/offices regarding authorization/referral requirements. Identifies potential need for financial responsibility forms or completed electronic forms with patients as necessary. Escalates accounts appropriately in accordance with department Defer/Delay policy to manager. Screens outpatient visits for medical necessity and issues Advanced Beneficiary Notice as appropriate for Medicare primary outpatients. Provides cost estimates. Collects and documents Medicare Secondary Payer Questionnaire (MSPQ) and obtains information from the patient if third party payers need to be billed (i.e., worker's compensation, motor vehicle accidents and any other applicable payer). Maintains operational knowledge of regulatory requirements and guidelines as outlined in the hospital and department Compliance Plans. Ensures Meaningful Use requirements are met as appropriate. Screens all patients self-pay & out of network patients using approved technology. Provides information for follow up and referral to the RHM Medicaid Vendor and/or Financial Counselor as appropriate. Initiates payment plans and obtains payment. Informs and explains all applicable government and private funding programs and other cash payment plans or discounts to the patient and/or family. Incorporates point of service (POS) collection processes into daily functions. Must possess the ability to comply with Trinity Health policies and procedures. Must be comfortable operating in a collaborative, shared leadership environment. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health. Other duties as assigned by manager. Hourly pay range: $17.1538 - $25.7307 Remote Work Opportunity Hours: M-F, 9:30am-6:00pm CST/10:30am-7:00pm EST/8:30am-5:00pm MST MINIMUM QUALIFICATIONS High School Diploma or equivalent. Two (2) to Five (5) years experience in area of expertise such as scheduling, financial clearance, or patient access. National certification in HFMA CRCR or NAHAM CHAA required within one (1) year of hire. Must be proficient in the use of Patient Registration/Patient Accounting systems & related software systems. Additional Qualifications (nice to have) Associates Degree, preferred. Comprehensive knowledge of scheduling with mastery in at least three (3) or more modalities & insurance verification processes with three (3) years scheduling experience in an acute care setting Experience in complex facility based ancillary testing across multiple facilities/states Strong knowledge of third-party & government payer billing & reimbursement guidelines as well as department performance standards & policies & procedures PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS This position operates remote in an in-home environment or in an onsite typical office environment. The area is well lit, temperature controlled and free from hazards. Incumbent communicates frequently, in person and over the phone, with people in all locations on product support issues. Manual dexterity is needed to operate a keyboard. Hearing is needed for extensive telephone and in person communication. The environment in which the incumbent will work requires the ability to concentrate, meet deadlines, work on several projects at the same time and adapt to interruptions. Must be able to set and organize own work priorities and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles. Ability to thrive in a fast-paced, multi-customer environment, with conflicting needs which some may find stressful. May warrant varied and/or extended hours, with changes in workload and priorities to keep pace with the industry and advance strategic priorities. Must possess the ability to comply with Trinity Health policies and procedures. The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned. 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.

Responsible for preparation, editing and submission of accurate and timely insurance claims (electronic and manual) to regulatory payers (including Medicare, Medicaid, L&I, VA, Crime Victims & Healthy Options), for primary, secondary, late charge and corrected claims. Reviews and resolves billing edits in EPIC and in claims scrubber system. Verifies accuracy of claims submitted to payers. Claims process includes reconciling claim runs, creating electronic claim files, and resolving errors. Resolve claims editing issues and interact with third party clearinghouse or the claims scrubber vendor to produce clean claims. Identifies recurring billing errors and trends and reports them to supervisor when necessary. Conduct research / analyze coding errors, document billing issues / trends, and assist with problem solving and solutions. Process credit balances due to regulatory payers. Providence Swedish caregivers are not simply valued – they’re invaluable. Join our team at ~Swedish Shared Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required qualifications: - Coursework/Training: Medical terminology and medical coding training in an accredited school. Or equivalent on-the-job training in a billing role - 1 year of experience in hospital insurance regulatory billing, including Medicare, Medicaid and / or Labor & Industries (L&I) Preferred qualifications: - Bachelor's Degree in Finance, Business Management or health care administration - A strong technical background including experience with automated systems - Experience working with Provider One, MECA, FSS0 and/or CWF Why Join Providence Swedish? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our mission of improving the health and wellbeing of each patient we serve. At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. Providence Swedish is the largest not-for-profit health care system in the greater Puget Sound area. It is comprised of eight hospital campuses (Ballard, Edmonds, Everett, Centralia, Cherry Hill (Seattle), First Hill (Seattle), Issaquah and Olympia); emergency rooms and specialty centers in Redmond (East King County) and the Mill Creek area in Everett; and Providence Swedish Medical Group, a network of 190+ primary care and specialty care locations throughout the Puget Sound. Whether through physician clinics, education, research and innovation or other outreach, we’re dedicated to improving the wellbeing of rural and urban communities by expanding access to quality health care for all. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. For any concerns with this posting relating to the posting requirements in RCW 49.58.110(1), please click here where you can access an email link to submit your concern.

Become a part of our caring community Are you a transitioning military service member or a military spouse looking for an internship that supports the goal to put health first? The DOW SkillBridge Internship and Military Spouse Fellowship Programs will provide you with key training to perform your internship. You will partner with your team to support members, projects, and to meet goals impacting business outcomes. The professionals you work with at Humana will depend on the type of internship you select. They may include healthcare professionals, HR, and IT, to name a few. The objective is to support and facilitate care for members. To be eligible for this internship, you must either be a transitioning military service member or a military spouse, and you must obtain eligibility to participate in these DOW sponsored programs. The Prior Authorization, Registered Nurse, RN, Intern will report to a manager of the National Medicaid team. You will utilize training and engage formerly acquired skillsets to complete medical necessity reviews for requested services using clinical judgment and provides referrals to internal stakeholders for further review depending on case findings. You will participate in the following assignments in this role: Clinical Review: - Conduct comprehensive clinical reviews of prior authorization requests to determine medical necessity and benefit eligibility. - Apply advanced evidence-based clinical guidelines in review decisions. - Ensure compliance with accreditation, state, and federal regulations. Communication and Coordination: - Communicate with healthcare providers to obtain necessary clinical information and clarify requests. - Coordinate with medical directors and interdisciplinary teams to support decision-making. - Serve as a liaison between clinicians, internal departments, and members. Documentation and Reporting: - Document all review findings and decisions in clinical documentation systems. - Ensure timely and accurate documentation of prior authorization determinations. - Support reporting initiatives and provide data for performance improvement projects. Quality Assurance: - Implement quality assurance measures to ensure accuracy and consistency in prior authorization decisions. - Conduct regular audits and reviews to maintain high standards of service. - Identify process improvement opportunities and contribute to performance improvement projects. Education and Training: - Educate providers and staff on prior authorization policies, criteria, and review processes. - Provide mentorship and feedback to nonclinical staff and peers to enhance workflow efficiency. - Stay current with clinical best practices and regulatory changes. Use your skills to make an impact Required Qualifications: - You must be a transitioning service member eligible to participate in the DOW SkillBridge or a military spouse eligible to participate in the military spouse fellowship· - Active Registered Nurse, RN, enhanced Compact, (eNLC) license without restrictions or disciplinary action.· - Minimum two (2) years clinical nursing experience such as acute care, emergency room, ICU, skilled or rehabilitation setting. - Working knowledge of MS Office including Word, Excel, PowerPoint, and Teams in a Windows based environment and an ability to quickly learn new systems and ability to troubleshoot and resolve basic technical difficulties in a remote environment. - Possess an interest in working in the managed care industry Preferred Qualifications: - Bachelor's degree - Previous Medicare/Medicaid experience. - Previous experience in prior authorization, utilization management. - Experience working with MCG or Interqual guidelines. - Certification in Case Management, (CCM) or Utilization Review, (UR). - Knowledge of payer policies, insurance companies and government health programs. Workstyle: Remote Work at Home Location: Must reside in a state that participates in the enhanced compact license, (eNLC) Work Schedule: Weekdays 8:00 AM to 4:30 PM Central Time Travel: None Additional Information Work At Home Requirements - WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. - A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. - Satellite and Wireless Internet service is NOT allowed for this role. - A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information The DOW SkillBridge Internship Program provides transitioning military service members time to gain civilian work experience while still on active duty with an employer for a period approved by their command and the DOW, with an average timeline of 90 days. The Military Spouse Fellowship Program connects military spouses with employers offering a variety of professional onsite, field, or remote based opportunities for a period up to 12 weeks. - Networking opportunities will be provided while participating in the Internship or Fellowship. - Due to factors such as location, and/or requirements that cannot be modified, full-time employment is not guaranteed upon completion of the Internship or Fellowship. Interview Format As part of our hiring process, we will be using a screening and interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring leaders with an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive an email correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. (please be sure to check your spam or junk folders often to ensure communication isn't missed) If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 1 About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com. ​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.