Job Description: The Referral Representative processes insurance pre-authorization for primary and specialty service office visits and testing. Receives and gathers pertinent information from patients, providers, insurance carriers, and other staff to confirm the patient’s financial obligations for services. Acts as liaison between clinical staff, health plans, providers and patients to obtain insurance authorizations acting as the patient advocate in this circumstance. Verifies insurance coverage and obtains required authorization when necessary. Documents referral information, communications, actions and other data in electronic medical information systems to communicate to other staff a patient’s authorization progress.We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, New York, Pennsylvania, Rhode Island, Vermont, and Washington. Colorado for remote caregivers’ whose assigned Intermountain facility or service area is not based in Colorado. Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings Schedule - Monday - Friday 8:45am - 5:15pm, hours will be expanding in June schedule will be Monday - Friday 9:00am - 5:30pm Essential Functions - Administrative departmental support, including processing into and through electronic medical records internal, external, and outbound referrals while assembling, researching, and triaging information about patient demographics, insurance, and medical needs. Maintains ongoing tracking and appropriate detailed documentation of referrals to promote team awareness and ensure patient safety. - Follows regulatory requirements as defined by provider or specialty department to route inbound referral appropriately. Including appropriate documentation, imaging, or any other requirements while maintaining Intermountain standards for adding and scanning required information into electronic medical records. - Liaison between patient, clinic, and insurance carrier to set details related to upcoming visit with Intermountain providers or scheduled procedures prior authorization requirements. Coordinates provider peer to peer interactions as it pertains to obtaining insurance approvals. Generates cost estimates for services as it relates to office visits and in-office testing; directs patients to financial counseling resources when appropriate. - Contacts insurance company representatives or their contracted review organizations to ensure prior approval requirements are met. Presents necessary medical information such as history, diagnosis, and prognosis. Assumes the advocate role on the patient’s behalf with the insurance carrier to ensure approval of necessary services for the patient in a timely fashion. - Multiple partnerships with Patient Service Representatives and Clinical Staff for effective pre-registration and pre-visit preparation as needed. Also collaborates with Payer Relations to provide the required documentation relating to any denial or appeal information needed. All other duties as needed - Utilization of different insurance platforms and medical records systems according to department protocols to include accurate data entry and retrieval of information for reporting purposes. - Meets performance standards, volume metrics while aligning with mission, vision, and values. Skills - Detail-Oriented - Medical Terminology - Customer Service - Medical Records Management - Critical Thinking - Researching - Communication - Documenting Minimum Qualifications - Have a level of computer literacy that ensures accuracy and timeliness. - Demonstrated ability to work well with coworkers and patients. - Ability to collaborate with multiple teams. - Skill to write clearly and professionally. - Be thorough, precise and detail oriented. - Knowledgeable in navigating Microsoft systems (Word, Outlook, Excel, OneNote). Preferred Qualifications - Experience with electronic medical records (EPIC). - CNA, MA, EMT or healthcare or health plan experience. - Referral coordination experience. - Medical terminology knowledge. - Bilingual (Spanish preferred) Physical Requirements - Ongoing need for employee to see and read information, labels, assess patient needs, operate monitors, identify equipment and supplies. - Frequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations. - Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use and typing for documenting patient care, accessing needed information, medication preparation, etc. - Expected to lift and utilize full range of movement to transfer patients. Will also bend to retrieve, lift, and carry supplies and equipment. Typically includes items of varying weights, up to and including heavy items. - Need to walk and assist with transporting/ambulating patients and obtaining and distributing supplies and equipment. This includes pushing/pulling gurneys and portable equipment, including heavy items. Often required to navigate crowded and busy rooms (full of equipment, power cords on the floor, etc.) - May be expected to stand in a stationary position for an extended period of time. - For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles. Location: Foothills Medical Office Bldg Work City: Wheat Ridge Work State: Colorado Scheduled Weekly Hours: 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $19.29 - $27.45 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here. Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process. All positions subject to close without notice.

Role Description This position is responsible for providing high quality customer service by receiving incoming calls, answering questions, solving problems, and providing program information to clients. - Handle all customer contacts by phone accurately and professionally. - Respond to all the customer’s inquiries and probe accordingly as to provide a first contact resolution. - Inform and educate participants on various program processes and timelines. - Research required information using available resources and knowledge. - Accurately and thoroughly record call log notations in the system of record. - Educate participants on program requirements and family obligations. - Inform participants of changes to housing assistance payment and tenant rent calculation. - Communicate concerns between owners, tenants, and the Public Housing Authority (PHA) through account notations. - Defuse and deescalate irate customers to ensure a great customer experience. - Verify and update customer information. - Identify and escalate priority issues. - Perform data entry into SharePoint and PHA business system. - Provide excellent customer service to participants, landlords, co-workers, clients, and vendors. - Ensure regular attendance and punctuality. - Obtain certification in Housing Choice Voucher Basics. - Perform other duties as assigned. Qualifications - High School Diploma is required. - Education equivalent to a two-year degree from a regionally accredited institution in Public Administration, Social Science, or a closely related field preferred; Alternatively, a minimum of two years of progressively responsible work. - Experience for a public agency, or related work in the social service or community service is preferred. - Ability to apply regulations pertaining to the program. - Ability to communicate effectively both orally and in writing is required. - Excellent interpersonal skills necessary for conducting HCVP Participant interviews is required. - Strong computer and organizational skills required to prioritize tasks and demands and consistently deliver work product on time is required.

Role Description The Revenue Cycle Specialist is responsible for supporting daily revenue cycle operations, including billing, accounts receivable, and cash applications. This role focuses on accurate and timely processing of claims, payments, and follow-up activities to support the organization’s financial performance. Fully remote position Wage: $18.00+ (wage based upon knowledge, skills, and experience) Essential Responsibilities - Support Accounts Receivable and Cash Applications functions, including: - Process insurance and patient payments accurately and in a timely manner. - Perform account follow-up on outstanding balances, including insurance claims and patient accounts. - Identify and resolve claim issues, denials, and payment discrepancies. - Assist with maintaining efficient billing, collections, and cash application workflows. - Utilize Practice Management Software effectively: - Enter, review, and update account and payment information with a high level of accuracy. - Identify system or workflow issues and report them to leadership for resolution. - Ensure timely claim submission and posting of payments. - Payor and Billing Support: - Assist with maintaining and updating payor fee schedules as directed. - Verify reimbursement accuracy and report discrepancies. - Follow established guidelines for claim submission and documentation requirements. - Performance and Quality: - Meet productivity and accuracy standards for assigned tasks. - Monitor assigned work queues and ensure timely completion. - Escalate unresolved issues or trends to the Revenue Cycle Manager. - Team Collaboration: - Communicate effectively with team members and leadership regarding account issues or workflow concerns. - Participate in team meetings and training sessions. - Support process improvements and adapt to workflow changes. - Perform other duties as assigned. Qualifications - High School Diploma or equivalent required. - Basic knowledge of healthcare billing, CPT/ICD-10 coding, and claim processes required. - Proficiency in Microsoft Excel and general computer skills required. - Prior experience in healthcare revenue cycle, billing, or accounts receivable preferred. - Understanding of medical terminology and EHR/practice management systems preferred. - Familiarity with insurance payors and registration data requirements preferred. Competencies - Ability to manage multiple tasks and meet deadlines in a fast-paced environment. - Strong Organizational and Problem-Solving Skills. - Ability to work independently & as part of a team. - Professional Communication and Demeanor. - Strong Attention to Detail and Accuracy. - Adheres to Confidentiality and Compliance Standards. - Professional Integrity. Physical Demands and Work Environment - Physical Demands: - Sedentary work requiring prolonged periods of sitting at a computer workstation. - Regular use of hands and fingers for keyboarding and other standard office equipment. - Ability to communicate effectively through verbal and written means. - Ability to hear and understand spoken information in-person and via electronic means. - Visual acuity to ensure the accuracy of work performed on screens and in documents. - Ability to maintain focus and attention to detail for extended periods. - Work Environment: - This position is based in a professional office and/or remote office setting that consists of a climate-controlled indoor environment with standard office noise levels that utilizes computers, phones, and related technology. - Reasonable accommodations may be provided to qualified individuals with disabilities to enable performance of essential job functions, in accordance with applicable laws.

Title: LTSS Service Care Coordinator Locations:Remote-IL JACKSON, WILLIAMSON, UNION, JOHNSON, POPE, ALEXANDER, PULASKI AND MASSAC. Work Type:Remote, Hybrid, Full Time Job ID: 1632775 Job Description: 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 THE WORK SCHEDULE IS MONDAY - FRIDAY 8AM - 5PM DURING TRAINING AND AFTER WOULD BE 8AM - 4:30PM WITH A HALF HOUR LUNCH. THIS POSITION IS HYBRID WORK FROM HOME 50% AND TRAVEL 50% TO VISIT MEMBERS IN THE COMMUNITY FOR THE MEDICAID MLTSS AND DUALS AGING AND PHYSICALLY DISABLED PROGRAM Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs. - Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome - Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care - Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members - Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans - Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs - Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met - Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators - May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate - Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits - Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner - Performs other duties as assigned - Complies with all policies and standards Education/Experience: Requires a Bachelor's degree and 1 year of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. For Illinois Plan Only: In addition to the requirements above the employee working on Physically Disabled/Elderly Candidate must meet one of the 3 following criteria: 1. RN licensed in Illinois. 2. Bachelor or Master’s Degree prepared in human services related field. Bachelor’s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology. 3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly. Pay Range: $22.94 - $38.79 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.