• Verify insurance eligibility and benefits, ensuring accurate coverage details are documented prior to services. • Obtain and manage prior authorizations and referrals, ensuring payer requirements are met to support timely reimbursement. • Ensure accurate and up-to-date payer and member insurance information is maintained to prevent claim rejections and delays. • Identify and resolve eligibility discrepancies, coverage issues, and missing information proactively. • Support members in navigating employer-sponsored benefits and insurance coverage, helping them understand financial responsibility and access to care. • Respond to billing, eligibility, and coverage-related inquiries from members with clarity, accuracy, and empathy. • Partner with internal teams (clinical, operations, customer support) and external stakeholders (payers, employer partners) to resolve eligibility and authorization issues.

Join us to support non-profit organizations by processing donation incoming phone calls and providing donors with quality customer service. This position offers the chance to support a wide range of non-profit and governmental organizations and allows you the flexibility to work from home. If you have excellent communication skills, are motivated, and are passionate about helping others, we want you on our team. We partner with independent contractors who are serious about remote work and capable of representing nonprofit organizations with professionalism and accountability. Types of Clients: Nonprofit/Charity TV and Radio stations Child welfare agencies Veteran support groups Spiritual and religious organizations Animal advocacy groups JOB DUTIES: Handling inbound donation-related calls Engaging donors professionally and respectfully Accurately entering pledge and donation information Following compliance and script guidelines Meeting attendance and performance benchmarks IMPORTANT DETAILS: This is an independent contractor opportunity, not an employee role. Certification and startup requirements apply. Contractors are responsible for managing their schedule and performance. ​​Visit www.kaizenadvance.com for more information. Requirements Minimum 6 months of remote call center experience or 1 year in-office call center experience Must be at least 18 years old Must be an US resident Must use a Windows 11 PC Quiet, professional background for calls Able to type at least 40 words per minute Intermediate computer skills Able to pass a background check Must be able to complete a voice assessment and a mock call Preferred Skills: Highly organized and self-motivated Excellent communication skills Intermediate PC proficiency Reliable and Dependable Able to provide excellent customer service Technology Requirements: Windows 11 ONLY – No Chromebooks or Apple (Macs) allowed 8 GB RAM PC (Minimum); 16 GB RAM PC (Preferred) Dual monitors Noise-canceling USB headset Hard-wired internet connection (Ethernet; No WiFi allowed) Benefits Inbound phone work: $0.20 - $0.32 per talk minute ($13 - $15/hr), depending on the project and performance Experienced agents can earn up to $0.35 per talk minute Advancement opportunities for email, ticket, and chat support available with varied pay rates are performance-based and earned through consistency Flexible hours with 24/7 available

Join us to support non-profit organizations by processing donation incoming phone calls and providing donors with quality customer service. This position offers the chance to support a wide range of non-profit and governmental organizations and allows you the flexibility to work from home. If you have excellent communication skills, are motivated, and are passionate about helping others, we want you on our team. We partner with independent contractors who are serious about remote work and capable of representing nonprofit organizations with professionalism and accountability. Types of Clients: Nonprofit/Charity TV and Radio stations Child welfare agencies Veteran support groups Spiritual and religious organizations Animal advocacy groups JOB DUTIES: Handling inbound donation-related calls Engaging donors professionally and respectfully Accurately entering pledge and donation information Following compliance and script guidelines Meeting attendance and performance benchmarks IMPORTANT DETAILS: This is an independent contractor opportunity, not an employee role. Certification and startup requirements apply. Contractors are responsible for managing their schedule and performance. ​​Visit www.kaizenadvance.com for more information. Requirements Minimum 6 months of remote call center experience or 1 year in-office call center experience Must be at least 18 years old Must be an US resident Must use a Windows 11 PC Quiet, professional background for calls Able to type at least 40 words per minute Intermediate computer skills Able to pass a background check Must be able to complete a voice assessment and a mock call Preferred Skills: Highly organized and self-motivated Excellent communication skills Intermediate PC proficiency Reliable and Dependable Able to provide excellent customer service Technology Requirements: Windows 11 ONLY – No Chromebooks or Apple (Macs) allowed 8 GB RAM PC (Minimum); 16 GB RAM PC (Preferred) Dual monitors Noise-canceling USB headset Hard-wired internet connection (Ethernet; No WiFi allowed) Benefits Inbound phone work: $0.20 - $0.32 per talk minute ($13 - $15/hr), depending on the project and performance Experienced agents can earn up to $0.35 per talk minute Advancement opportunities for email, ticket, and chat support available with varied pay rates are performance-based and earned through consistency Flexible hours with 24/7 available

Position Summary: As a valued member of the DRG Review Team, the DRG Integrity Specialist performs a secondary level review of medical records and code assignment using knowledge of Accuity technology and client systems with a physician in accordance with federal coding regulations and guidelines as well as client specific coding guidelines to ensure accurate DRG assignment. This function requires a broad knowledge of the compliance structure to support the appropriate reimbursement. Primary Job Responsibilities: - Review pre-bill cases simultaneously with a physician during each work shift excluding breaks and meetings to analyze and validate diagnosis and procedure codes for inpatient services via coding compliance and clinical knowledge to support accurate DRG assignment - Utilizes Accuity technology for tracking of coding errors, query opportunities and other data collection as needed - Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, and client denials - Possesses a high level of dependability and ability to meet Accuity coding recommendations, accuracy rate, and production standards - Interacts with Accuity physicians, peers, CDIS, and management regarding documentation, policies, procedures, and regulations - Interacts with management on an ongoing basis including assisting senior level staff in providing recommendations for process improvement so that productivity and quality goals can be met or exceeded, and operational efficiency and financial accuracy can be achieved - Reviews, develops, modifies, and/or adapts relevant client procedures, protocols, and systems to coordinate with Accuity methodology - Creates and provides group education and training based on accurate coding practices, coding compliance documentation, and regulatory provisions - Attends in-house training sessions to receive updated coding information and changes in coding and/or regulations - Adheres to stringent timelines consistent with project deadlines and directives - Ensures strict confidentiality of patient medical records - Always acts in an ethical and collaborative manner while monitoring own work to help ensure quality - Codes medical records as needed based on organizational needs - Performs miscellaneous job-related duties as assigned Position Qualifications: Education: - High School Diploma or GED required - Associates Degree in Health Information Management or similar preferred Experience: - Minimum 4 years of inpatient coding experience in hospital facility coding - Minimum 2 years of experience that is directly related to the duties and responsibilities specified above - Experience and knowledge in DRG reimbursement (i.e., MS-DRG, APR-DRG) Licensure and/or Credentials: - Coding credential required from AHIMA/AAPC (RHIA, RHIT, CCS and/or CPC, or CIC) Knowledge, Skills, and Abilities: - Knowledge of auditing concepts and principles - Expert of coding guidelines Ability to use independent judgment and to manage and impart confidential information - Advanced knowledge of medical coding, electronic medical record systems, coding systems - Critical thinking skills to analyze and solve problems - Strong communication and interpersonal skills - Knowledge of legal, regulatory, and policy compliance issues related to medical coding and documentation - Knowledge of current and developing issues and trends in medical coding diagnosis and procedure code assignment - Ability to clearly communicate medical information to physicians and CDIS staff - Ability to provide guidance and training to when needed - Ability to use a PC in a Windows environment, including MS Word - Independent, focused individual able to work remotely or on-site Physical Requirements: The requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without reasonable accommodations. Unless otherwise indicated, Accuity positions require interaction with people and technology while either sitting or standing. Employees must be able to communicate via phone, email, etc. and sit for extended periods of time, with or without reasonable accommodations. Physical effort and exposure to physical risk are limited to that of an office role environment. While this job description is intended to be an accurate reflection of the job requirements, management reserves the right to modify, add or remove duties from a job and to assign other duties as necessary and at any time. All positions at Accuity are at-will employment, and a position description is not a guarantee of a job or of job responsibilities.