Appeals Professional II Location: US, Remote Job Type Full-time Description Overview Tanaq Support Services (TSS) delivers professional, scientific, and technical services and information technology (IT) solutions to federal agencies in health, agriculture, technology, and other government services. TSS is a subsidiary of the St. George Tanaq Corporation, an Alaskan Native Corporation (ANC) committed to serving Federal customers while also giving back to the Tanaq native community and shareholders. About the Role We are seeking an Appeals Professional II to support a contract with our federal client. Performs complex work. Provides dissatisfied beneficiaries and/or providers the opportunity to present documentation or evidence to demonstrate why an appeal or rebuttal for an enrollment denial, revocation, or suspension should be allowed. Provides an independent second level determination based on the documentation, facts, laws, regulations, and guidelines. Works under general supervision, with moderate latitude for the use of initiative and independent judgment. This is a remote position that can be based anywhere in the United States. Must be able to work on a rotating schedule on weekends and holidays. Responsibilities - Responsible for significant or complex programs, may assist with quality reviews and audits. - Reviews medical records/case file, writes a decision that is clear, concise, and impartial and supports the determination made, and documents review. - Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation, rulings, and policy. - Responds to and ensures that all issues raised by the beneficiary, representative, supplier, and provider have been addressed. - Provides a fair and impartial decision based on current evidence, regulations, policies, and procedures. - Conducts research using online federal regulations, contract policy, standards of medical practice, contract manuals, coverage issues manuals, medical literature, and other related resources to complete an accurate and well-supported decision. - Stays abreast of changes in regulations, medical and healthcare practices, policies and procedures. - Participates in special projects and performs other duties as assigned. Requirements Required Skills and Experience - Three (3) years of medical dispute resolution or Medicare appeals, medical review, clinical, or related experience in a healthcare setting - Proficiency with research techniques, medical terminology, analyzing and interpreting policies, along with state and federal law and regulations - Must have experience and working knowledge of the Medicare program, including coverage and payment rules - Experience with Medicare regulations, claims administration, and medical review process, and applicable laws, rules, and regulations - Ability to prioritize and organize work assignments to multitask and meet deadlines - Ability to prepare correspondence/documents using correct spelling, grammar, and punctuation; proofreading and reviewing documents for clarity and consistency. - Exercise logic and reasoning to define problems, establish facts, and draw valid conclusions - Experience in making decisions that support business objectives and goals - Ability to identify and resolve problems or refer issues appropriately - Communicate effectively verbally and in writing - Adapt to the needs of internal and external customers - Show integrity and ethical behavior; respect confidentiality, business ethics, and organizational standards - Ensure compliance with company policies, procedures, and guidelines, including cybersecurity, regulatory, contractual, and accreditation entities - Experience directly relevant to Medicare managed care appeals, preferred - Must have resided in the United States for a minimum of three (3) years out of the last five (5) years (Per Contract Requirement) - Ability to obtain and maintain Public Trust or equivalent security clearance and customer approval - Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future Education and Training - Associate's degree or 60 or more credit hours towards a Bachelor’s degree from an accredited college or university in healthcare or related discipline. - Additional experience in Medicare appeals, medical review, clinical, or other related experience in a healthcare setting may be substituted for an Associate’s degree on a year per year basis. (Experience requirements may be satisfied by full-time experience or the prorated part-time equivalent.) Physical Requirements and Work Environment - Requires working in an office/cubicle environment; sitting, standing, walking, bending, twisting, and/or reaching. - Prolonged periods of sitting at a desk and working on a computer. May need to lift 25 pounds occasionally. - May require the ability to operate a motor vehicle and travel by motor vehicle and commercial airline. May require overnight travel. Who We Are Tanaq Management Services (TMS) is a public health contractor, certified 8(a) business, owned by St. George Tanaq Corporation, an Alaska Native Corporation. (ANC). We listen to our stakeholders and leverage our science, technology, communication, and program expertise to understand and provide feedback as we develop solutions. Notice on Candidate AI Usage Tanaq is committed to ensuring a fair and competitive interview process for all candidates based on their experience, skills and education. To ensure the integrity of the interview process, the use of artificial intelligence (AI) tools to generate or assist with responses during phone, in person and virtual interviews is not allowed.

• Accurately assign and appropriately sequence ICD-10 and CPT codes and all applicable modifiers • Contact clients as appropriate when documentation in the medical record is inadequate, ambiguous or unclear for coding purposes • Monitor regulatory and payer changes as they apply to diagnostic and procedure coding • Research and resolve coding related system edits, payer rejections and insurance denials • Identify system edit, payer rejection, and insurance denial trends for client policy and procedure improvement • Maintain up to date knowledge of the current changes of coding practices by continuing education and reading resource material • Other innovative and progressive duties as assigned

EDI Enrollment Specialist Position Type: Full Time Salary Range: $65,000 - $75,000 annually, DOE; may be eligible for bonus Location: This position offers 100% remote work. About the Company: Ensign Services, Inc. (“ESI”) is a subsidiary of The Ensign Group, Inc. whose affiliated entities are considered national leaders in the fast-growing post-acute care industry. ESI provides service and support to over 378 facilities in the long-term care continuum that employ over 55,000 employees. ESI is known as the “Service Center” and provides the facilities and leaders it serves with “back-office” support in areas such as accounting, construction, compliance, human resources, information technology, learning and development, legal and risk management and recruiting. This structure allows the onsite leaders and caregivers to focus on day-to-day care and operational issues in their individual operations. What sets ESI apart from other companies is the quality of our most valuable resource - our people. We take our core values of Celebration, Accountability, Passion for Learning, Love One Another, Intelligent Risk Taking, Customer Second, and Ownership (“CAPLICO”) seriously. We want an individual in this role who will demonstrate these values through actions and words. About the Opportunity The EDI Enrollment Specialist manages and maintains Electronic Data Interchange (EDI 837), Electronic Remittance Advice (ERA 835), and Electronic Funds Transfer (EFT) enrollments. In this role, you will also develop and maintain documentation for enrollment processes across all Ensign Skilled Nursing Facilities and Assisted Living Facilities, supporting operations in multiple markets. Specific Duties include, but are not limited to: - Enroll new and existing clients in EDI and ERA programs (837, 835, DDE and EFT) to support claim submission, paperless insurance payments, and electronic fund transfers to facility operating accounts. - Follow up to confirm EDI, ERA, and EFT setups are completed and document outcomes appropriately. - Collaborate with the Accounts Receivable (AR) team to troubleshoot EDI, EFT, and ERA enrollment issues at the facility level. - Partner with the EDI Lead and key stakeholders to map data, standardize processes, and expand the database of recognized insurance payers. - Complete EDI, EFT, and ERA enrollment applications through claims systems or payer portals, as appropriate. - Work with the AR team to ensure portal enrollments are completed when required. - Monitor and follow up on EDI, EFT, and ERA enrollments and provide status updates to relevant stakeholders. - Ensure carriers are properly set up for EFT and ERA processing. - Identify enrollment issues and escalate as needed to ensure timely resolution. - Collaborate with the EDI Lead to review, streamline, and improve workflows and processes. - Work with internal and external stakeholders to resolve provider enrollment issues, including claim denials related to enrollment. - Provide subject matter support and conduct training for AR staff as needed. - Collect, organize, and maintain enrollment documentation as part of the onboarding process. - Assist in managing information flow between facilities and payers. - Perform other duties as assigned by the supervisor. Position Requirements: - 3+ years of experience in a healthcare business office environment - Strong ability to prioritize and organize tasks to meet established deadlines - High level of attention to detail and accuracy - Proficiency in Microsoft Word, Outlook, and Excel - Working knowledge of applicable state regulations - Excellent written and verbal communication skills - Ability to collaborate effectively with a diverse group of individuals Additional Information: - Pre‑employment criminal background screening required. What We Offer We are committed to providing a competitive benefits and compensation package which includes medical/dental/vision coverage, company-provided life insurance, 401(k) with company match, and sick/vacation plans. We also believe in supporting our employee’s professional growth and development through our Learning Management System as well as training sessions and seminars. Take a look at these benefits (and more!) at www.ensignbenefits.com Ensign Services, Inc. is an equal opportunity employer. If you need assistance or accommodation during the application process, please contact us at 888-659-3616. Job ID 1472

Responsibilities Telepsychiatry Opportunities: HealthLinkNow is currently hiring Telemedicine Psychiatrists (MD/DO) – Licensed in Arizona. This position will be primarily – Emergency Department Coverage. We are seeking motivated Psychiatrists who are committed to providing exceptional patient care from the convenience of a home or office. Schedule: Mountain Standard Time / Pacific Standard time depending on time of year. – Mon. & Fri. - 9a-12p (3 hours each day) / Tues., Wed., Thur., and Sat. - 9a-11a (2 hours each day) Population: Emergency Department Patients. Who are we? We are a team of healthcare professionals dedicated to providing patients access to behavioral health treatment without boundaries. HealthLinkNow (HLN) is a national Telehealth company owned by Universal Health Services and is the first of its kind to be accredited by the Joint Commission. Psychiatrists joining would be among our growing team of providers, providing quality care with 98% patient satisfaction ratings. As Service Excellence leaders in Telehealth, our systems are simple and easy to use. What We Offer: - 100% Remote: Enjoy the convenience of working from your own home, providing quality care to patients in Arizona. - Contract Position (1099): Flexible working arrangements that suit your needs. Technology requirements: - Must use personal laptop/computer that can run Zoom and other applications required for Telehealth remote work. - Internet connection - broadband wired or wireless (3G or 4G/LTE) - Speakers and a microphone – built-in, USB plug-in, or wireless Bluetooth - A webcam or HD webcam – built-in, USB plug-in or an HD cam or HD camcorder with a video-capture card OR virtual camera software for use with broadcasting software like OBS or IP cameras. Supporting operating systems: - macOS X with macOS X (10.11) or later - Windows 11 - Windows 10 Note: Devices running Windows 10 must run Windows 10 Home, Pro, or Enterprise. S Mode is not supported. - Please note that the Zoom desktop app will no longer be supporting Windows 7 and Windows 8/8.1 Web browsers: - Chrome: Within 2 versions of current version - Firefox: Within 2 versions of current version - Edge: Within 2 versions of current version - Safari: Within 2 versions of current version Provider Opportunities: HLN supports behavioral health facilities and outpatient programs by providing tele-psychiatry services that accommodate their treatment programs. All inquiries are welcomed. Interested applicants licensed in the following states especially encouraged to apply: - ARIZONA We connect people to the right care when and where they need it. Join our outstanding team and enjoy the opportunity to work from anywhere, while providing much needed behavioral health treatment beyond borders. For additional information, please refer to: - Website: HealthLinkNow.com EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449. UHS is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at UHS via-email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means. Qualifications - Active Medical License (MD/DO) in Arizona. - Must be ABPN Board Certified in Psychiatry. - DEA license in Arizona preferred. - Must provide Case Log of inpatient services for last two years.