Role Description American Specialty Health Incorporated (ASH) is seeking an Examiner to join our Medical Necessity/Benefits Administration department. The primary function of this position is to enter data from Medical Necessity Review Form (MNR Form) and Clinical Quality Evaluator (CQE) worksheets. Training on ASH Company Culture and Values; MNA Department SOPs; IHIS, ASHCore, ELIG, Other ASH Company Software Applications; Processing requirements for Medical Necessity Review Forms. Remote Worker Guidelines: This position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network. The internet connection must have a consistent 50 down/10 up Mbps minimum internet speed. 100 down/20 up is recommended to support higher quality video meetings. Responsibilities - Enters data from MNR Form and/or CQE worksheets. - Maintains a minimum level of production of 20 MNR Forms per hour and quality at or above 98.0%. - Processes a minimum level of back end treatment forms as required. - Front-end data entry: - Reviews MNR forms to ensure all information is complete. - Verifies member eligibility and creates patient records. - Checks patient and provider information on MNR Forms against information on the eligibility tape in the Integrated Health Care System (IHIS). - Inputs all required data from MNR forms into IHIS in accordance with MNA guidelines. - Forwards MNRs to the Clinical Quality Evaluators for medical necessity verification. - Back-end data entry: - Retrieves patient files or history for the CQEs as necessary. - Reviews CQE’s worksheets to ensure they are complete. - Inputs all required data from worksheets into IHIS. - Processes CQE worksheets in accordance to the MNA guidelines. - Forwards worksheets to the Administrative Support staff for final processing. - Additional Examiner Skills / Tasks: - Demonstrates proficiency in eligibility verification, provider verification, identifying and pre-screening different form types. - Adds new members and sequence numbers in Member Maintenance. - Researches via ASHCore logs. - Performs production query via Reports Manager. - Forwards eligibility research to Membership. - Processes Duplicate requests. - Administrative Duties: - Contacts provider’s office to clarify missing or illegible information on the MNR forms. - Completes daily tally sheets and production reports for Supervisor. - Performs other duties as assigned. - Complies with all policies and standards. Qualifications - High School Diploma or GED certificate required. - 2 years of data entry experience (10,000 keystrokes per hour - minimum) and working knowledge of the computer keyboard required. Requirements - Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships. - Ability to display excellent customer service to meet the needs and expectations of both internal and external customers. - Excellent listening and interpersonal communication skills. - Ability to effectively organize, prioritize, multi-task and manage time. - Demonstrated accuracy and productivity in a changing environment with constant interruptions. - Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions. - Ability to exercise strict confidentiality in all matters. Mobility - Primarily sedentary, able to sit for long periods of time. Physical Requirements - Ability to see, speak, and hear other personnel and/or objects. - Ability to communicate both in verbal and written form. - Ability to travel within and around the facility or Work from Home (WFH) environment. - Capable of using a telephone, computer keyboard, and mouse. - Ability to lift up to 10 lbs. Environmental Conditions - Work-from-home (WFH) environment. Company Description American Specialty Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to sex, gender, race, color, religion, creed, national origin, citizenship, ancestry, physical or mental disability, legally-protected medical condition, marital status, age, sexual orientation, genetic information, military or veteran status, political affiliation, or any other basis protected by applicable local, federal or state law. If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

Role Description Federated Insurances Commercial Insurance Specialists work hard to build and maintain relationships with commercial businesses across the province to provide a variety of insurance products. At Federated, our insureds’ interests are our top priority. Our goal is to provide the best service in the business. The Commercial Insurance Specialist meets with clients and recommends the most appropriate coverage for their needs. You will have the opportunity to employ your skills in a wide variety of fields. This position requires both strong analytical skills and solid people skills. Join Federated, a dynamic and growing company with a long tradition of providing innovative insurance solutions to clients across the country. Qualifications - Sales experience - A competitive spirit and a desire to deliver a high level of performance - A knack for catching on quickly and solid math skills - A willingness to obtain an AMF damage insurance representative certificate in commercial-lines damage insurance within the first four months of your employment Requirements - Interacting with clients and understanding their needs - Communication and active listening - Taking initiative and achieving goals Benefits - This position is 100% remote. You will work from your home office, with the flexibility to create your own schedule. - We provide you with all the hardware you will need to set up your workspace! - Competitive salaries and support for your financial health through our employee share purchase plan, pension plans, RRSP, discounts on staff insurance, and more! - Flexible health benefits, early leave days, wellness programs, rewards, and recognition programs. - Education assistance to complete your CIP, FCIP, CRM or other desired courses, internal mobility, Leadership training, and mentoring programs. - Donation matching and team volunteer days to support the community and causes you believe in. Company Description We’re Federated Insurance. We’ve proudly been serving Canadian businesses for 100 years. We have a reputation for being one of Canada’s leading commercial insurance providers. Our employees are dedicated to focusing on our customers’ unique needs and we go above and beyond to help Canadian businesses have a safer and brighter future. We’re a company of passionate people who put people first. At Federated we embrace and celebrate you and are committed to creating an inclusive workplace for all! No matter who you are or what makes you unique, we welcome you. Please let us know how we can assist or accommodate you during the selection process.

• Ensure that benefit information, authorization, and patient liability are obtained prior to clinical staff starting care • Work closely with other departments to ensure updates in funding source information • Obtain detailed and accurate benefit information using payer portals, phone, or fax for all insurance companies • Validate and document all payor information in the EMR • Reduce write-offs by documenting benefit information in patient charts • Continuously monitor task flow screen related to all insurance issues • Review entitlement verification reports daily, researching any questionable answers • Reverify current Medicaid patients to monitor HMO status monthly • Contact patients, hospitals, or physician offices for information or to clarify benefit • Assist billing department with insurance verification discrepancies

Role Description Under the direction of the Financial Coordinator Supervisor, ensures that all information necessary for proper financial reimbursement for high dollar patient care is analyzed and submitted to insurance companies for approval prior to the patient’s date of service. Collaborates with insurance companies and physician offices when necessary to verify eligibility and authorization requirements to ensure financial reimbursement for services. - Perform all insurance verification for eligibility, coverage, and authorization requirements via Web or phone with third party payers. - Ensures all possible coverages are created and verified, through electronic or manual methods, and all discrepancies are resolved. - Validates that coverages are assigned to appropriate visit. - Collects and validates order-related information including office visit, radiology and surgical orders. - Follows up with ordering provider to verify CPT codes. - Escalates challenging accounts to team lead to ensure accounts are approved at prior to patient appointment/surgery. - Escalates non-certified urgent cases to appropriate clinical departments and leadership for approval to proceed or communicate rescheduling. - Contacts providers and insurance companies to validate data, collect missing information and resolve information discrepancies. - Understands clinical guidelines for payors requiring authorization to better build cases for authorization requests and provide feedback to clinical departments on required notes. - Work closely with physician offices obtaining authorization for inpatient and outpatient services. - Work collaboratively with Case Management for all patients’ financial issues and updating accounts. Qualifications - High school graduate or equivalent; some college preferred. - 1-2 years of insurance, third party payor or secretarial experience in a health care setting required. - Medical Terminology required. - Analytical ability to gather and interpret data and communicate desired outcomes orally and in writing in a professional manner. - Strong communication and interpersonal skills. - Ability to handle multiple duties. Requirements - Remote Type: Remote. - Work Location: 2014 Washington Street. - Scheduled Weekly Hours: 40. - Employee Type: Regular. - Work Shift: Day (United States of America). - Pay Range: $ - $25.28/Hourly. - Grade: 2. Benefits - Comprehensive benefits. - Career advancement opportunities. - Differentials, premiums, and bonuses as applicable. - Recognition programs designed to celebrate your contributions and support your professional growth. Company Description Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.