Title: Denial Prevention Specialist Location: Weatherford United States Job Description: Remote (must be located in DFW) 6-month contract + extension $18-$20/hr This is primarily a remote position, however there are times the employee might have to come into the office for training, team building events or as requested by their supervisor or manager. JOB SUMMARY The successful candidate will review, research, and resolve claim denials and appeals for various insurance companies while identifying payment trends in an effort to maximize collections. A successful candidate should have, but not be limited to the following skills: - Capable of reviewing Explanation of Benefits (EOB) from payors to determine how the claims were managed. - Contacting insurance carriers to check on the status of claims, appeals, and insurance verification. - Knowledgeable with payors including Managed Care, Commercial, Medicare, and Medicaid - Preparing/Submitting appeals related to denied services This is a work from home (WFH) opportunity. The successful applicant must live within the Greater DFW area and be available to come to the office for equipment pickup, office meetings, and training. Additional details regarding WFH will be discussed as part of the interview process. ESSENTIAL FUNCTIONS Job Duties - Analyze payer denials by denial groupers and submit appeals. - Contact patients and/or third party payers to resolve outstanding insurance balances and underpaid claims. - Make necessary adjustments as required by plan reimbursement. - Functions as a liaison between clinical departments and MSRDP management team. - Completes special projects as assigned. - Performs other duties as assigned. QUALIFICATIONS 2 years experience in medical claims recovery and/or collections required Knowledge, Skills and Abilities - Work requires a self-starter, with ability to work well as part of a team and independently. - Work requires ability to communicate effectively with patients, insurance companies, clinical staff and management. - Work requires ability to handle large volumes of work. - Work requires ability to work in a fast paced, production oriented environment. - Work requires excellent customer service skills. - Work requires experience in Medical Billing, Accounts Receivables, and/or Collections within a healthcare or insurance environment. - Work requires good organizational, flexibility and analytical skills when resolving more complex unpaid claims. - Work requires knowledge of billing and/or collections and regulations. - Work requires knowledge of CMS 1500, ICD-9, and CPT coding is preferred. - Work requires one to exhibit excellent work ethics and commitment to job responsibilities. - Work requires one to possess a professional and courteous demeanor while being assertive and confident in their collection efforts. - Work requires one to possess quick and accurate alpha/numeric data entry skills. - Work requires presence of a positive image that reflects well on the organization. - Work requires strong written and verbal communication skills. - Work requires understanding of the requirements of Medicaid, Medicare and insurance billing. Everforth Apex is a world-class IT services company that serves thousands of clients across the globe. When you join Everforth Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRated's Best of Staffing in Talent Satisfaction in the United States and Great Place to Work in the United Kingdom and Mexico. Everforth Apex Benefits Overview: Everforth Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Everforth Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Everforth Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our 'Welcome Packet' as well, which an Everforth Apex team member can provide. Employee Type: Contract Location: Weatherford, TX, US Pay Range: $18 - $20 per hour

Remote Billing Specialist Location: Lincoln, NE Job Description: Remote Billing Specialist TELCOR Revenue Cycle Services (RCS) is a billing service designed to manage the unique nuances of laboratory billing by using TELCOR's industry-leading RCM SaaS solution to provide the highest returns for our customers. We are searching for a talented and engaged remote billing professional to join our team and provide operational revenue cycle tasks for RCS customers. This includes but is not limited to working payer denials and appeals by performing analysis and investigation of individual scenarios while identifying trends within current worklists or across future/past worklists in order to continuously improve quality and efficiency for customer outcomes, as well as RCS success. The Billing Specialist will also follow-up on unpaid balances to obtain payment and determine when to bill a patient and when to assign work back to the customer to review. Employees in this position will work remotely, unless the employee prefers to work in the office. In that case, accommodations may be able to be made depending on space availability in the Lincoln, NE office. Copy and paste the following link into your browser to learn more about TELCOR and what it means for TELCOR to be a certified Great Place To Work®: https://www.greatplacetowork.com/certified-company/7054288 Requirements of the Remote Billing Specialist Position - Must be able to uphold confidentiality and comply with federal, state and company policy/procedures - Ability to meet performance expectations set forth by supervisors and leadership team - Ability to effectively and professionally communicate, both in writing and verbally with tact, diplomacy and respect for others - Must be able to work independently and within a team to achieve individual and team goals - Must have strong computer skills and be able to leverage and navigate using technology to complete daily tasks (e.g. Excel, electronic documentation storage and retrieval, keyboarding and mouse navigation, email/outlook) - Self-motivated, analytical, quick learner, organized, detail oriented, multitask, resilient, self-disciplined in time management - Knowledge of payer requirements, clearinghouse portal navigation and appropriate interpretation of information is preferred - Knowledge of CPT, HCPCs modifiers, ICD-10 codes and EOB interpretation is preferred - Minimum of (1) year of medical or healthcare related billing or revenue cycle experience preferred - Must have high school diploma or GED TELCOR is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status, or any other characteristic protected by law. All trademarks, service marks, trade names, trade dress, product names and logos appearing herein are the property of their respective owners. Microsoft, Windows, Crystal Reports and SQL Server are either registered trademarks or trademarks of Microsoft Corporation in the United States and/or other countries.

Role Description We are seeking a detail-oriented Payment Posting / Balancing Specialist with strong experience in healthcare revenue cycle operations. The ideal candidate must be well versed in Explanation of Benefits (EOBs), healthcare provider and insurance payer behaviors, payment balancing, and reconciliation processes. This role is responsible for accurately posting insurance and patient payments, balancing daily deposits, and ensuring accurate accounts receivable records. - Interpret and accurately post data from paper and electronic EOBs into the Revenue Management System (RMS) - Post insurance carrier payments, denials, adjustments, and patient payments with high accuracy - Identify, calculate, and apply contractual adjustments, deductibles, copays, and coinsurance based on payer contracts - Balance daily deposits and cash logs against posting reports and remittance data - Research and resolve discrepancies between billed amounts and payment amounts - Review payer denials and underpayments for accuracy and escalation - Maintain productivity and quality standards in a fast-paced environment - Ensure compliance with HIPAA regulations and confidentiality guidelines while handling PHI - Collaborate with internal billing, collections, and AR teams to resolve payment-related issues Qualifications - Strong experience with Explanation of Benefits (EOBs) - Good understanding of healthcare providers, insurance payer behaviors, and reimbursement methodologies - Hands-on experience in payment posting, balancing, and reconciliation - Knowledge of deductibles, copays, coinsurance, contractual adjustments, and remittance processing - Experience working with paper and electronic remittances (ERA/EFT) - Familiarity with healthcare billing systems/RMS platforms - Strong analytical and problem-solving skills - Excellent attention to detail and accuracy - Understanding of HIPAA compliance and PHI handling Preferred Qualifications - Experience in healthcare revenue cycle management (RCM) - Prior experience in physician billing, hospital billing, or medical claims processing - Knowledge of commercial insurance, Medicare, and Medicaid payment processing Company Description Join our team at MetaRPO and embark on a journey of growth and innovation.

Role Description Asegurar la ejecución exitosa de los proyectos asignados mediante una planificación sólida, coordinación efectiva de los involucrados y un seguimiento constante, manteniendo informados a todos los grupos de interés sobre el avance, riesgos y resultados de cada proyecto. What you will do in this role - Planificar, ejecutar, dar seguimiento y controlar proyectos bajo metodologías estándar, asegurando el cumplimiento de tiempo, presupuesto y alcance. - Gestionar y dar seguimiento a la aprobación de presupuestos con sponsors y aprobadores locales y regionales. - Coordinar sesiones de planeación y crear el Project Charter. - Elaborar y dar seguimiento al cronograma del proyecto. - Facilitar reuniones periódicas con stakeholders para comunicar avances, riesgos e inconvenientes. - Identificar riesgos, proponer acciones de mitigación y monitorear indicadores (KPI). - Monitorear el presupuesto del proyecto, órdenes de compra y certificaciones de gasto. - Gestionar documentación y firmas de cierre de proyectos, incluyendo lecciones aprendidas. - Acompañar y asesorar a líderes y equipos durante todo el ciclo del proyecto. - Elaborar informes para capitalización de activos y coordinar con el área contable. Qualifications - Licenciatura en Administración de Empresas, Ingeniería Industrial o carreras afines (enfoque en gestión de proyectos). - Posgrado o Diplomado en Gestión de Proyectos (deseable). - Mínimo 1 año de experiencia en gestión, formulación o evaluación de proyectos. - Experiencia en gestión de presupuesto o planificación financiera. - Manejo de Microsoft Office (idealmente Microsoft Project y Excel). - Conocimiento en KPI, análisis de riesgos y control de proyectos. Key Skills - Trabajo en equipo y excelentes relaciones interpersonales. - Enfoque a resultados e innovación. - Alta capacidad de análisis y organización. - Proactividad y orientación a la solución de problemas. Company Description In Nicaragua we are one of the leading fixed-mobile convergent operators in the country with more than 4 million customers with a 4G LTE network in the process of modernization and growth, in addition to offering fixed internet and television solutions for homes and businesses. We live under the purpose of "Building digital networks that connect, improve lives and develop our communications." The commitment and values shared by the people who work for Tigo Nicaragua are defined by what we proudly call Sangre Tigo. Sangre Tigo, which is the culture that unites more than 1,000 men and women in our country, behind our purpose and makes it come alive. Being on the list of Great Place to Work® Institute Central America & Caribbean, Tigo Nicaragua contributes not only by providing a comprehensive and quality service, but also to the development of the country. We invite you to be part of the change, to generate a positive impact and to develop yourself as a professional. Come join Tigo Nicaragua!