• Engage in Outbound recovery calls, to Healthcare Carriers and Providers regarding improperly paid claims • Decision Support- Ability to accurately review supporting documentation provided to Performant, by Providers/Carriers to determine accuracy of finding or overpayment allegation, for Complex appeals and disputes • Maintain current knowledge in Medicare and Medicaid practices and regulatory issues that may affect clients • Leverage knowledge and expertise to research Overpayments and provide information that will lead to successful resolution and payment • Educate Healthcare providers/carriers on their obligation to pay • Analyze and understand written communication from insurance companies • Support internal groups or functions with billing and collections work • Leverages existing excel skills to create Provider centric reporting on demand • Efficiently work through assigned inventories to meet productivity metrics • Update company systems with accurate information as applicable • Arrives to work on-time and maintain regular attendance • Follows and complies with company and departmental policies

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Laboratory Information Management System (LIMS) Programmer works within Covia’s IT team and provides programming support to the team overseeing the Labware LIMS used in the Covia Analytical Services Laboratory and Covia plant locations. The role requires the job holder to gain a detailed understanding of the LIMS system. - Work with the LIMS Administrator to provide support to any projects related to new LabWare development within the lab and plant facilities. - Process change requests to ensure the LIMS is up to date and meets the needs of both the Analytical Services team and Plant locations. The successful candidate will have the following Key Accountabilities: - Requirements Gathering: Elicit, analyze, and document business requirements from stakeholders. - Process Analysis: Examine current business processes and identify areas for improvement or optimization. - Solution Development: Collaborate with technical teams to design solutions that align with business needs. - Stakeholder Communication: Act as a bridge between stakeholders and project teams, ensuring alignment and clarity. - Testing Support: Assist in defining test cases, validating solutions, and ensuring they meet business expectations. - Change Management: Facilitate smooth adoption of changes by providing training and support to end-users. - Documentation: Create clear, detailed documentation such as use cases, process flows, and functional specifications. - Problem Solving: Analyze and resolve issues that arise during project execution or operations. - Continuous Improvement: Identify opportunities to enhance business efficiency and value through innovative solutions. Qualifications - Highly proficient with relational databases and SQL - Proficiency in at least one high level programming language (Python, C# etc) - Knowledge of LIMS software is a plus - Familiarity with laboratory testing methods, equipment would be helpful - Experience with web development and web APIs would be a plus (HTML, CSS, REST, SOAP, JSON, XML) - Strong written and oral communications skills - Strong organizational skills - High level of motivation and ability to work both independently and within teams - Must be detail oriented and have strong analytical, troubleshooting, and problem-solving abilities - Familiarity with Crystal Reports Requirements - Bachelor's degree in technical field. - Certified LabWare LIMS Administrator (Preferred) - Proficiency in MS Office Suite applications (Word, Excel, PowerPoint, Visio, SharePoint, Teams and Outlook) - 5+ years' experience in information systems, including supporting software applications, analyzing, testing and implementing business system changes and/or user acceptance testing. Travel Requirements - Up to 20 percent to Covia locations. Benefits - Excellent Healthcare Benefits – Medical, Vision, Dental - 401K with Company Matching - Paid Time Off + Paid Holidays - Disability Plans and Life / AD&D - Employee Assistance Program Commitment to Our Culture Our core values - Safety, Team, Customers, Growth, and Courage—guide our work every day and will help us achieve our vision: Covia is the leading minerals solutions provider, and through the passion and commitment of our people, we enable customer success—ensuring a sustainable future for our company. - Live the Life-Saving Rules. - Build high-performing work teams. - Focus on customers. - Demonstrate a growth mindset. - Do the right thing, always.

JOB SUMMARY The QA Specialist plays an integral role in the review process as they are responsible for communicating with the customer, reviewer, and management to ensure a completed report is delivered by the customer requested due date.  The QA Specialist is responsible for the timely completion and overall completeness of a reviewer report. Completeness is determined by customer requirements, company best practices, and clinical accuracy. In addition, the QA Specialist participates in improving DS processes and works with the Manager to ensure high efficiencies are achieved. Dane Street’s success relies on individual and team contributions every day. We care for our customers, each other and Dane Street. It is the responsibility for all of us to maintain a positive working environment that promotes client satisfaction and results. Shift hours: 12:00 pm - 8:30 pm EST MAJOR DUTIES & RESPONSIBILITIES Client Interaction - Provides regular report status updates to the client. - Evaluates the Quality of physician’s report and determines if the report will meet all client and jurisdictional standards; the QA Specialist is also responsible for ensuring that the clinical rationale supports the physician’s determinations. - Clarifies ambiguous report questions with clients. - Distribute final report back to client according to client specific requirements. - Receives, coordinates & executes all aspects of clarification & addendum requests from the client.  - Participates in phone calls OR meetings with client(s) when a report is in question. - Follow up with the client for any missing information that is pertinent to the referral.  Physician Interaction - Works directly with physicians to ensure that all client questions are answered and supported by clinical rationale. - Conduct regular follow up with the physician or their office staff to ensure an on-time delivery of the report.  - Compose and provide verbal or written feedback to the doctor regarding report quality.  - Compose and provide verbal or written requests to the physician or their office staff for clarifications.  - Receive written or verbal confirmation from the physician that a report has the doctor’s approval and ensures the doctor provides his/her signature for the final report. Report Analysis - Review each physician report for data accuracy including spelling, grammar & punctuation.  - Responsible for ensuring that all state requirements for reporting are met.  - Responsible for report format and adhering to each client’s specific requirements. - Must ensure that all client special handling instructions with regard to report completion and delivery are met. Additional Duties - May provide oversight to the work of the team members. - Continuously improves processes that help to facilitate better turnaround time, peer to peer success rates and lessens returned reports by clients for clarification purposes, ultimately resulting in higher client satisfaction.  - Responsible for the final approval on cases for release to the client. - Will act as a liaison and coordinate quality issue reports along with all new reviewer reports with the VP of Clinical Operations. Other duties & special projects, as assigned and based on business needs.

• Uses ICD-10-CM and/or HCPCS/CPT codes to assign, validate, and/or work pre-bill coding edits for the following patient types: • Medical Oncology (Med-ONC), Radiation Oncology (Rad-ONC), Bone Marrow Transplant (BMT), Infusion & Injections, and multispecialty hospital-based outpatient clinics (Oncology, HepC, MS, Pulmonary, etc.) • Works pre-bill edits daily to resolve issues related to coding assignments, charge errors, and missed modifiers • Maintains or exceeds established productivity standard (minimum of 75 pre-bill edits cleared daily or a combination of daily charge capture and pre-bill edits) • Ensures that all assigned charges are captured timely and consistently within the 3-day charge goal • Performs coding audits for BCC coders upon request and as needed to reduce coding error trends • Utilizes the complete medical record documentation in code assignment, validation, and/or editing of codes