Role Description As a member of the Optum team, you will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. - Review of Musculoskeletal (MSK) care requests to determine if medical necessity has been met or refer to Medical Directors when clinical information does not meet clinical criteria. - Review documentation submitted to support the medical necessity of the request. - Determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination. - Maintain contact with all parties involved in case necessary for case management for the client. - Adhere to all documentation and performance guidelines. - Assess and interpret customer needs and requirements. - Identify solutions to nonstandard requests and problems. - Work with minimal guidance; seek guidance on only the most complex tasks. Qualifications - Associates, Bachelors or equivalent in Nursing. - Current and active unrestricted Nursing License or certification. - 3+ years of experience, with 1+ years of Musculoskeletal, or Pre-Authorization related experience. - Knowledge of the clinical criteria (e.g. CMS, InterQual, etc.). - Proficiency in operating computer applications. - Willing to work an occasional Saturday if requested by the business. Requirements - Medicare Pre-Authorization experience (preferred). - Managed Care experience (preferred). - Proven excellent interpersonal skills (preferred). - Proven excellent verbal and written communications skills (preferred). Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase. - 401k contribution (all benefits are subject to eligibility requirements). - Hourly pay for this role will range from $28.94 to $51.63 per hour based on full-time employment. Application Deadline This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

Title: Commercial Accounts Auditor Location: United States Job Description: Description A New Role. A New Opportunity. Your Next Step ServiceMaster Brands is growing! Were adding a brand-new position to our team, and this is your chance to be part of something exciting. We always Act with Agility, which means were always learning, evolving, and finding better ways to succeed together. If youre ready to help us innovate, adapt, and deliver results that matter, were ready for YOU! Perks & Benefits That Support You: - Medical, Dental, and Vision insurance starting the first day of the month after youre hired - Competitive 401(k) match to help you invest in your future - Enjoy 15 days of paid time off, plus 10 paid holidays and 2 floating holidays to recharge and celebrate - Were committed to your development with career advancement and professional growth Compensation: The salary range for this position is $70,000-$75,000 annually Join our team as a Commercial Accounts Auditor! Step into a pivotal role where you become the trusted expert behind national account performance. As the SRM Commercial Accounts Auditor, youll manage key commercial client relationships, act as the central communication hub across internal teams, and ensure every project meets the highest standards of accuracy and compliance. Youll also partner with sales leadership to uncover growth opportunities and strengthen longterm client partnerships that drive the business forward. What you'll do: - Review project files, estimates, and invoices to ensure accuracy, contract compliance, and alignment with client requirements. - Submit invoices and manage all required documentation through client and vendor portals. - Investigate and resolve invoice discrepancies, service issues, and client concerns with timely, effective followthrough. - Serve as a primary communication hub for clients, vendors, and franchise partners, ensuring clear and consistent updates. - Analyze data to identify root causes and drive resolutions that balance cost, quality, and speed. - Track and manage multiple files, work orders, and priorities in a fastpaced environment. - Collaborate across teams to support project transitions, process improvements, and operational efficiency while guiding franchise partners on invoicing and documentation best practices. What you'll bring: - Proficiency with Microsoft Office Suite, along with strong communication and interpersonal skills. - Ability to manage multiple projects, prioritize effectively, and meet deadlines with strong attention to detail. - Solid problemsolving skills and the ability to analyze information and resolve issues independently. - 2+ years of experience in client service, billing, auditing, or operations support. - Proficiency with restoration industry platforms such as Restore 365, XactAnalysis, Xactimate, or equivalent tools. - Required experience with Cotality products, including Workspace, Estimate, and Validate. - Understanding of hazardous materials handling (asbestos, lead paint, mold, IICRC standards), unsanitary water categories, and timeandmaterial estimating programs. Working Conditions: Work is performed remotely; some travel may be required. During CAT events you may need to work at night or during the weekends. About SMB: ServiceMaster Brands is a leading provider of residential and commercial services in restoration, cleaning, moving, and bioremediation. Founded in 1929, we operate 4,600+ locations through 3,200 franchisees, serving over 1 million homes and businesses annually. Today, we do business under several trusted brands across 50 states and nine countries, generating more than $3.5B in system-wide sales: ServiceMaster Restore, ServiceMaster Clean, Merry Maids, TWO MEN AND A TRUCK, and TWO MEN AND A JUNK TRUCK. . While each brand has its own identity, we share a vision: to become the most admired brand in every industry we serve. Our purposeBe there when you need usextends to our team, where growth, well-being, and success are priorities. Equal Opportunity Employer: It is the policy of ServiceMaster Brands, in accordance with all applicable laws, to recruit, hire, train, and promote persons in all job titles without regard to race, color, national origin, genetic information, religious beliefs, sex, gender identity, sexual orientation, age, marital status, pregnancy, disability, protected veteran status, or any other protected classifications, activities, or conditions as required by federal, state and local laws. Accessibility & Accommodations: If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process at weacknowledge@servicemaster.com. Pre-Employment Screening: Employment with ServiceMaster Brands is contingent upon the successful completion of a background check and drug screening. These screenings include criminal background and substance use testing in accordance with applicable laws and regulations. California Applicants: Background checks are required, and qualified applicants with arrest or conviction records will be considered for Employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. Privacy Policy: https://www.servicemaster.com/california-applicant-privacy-notice/

• Manage multiple audit engagements and lifecycles at one time: overseeing the entire audit process including compiling data from third-party administrator on claims handling structure and requesting information in preparation for the audit. • Audit Third-Party Administrators and Client Claims Teams to ensure adherence to contractual agreements, SLAs, industry standards, and regulatory requirements. • Review pre audit questionnaire (PAQ) responses and necessary documentation; drafting follow-up questions and inquiries as needed. • Manage communication, preparatory, onsite/remote, wrap up, meeting, and post audit/reporting activities. • Analyze claims data to identify trends, exposures, and comparing to best practices. • Evaluate any liability or coverage decisions to evidence appropriate claims handling decisions . • Write professional, detailed reports and appendices; if required or if significant issues identified, prepare the initial summary assessment of findings for client. • Liaise with Audit Administrator regarding audit preparations and MGA/Coverholder/TPA readiness. • Refer to Peer Reviewer before releasing to client.

• Collaborates with coding leadership and peers in the development and/or implementation of audit/monitoring plans. • Evaluates prebill hospital inpatient coding compliance edits to ensure compliance with payer reimbursement methodologies and official coding guidelines. • Summarizes quality review results for Coding Managers, Supervisors, Coding Educator, and coding staff. • Participates in team meetings with coding personnel when necessary to discuss coding findings. • Act as a subject matter expert regarding payer reimbursement methodologies and official coding guidelines. • Provides details specific to audit trends to the Coding Educator for preparation of ongoing education. • Notifies coding leadership of trends and topics for education and feedback to coders, physicians, and departments.