Role Description Under Supervision, This Position Is Responsible For Processing Complex Claims Requiring Further Investigation, Including Coordination Of Benefits And Resolving Pended Claims. Qualifications - High School diploma or GED. - Data entry and/or typing experience. - Clear and concise written and verbal communication skills. - Experience processing medical claims. Requirements - Referral preference given to applicants able to take and meet testing criteria. - Must have trained on the six-eight-week Blue Chip claims processing system or have the ability to fully complete the six-eight-week Blue Chip Training class. - Knowledge of medical terminology and CPT, HCPCS, and ICD9 coding. - Knowledge of coordination of benefits principles and terminology. - Experience with multi-tasking and prioritizing. Benefits - Health and wellness benefits. - 401(k) savings plan. - Pension plan. - Paid time off. - Paid parental leave. - Disability insurance. - Supplemental life insurance. - Employee assistance program. - Paid holidays. - Tuition reimbursement. - Other incentives. Company Description At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.

Role Description Dental Care Alliance is seeking a professional and detail-oriented Scheduling Coordinator to support its Centralized Scheduling. This role is responsible for managing inbound scheduling activity, supporting a centralized new patient call center, and completing human follow-up on AI-escalated scheduling interactions. The Scheduling Coordinator plays a critical role in ensuring accurate appointment placement, maximizing office schedules, and delivering consistent, high-quality patient experience across supported practices. Bilingual is a plus! Responsibilities - Respond to inbound patient communications via phone, text message, and email in a timely and professional manner. - Schedule, reschedule, and cancel appointments for new, existing, and lapsed patients in accordance with departmental policies and procedures. - Ensure appointments are scheduled accurately using approved templates and scheduling guidelines. - Update and maintain patient demographic and appointment information within scheduling systems. - Document scheduling activity using designated task forms and systems. - Identify issues requiring office-level involvement and escalate appropriately. - Communicate effectively with leadership regarding questions, workload concerns, or process issues. New Patient Call Center Responsibilities - Answer inbound calls from new patients seeking to establish care. - Collect and verify required patient information and determine appropriate appointment placement based on scheduling guidelines. - Provide clear and professional explanations regarding appointment expectations, next steps, and required documentation. - Deliver a consistent, patient-centered experience that reflects organizational service standards. AI Scheduling Escalation Follow-Up - Review and manage scheduling conversations escalated from AI-based scheduling tools. - Complete patient follow-up via phone or text message to resolve scheduling needs. - Ensure escalated interactions result in accurate appointment placement or appropriate documentation. - Maintain timely resolution of all assigned AI escalations. Schedule Optimization and Patient Experience - Support schedule utilization by placing patients appropriately to maximize provider and hygiene availability. - Apply problem-solving skills to balance patient preferences with operational scheduling needs. - Maintain a professional, courteous, and patient-focused approach in all interactions. - Collaborate with team members to ensure consistent service delivery. Competencies - Patient Service Orientation: Demonstrates professionalism, empathy, and responsiveness in all patient interactions. - Attention to Detail: Ensures accuracy in scheduling, documentation, and patient information. - Communication Skills: Communicates clearly and professionally through verbal and written channels. - Technology Proficiency: Effectively utilizes scheduling systems, communication platforms, and AI-supported workflows. - Judgment and Decision Making: Appropriately assesses situations and escalates when necessary. - Time Management: Manages multiple tasks efficiently while meeting productivity and quality expectations. - Team Collaboration: Works cooperatively with supervisors and peers in a centralized environment. Qualifications - Previous experience in scheduling, call center, dental, or healthcare operations preferred. - Ability to work independently in a remote environment. - Strong organizational skills and adherence to established processes. - Proficiency with computer systems and willingness to learn new technologies. - Bilingual (English/Spanish) skills are a plus. - Proficiency in Microsoft programs, including Outlook, Teams, Excel, and Word, is required. - Experience using dental or patient communication systems such as Denticon, RavePoint, and Talkdesk is preferred. Additional Information - All duties are subject to change based on business needs. - This position requires participation in ongoing training and performance monitoring.

Role Description TCC Solutions is looking for a Support Center Agent who will review, triage, escalate, and potentially resolve customer inquiries. Support Center agents interact with client users and are required to maintain a professional demeanor through ticket responses, phone calls, and email. Utilizing a client-based ticketing system, the Support Center Agent will ensure tickets are set to the correct status and proactive follow-up occurs. The Support Center Agent will be trained in all the client-specific processes and will, eventually, participate in testing new workflows to maintain working knowledge. Duties and Responsibilities - Work directly with customers to resolve a variety of issues such as resetting passwords, navigating through the system(s), creating new accounts for customers, troubleshooting or recreating reported issues, routing calls to the appropriate departments, escalating difficult issues to management, etc. - Assist client users in all defined client processes in a professional manner. - Interact with end-users in a positive and friendly manner as well as exhibit empathy in dealing with non-technical users. - Adapt to different customer interactions and situations as well as varying ticket volumes. - Respond to and triage incoming tickets in a timely manner and respond to customers’ emails (when applicable). - Serve as a liaison between customers and development support teams. - Manage internal and external communications for clients via email, Teams, and SharePoint as required. - Maintain working knowledge of both TCC and client-specific workflows, as well as any SOPs. - Attend meetings as required. Qualifications - High school diploma or equivalent (required) - Associate or Bachelor’s degree (preferred) - Proven ability to work independently, stay organized, and learn quickly - Proficiency in Microsoft Office applications - Strong troubleshooting skills - Critical thinking ability and commitment to maintaining foundational knowledge Preferred Experience - Two years of phone and/or web-based support experience in a customer support environment - Prior experience with support ticketing systems such as Jira Work Environment This is a remote position. Candidate must be available during the “core” work hours of 8:30 a.m. to 5:00 p.m. EST. Occasional evening and weekend work may be required as job duties demand. Must pass background check and drug screening.

Role Description Pertinent information will be gathered from incoming calls concerning medications, and along with review of the electronic medical record, call center employees will utilize scripting to determine a response to the needs of the caller. Responsible for addressing medication related questions, issues, prior authorizations, as well as refill approvals. Perform a medication review at the time of the call and do a complete clinical review and address any medication related questions. - Support the overall goals and objectives that result in improved access, quality of patient care and higher levels of patient satisfaction. - Demonstrates proficiency in order processing. - Receives and interprets physicians' medication orders and clarifies or corrects orders with the physician. - Reviews patient medication profiles to guard against drug sensitivities, contraindications, duplications, and major drug interactions. - Enter into a collaborative practice agreement with health system physicians to review patient’s electronic medical record and authorize prescription refills on pre-specified maintenance medications. - Conduct a thorough review of each individual patient’s electronic medical record and develop an appropriate plan according to the Pharmacist refill authorization protocol and the most recent clinical guidelines. - Use clinical judgement to determine if any additional information is required prior to refill authorization and take necessary actions to resolve issues within defined terms of collaborative practice agreement. - Document encounters within electronic medical record. - E-scribe approved prescription refills to appropriate pharmacy and notify patient of completion. - Participate in the creation and update of scripting and documentation materials. - Work is typically performed in a clinical environment. - Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. Qualifications - Bachelor's Degree in Pharmacy (Required) - Doctoral Degree (Preferred) - Minimum of 4 years related work experience (Required) - Licensed Pharmacist (Pennsylvania) within 90 days Requirements - Teamwork Benefits - Healthcare benefits for full-time and part-time positions from day one, including vision, dental, and domestic partners. - Encouragement of an atmosphere of collaboration, cooperation, and collegiality. Company Description We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members, and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.