• Researching and resolving claims to maximize cash collections, minimizing denials and lost revenue • Modeling the organization's values, and working on individual and project denial and claim assignments • Performing various complex duties, including working outstanding insurance or contract claims and resolving claim edits and denials • Maintaining worklists and assignments at acceptable levels based on performance targets, KPI, and quality scores • Conducting all insurance or contract follow-up aspects, including interfacing with payers, communicating with internal and external business partners by conducting phone calls, and utilizing web-based tools • Escalating items promptly • Identifying opportunities to improve department workflows and cross-functional processes • Contributing to the development and maintenance of company-wide payer matrices and updates to Standard Operating Procedures • Serving as an active contributor in team meetings • Maintaining knowledge of current government and carrier regulations relevant to the industry • Performing and assisting with other department duties as needed

• Serve as the primary point of contact for Premier Services customers, providing timely communication and white-glove customer service. • Handle inbound customer calls, warm transfers from the Call Center, booking requests, emergencies, and escalations, ensuring issues are resolved promptly and professionally. • Manage customer follow-up requests generated through ServiceTitan Task Management when live transfer support is unavailable. • Maintain accurate customer records, contacts, billing instructions, service requirements, and account preferences within company systems, including correcting information as needed. • Build and maintain strong relationships with property managers, contractors, builders, HOAs, commercial customers, and other business partners. • Proactively communicate with customers regarding job status, estimates, approvals, invoicing, and outstanding requests. • Book and coordinate Premier Services jobs, including service requests, recalls, warranty calls, installations, and tune-ups, ensuring requests are accurately created, documented, and assigned. • Manage emergency, priority, and time-sensitive service requests while balancing customer expectations and operational capacity. • Monitor active jobs throughout the service lifecycle and provide customers with timely status updates. • Communicate customer-specific requirements to technicians, including NTE limits, purchase order requirements, site instructions, and communication expectations. • Coordinate estimates, change orders, customer authorizations, and required follow-up activities. • Review and validate Premier Services jobs created after hours or by other departments to ensure customer records, job details, billing requirements, and service information are accurate prior to invoicing. • Partner with Operations and field teams to resolve service issues and deliver a positive customer experience. • Audit job records prior to invoicing to ensure customer information, billing instructions, approvals, photos, and supporting documentation are complete and accurate. • Correct invoice details to meet customer-specific billing guidelines and submission requirements. • Submit invoices through customer portals, direct-bill processes, and other approved billing platforms. • Partner with Accounting to resolve billing discrepancies, payment delays, and customer invoicing questions. • Assist with accounts receivable follow-up and outstanding invoice resolution as requested. • Upload invoices, work orders, estimates, and required documentation to customer vendor portals. • Maintain portal activity and ensure required submissions are completed accurately and on time. • Monitor customer-specific portal requirements and communicate any changes that may impact operations or billing. • Escalate portal registration, compliance, access, or technical issues to the Premier Services Supervisor. • Partner with Operations, Call Center, Dispatch, Install Coordination, Accounting, ServiceTitan Administration, and field personnel to support customer needs and service delivery. • Provide guidance to internal teams regarding Premier Services customer requirements and expectations. • Assist with the development, maintenance, and improvement of Premier Services procedures, workflows, and documentation. • Identify opportunities to improve customer experience, operational efficiency, billing accuracy, and department performance. • Participate in special projects and department initiatives as assigned.

Role Description Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Schedule: Monday to Friday, 6 AM-6 PM, local time Location: Onsite - Remote, Nationally You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Intake credentialing application review for completion and supporting documentation - Process name and address changes - Process initial credentialing and recredentialing applications following policy and procedures - Process status changes following policy and procedures - Perform primary source verifications (PSV) from various online sources according to the definition of primary source - Data entry and maintenance into credentialing database in accordance with internal policies and procedures - Communicate with Credentialing Committee Members, Credentialing Chair, and Chief Medical Officer (CMO) - Provide feedback to reduce errors and improve processes - Provide continuous monitoring of OIG/SAM/NPDB sanctions - Support Provider Enrollment team efforts - Develop and maintain relationships with market leadership of various levels - Anticipate customer needs and proactively identify solutions - Independently and as a team solve complex problems - Be able to act without direct supervision in a virtual, fast-paced environment - Undergo delegation and internal audits - Other duties as assigned You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Qualifications - High School Diploma/GED - 2+ years of experience in allied health and/or medical credentialing processes - 2+ years of experience with NCQA Standards relating to credentialing - Intermediate level of proficiency with computer skills including, but not limited to: MS Office, MS Excel, MS Word, MS Outlook, Adobe Pro, and/or MS Access Requirements - Experience with MDStaff - Experience with CAQH ProView - Provider Enrollment understanding or experience - CPCS or CPMSM Certification by NAMSS Benefits - Comprehensive benefits package - Incentive and recognition programs - Equity stock purchase - 401k contribution (all benefits are subject to eligibility requirements) 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.

• Ensure accurate and timely qualification of patient orders for Positive Airway Pressure (PAP) devices. • Review referral documentation and verify insurance eligibility and coverage requirements. • Enter patient information into the electronic medical record (EMR) system accurately. • Work collaboratively with referral sources and internal sales teams to obtain missing documentation. • Provide patients with clear information regarding insurance coverage and benefits. • Maintain knowledge of payer guidelines, company workflows, and industry regulations.