Job DetailsJob Location: Remote NV: Las Vegas1 - Las Vegas, NV 89144Position Type: Full TimeSalary Range: $15.00 - $16.00 HourlyCall Center Specialist – Remote Nevada www.niftyafterfifty.com Encore Wellness is seeking a passionate Wellness Call Center Specialist driven by the aspiration to improve the lives of the senior adult population through fun and wellness. With your lively and positive personality, you will educate potential members on all of the benefits they have available at zero out of pocket cost. Additionally, you will schedule them for a free one on one evaluation with a Wellness Coach. You will have direct positive impact on the lives of our members as you help them take the first step on their journey towards a better and healthy lifestyle. *To be considered, you must reside in Nevada and bi-lingual in Spanish & English. Essential Duties and Responsibilities: Perform high call volume to offer company services and schedule appointments. Able to handle customer inquiries and clearly explain services being offered. Enter new and update existing member information into system. Follow up member calls when necessary. Research required information using available resources. Complete call logs and produce call reports. Manage and resolve customer complaints. Knowledge of administrative and clerical procedures and systems. Demonstrate excellent customer service skills. Courteous, helpful, skillful care is to be demonstrated to all members and coworkers at all times. Adhere to all position applicable Encore Wellness policies. Ensure that all company policies are understood. It is the employee’s responsibility to act on all policy changes. Perform other duties upon request. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Education: High school diploma or GED Remote Work Experience preferred Experience: 1-2 years customer service/service center support preferred Bilingual (English/Spanish) Required While working from home, the Call Center Specialist must have a clean, organized and dedicated space for working. The Call Center Specialist must be able to dedicate their full time and attention to their work, during their scheduled working hours; the environment must be distraction free. Technical Requirements: Company will provide a computer Employee must provide their own noise cancelling headset Internet Reimbursement of $10/month will be provided Skills, Abilities, and Requirements: Excellent written and verbal communications skills Friendly voice Phone and active listening skills Customer service skills Ability to reason and carry out instructions Physical Demands: Must be able to stand and/or sit for extended periods of time, as well as bend, stretch, reach, kneel, crouch, and stoop. Manual dexterity. Hearing and vision capabilities required. Ability to follow instructions verbally and in writing. Working Environment: This is a remote position and performed in the employee’s home. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. Benefits: Three weeks paid time off the first two years; four weeks beginning third year Heath benefits offered the 1st of the month, following 60 days Company paid Basic Life and AD&D Insurance 401k (Traditional & Roth Options), following 90 Days Paid Holidays, including one for your Birthday! Competitive pay, depending on experience Monday - Friday workweek Qualifications

We are seeking an experienced Registered Nurse (RN) with multi-state experience to perform utilization reviews, medical necessity evaluations, demand package reviews, and provide litigation support including deposition and testimony services when needed. This position is RN only. Coding credentials are not required. The ideal candidate must have experience reviewing medical records across multiple states and payer environments and be comfortable applying varying state Medicaid policies and commercial insurance guidelines. Responsibilities: • Conduct comprehensive utilization reviews to determine medical necessity and level of care • Review medical records for documentation completeness and clinical appropriateness • Evaluate inpatient, outpatient, and procedural services for compliance with payer guidelines • Assist with preparation and review of demand packages for legal and insurance cases • Analyze cases involving payer disputes, denials, and recoupments • Prepare detailed, defensible written clinical review reports • Provide affidavit support, deposition preparation, and testimony when required • Interpret CMS guidelines, Medicare policies, and state-specific Medicaid requirements • Identify clinical risk, quality-of-care concerns, and documentation deficiencies

• Assists in monitoring call volumes to ensure achievement of service standards • Responsible for specialty accounts to include: high balance accounts, payroll deduction and long-term payment plan processing, deceased and estate accounts, bad address/held statement review, bankruptcy processing, and client (non-patient) billing and collections • Provides staff with support, answering questions and ensuring the team consistently provides accurate information and exceptional customer service • Responds as needed to escalated calls and serves as department liaison for systemwide Patient Complaint Management System • Assists with monitoring the team’s customer service skills, working with the Patient Contact Center leadership in identifying areas that require further development/training • Collect, analyze and summarize data and track trends from various performance and audit reports • Ensure that customers' questions and problems are resolved properly and quickly • Review and resolve complaints logged on SPRC complaint tool received by PCC staff and referred to PCC using NGHS complaint tool • Review specialty accounts for resolution and trending

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Contact Center Representative (Patient Experience Navigator) is responsible for scheduling of all procedures, registration activities, and gathering and processing of patient demographic and insurance information. Salary: $18.50-$21.00 per hour depending on previous experience Day Shift: Monday – Friday Training (4 weeks): M-F; 8a-5p After Training: M-F; 8:30a-5:30p with an hour for lunch or 9a-5:30p with a 1/2-hour lunch. Work Setting: REMOTE - Work from home - Secure private work location - Access to High-Speed Internet is required Responsibilities - Handle inbound and outbound phone calls. - Assist customers with inquiries and issues. - Provide accurate information and solutions. - Maintain detailed records of customer interactions. - Meet performance targets. - Coordinate with insurance verification and pre-certification to assist patients with insurance questions. - Work with center staff to coordinate STAT add-on exams. - Maintain scheduling knowledge and requirements for procedures. - Seek out guidance from supervisor and teammates when uncertain of procedure. - Solicit feedback from the supervisor/manager to assess the quality and effectiveness of work. - Demonstrate a personal commitment to continuous quality improvement through active participation and ongoing dialogue with the supervisor/manager. - Organize and manage time effectively to optimize productivity. - Meet departmental scheduling and quality goals in accordance with policy and procedures. - Possess the ability to accept change in a positive manner and implement change with positive results. - Maintain composure in difficult situations. - Use best judgement to resolve patient problems or refer issues to department supervisor/manager. - Answer phone calls from outside clinicians, requesting information. - Take requests from referring physicians scheduling procedures. - All other duties as assigned. Qualifications - High School Diploma or GED - 1 year experience in a related field - Ability to understand basic medical terminology. - Excellent interpersonal and communication skills. - Experience and competency in customer relation skills in a professional environment. - Ability to organize and prioritize work in a stressful environment. - Ability to work effectively as a member of a team and is self-directed. - Good problem-solving skills. - Exemplary keyboarding skills and experience in patient registration systems and familiarity with personal computers. - Basic knowledge of hospital performed procedures. Benefits - Competitive salary package - Health, Dental, and Vision insurance - Health Savings Account - Life insurance - Short/Long term disability insurance - 401(k) retirement plan