This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are seeking an experienced Home Care Credentialing & Provider Enrollment Specialist to manage provider credentialing and payer enrollment activities. This role ensures that our agency remains actively credentialed, compliant, and eligible for reimbursement across Medicare, Medicaid, and commercial insurance networks. You will work closely with operations and billing teams to maintain accurate provider records and support our growth initiatives. - Maintain and update CAQH ProView profiles for all providers. - Complete initial and re-credentialing applications with Medicare, Medicaid, and commercial payers. - Track enrollment status, follow up with payers, and ensure timely approvals. - Maintain credentialing files, audit documentation, and compliance reports. - Collaborate with operations and billing teams to support reimbursement and network participation. - Monitor expiration dates and manage re-credentialing processes. - Act as a liaison between providers, payers, and internal teams to resolve credentialing issues. Qualifications - 2+ years of provider enrollment or healthcare credentialing experience, preferably in non-skilled home care in the state of Michigan. - Strong knowledge of CAQH ProView, Medicare PECOS, Medicaid portals, and commercial payer systems. - Excellent attention to detail, organization, and follow-up skills. - Ability to manage multiple tasks and meet deadlines. - Strong verbal and written communication skills. - Experience with credentialing software or tracking systems is a plus. Preferred Qualifications - Prior experience with non-skilled home care licensing requirements in the state of Michigan. - Knowledge of provider contracting and network participation. - Familiarity with auditing credentialing and compliance documentation specifically in the state of Michigan.

Role Description Les activités du service : - Gestionnaire administratif (gérer les positions administratives, répondre aux demandes des agents, suivi de certains dossiers, rédaction d’arrêtés) - Secrétariat (traitement du courrier, réponses téléphoniques, gestion des fournitures, organisation du classement) - Économat (gestion financière du budget, gestion des frais de déplacement, des frais de changement de résidence, des frais de santé, des effets d’uniforme) - Comptabilité (comptabilisation des opérations de trésorerie, états de rapprochement bancaire) - Greffe (préparation et participation au CAP, exécution et suivi des décisions de la CAP, instruction des aménagements de peine, classement, archivage, courrier) - Assistant gestionnaire CHORUS (mise à disposition des crédits, gestion des engagements juridiques, gestion des recettes, gestion des actifs, travaux de fin d’exercice) Qualifications - Poste réservé au corps des adjoints administratifs (ou équivalent) de la fonction publique. - Poste accessible par détachement d'un autre ministère hormis les agents militaires ou gendarmes qui doivent candidater via la CNOI. Requirements - Connaissances du statut de la fonction publique. - Connaissances du circuit de la dépense et des règles budgétaires. - Maîtrise des outils bureautiques. Benefits - Esprit d'équipe. - Discrétion professionnelle. - Polyvalence. - Anticiper. - Mettre en œuvre une règle, une procédure. - Prioriser. - Travailler en équipe. Éléments de candidature - Documents à transmettre : Pour postuler à cette offre, l'envoi du CV et d'une lettre de motivation est obligatoire. - Personnes à contacter : drh.cd-mauzac@justice.fr

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are seeking a dependable and detail-oriented Remote Administrative Support Specialist to assist with day-to-day operational and client support tasks. This role focuses on organization, communication, and maintaining smooth workflows while working within a structured remote environment. The ideal candidate is someone who enjoys keeping systems organized, communicating clearly, and ensuring that important details are handled accurately. You will help support client requests, maintain records, coordinate schedules, and assist with administrative tasks that keep operations running efficiently. This position is well suited for individuals who are comfortable working independently, managing multiple tasks, and maintaining a high level of professionalism while working remotely. - Provide administrative support for daily operational tasks - Manage schedules, confirmations, and appointment coordination - Communicate with clients to gather information and provide updates - Maintain accurate records and documentation within internal systems - Track outstanding items and follow up to ensure tasks are completed - Organize information and assist with workflow coordination - Ensure communications and updates are handled in a timely and professional manner Qualifications - Strong communication and interpersonal skills - Excellent organization and time-management abilities - Ability to work independently while following established processes - High attention to detail and accuracy - Comfortable using digital tools, scheduling systems, and online platforms - Reliable, professional, and self-motivated - Must be authorized to work in one of the following locations: United States, United Kingdom, Mexico, Spain, Australia, or LATAM regions Benefits - 100% remote work environment - Structured training and support - Clear systems and tools to help you succeed - Opportunity to develop valuable administrative and coordination skills

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This is a hands-on role for someone who thrives in high-volume operational environments and is comfortable balancing individual contribution with team support. You will continue to process prior authorizations directly—often at high volume—while also serving as a go-to resource for other Ascertain Assistants. Over time, this role will evolve into a hybrid operations + technology position as workflows become increasingly automated and integrated with Ascertain’s platform. This is not a traditional healthcare shift-based, desk role. It is an outcome-driven position that rewards ownership, judgment, and follow-through. What You'll Do - Play a critical role in our new AI-powered prior authorization solution. - Collaborate directly with Ascertain leadership and product teams. - Work closely with healthcare providers to reduce administrative burdens and streamline detailed workflows. - Manually process authorizations and oversee automated submissions for office visit referrals, procedures, pharmaceuticals, and more. - Review and verify insurance information and patient eligibility for prior authorizations for prescription medications. - Work directly with insurance payers, PBMs, and pharmacy benefit plans. - Interpret formularies, step therapy requirements, quantity limits, and coverage criteria. - Communicate with healthcare providers to gather necessary medical documentation and information. - Monitor and track authorization requests to ensure timely processing and resolution. - Respond to inquiries from healthcare providers, patients, and insurance companies regarding authorization status. - Maintain accurate records of authorization requests, approvals, and denials. - Collaborate with internal teams to resolve authorization issues and improve process efficiency. - Stay updated on insurance policies, regulations, and industry trends related to prior authorizations. Qualifications - 4+ years of experience with prior authorization and billing in multiple specialties, including 2+ years of direct pharmacy prior authorizations experience. - Experience handling denials and the appeals and peer to peer process. - Strong understanding of formularies, step therapy, and medication coverage policies. - Familiarity working with different specialty pharmacies and online portals. - Bonus if you have experience in client relationships. - Hands-on leadership roles (e.g., Team Lead, Supervisor, or informal leadership), paired with a roll-up-your-sleeves approach. - Engaging with C-suite executives. What You'll Bring to the Table - Detail-Oriented: Meticulous in your work, catching errors and ensuring every authorization is processed accurately the first time. - Collaborative: Energized by working with others, building trust and communicating clearly with providers, teammates, and cross-functional stakeholders. - Adaptable: Comfortable shifting between manual workflows and leveraging new AI-powered tools, adjusting quickly as processes evolve. - Empathetic: Attuned to the needs of healthcare providers and patients, approaching each interaction with patience, professionalism, and understanding. - Process-Driven: Motivated by structure and consistency, following established workflows while identifying opportunities for improvement. Why Ascertain? Your work will directly impact healthcare organizations and improve patient care. Join Ascertain in transforming healthcare with AI!