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Innovaccer activates the flow of healthcare data, empowering providers, payers, and government organizations to deliver intelligent and connected experiences that advance health outcomes. The Healthcare Intelligence Cloud equips every stakeholder in the patient journey to turn fragmented data into proactive, coordinated actions that elevate the quality of care and drive operational performance. Leading healthcare organizations like CommonSpirit Health, Atlantic Health, and Banner Health trust Innovaccer to integrate a system of intelligence into their existing infrastructure—extending the human touch in healthcare. For more information, visit www.innovaccer.com.
Role Description Story Health Partners is seeking an Advanced Practice Nurse to contract with our team. You will work directly with patients to optimize their medical therapy and serve as the liaison with other healthcare providers. This is a unique opportunity to work in an innovative health tech company. - Conduct synchronous telehealth patient visits to assess patients with chronic diseases such as hypertension, dyslipidemia, diabetes, obesity, and early stage kidney disease. - Order lab tests and other diagnostics as needed to assess the status of chronic conditions. - Provide treatment recommendations back to the referring provider. - Review and respond to remote patient monitoring (RPM) data, lab results, vital signs, and patient reported symptoms. - Prescribe and optimize patient medical therapy according to clinical practice and evidence based guidelines for patients not meeting clinical outcomes targets. - Achieve clinical outcomes and KPIs for a panel of patients. - Serve as the interface between the patients and others in the healthcare system, including providers, clinics, pharmacies, etc. - Support the internal growth of clinical programs in a fast paced and dynamic team environment. - Participate in program building and operational workflows during growth and implementation phases. Qualifications - Minimum 3+ years of experience treating patients with cardiovascular/cardiometabolic/cardiorenal diagnoses, diabetes and/or obesity in an outpatient setting. - Must reside in a nurse compact state and hold an active multistate RN license. - Completion of an accredited graduate-level Advanced Practice Registered Nurse (APRN) program. - Active licensure as an Advanced Practice Nurse in a minimum of 5 states and willingness to obtain additional state licensures as needed. Must be licensed in at least one of the following states at the time of hire: Arizona, Colorado, Georgia, Illinois, Indiana, Michigan, Ohio, South Carolina, or North Carolina. - National certification as an APRN with an Adult, Adult-Gerontological, or Family focus. - Current enrollment as a Medicare Part B provider. - Prior experience working in digital health and remote/virtual patient management. - Passion for helping patients improve cardiovascular health through the application of clinical practice guidelines and evidence based medicine. - Interested in implementing technology to improve healthcare and able to quickly learn and use new software and tools. - Strong customer service skills, with ability to identify hurdles and formulate solutions. - Proven ability to think critically and make decisions under pressure. - Ability to handle conflict resolution and remain tolerant/flexible in all situations. - High-speed home internet access. - Quiet home office space, free of distractions. Requirements - Board Certified - Advanced Diabetes Management (BC-ADM) or Certified Diabetes Care and Education Specialist (CDCES). - 10 or greater state licenses as an Advanced Practice Nurse. - Prior experience in designing and implementing new clinical programs at the population level. - Prior experience in a nursing leadership or management role. Benefits - Generous Paid Time Off: 20 days of fixed time off per year, in addition to company holidays. - Best-in-Class Parental Leave: One of the industry’s most generous parental leave policies. - Recognition & Rewards: Monetary incentives and company-wide recognition for your impact and dedication. - Comprehensive Insurance Coverage: Medical, dental, and vision insurance, plus 100% company-paid short- and long-term disability and basic life insurance. - Optional perks include discounted legal aid and pet insurance.
Kaiser Permanente is comprised of numerous regional Permanente Medical Groups, the Kaiser Foundation Hospitals, and the Kaiser Foundation Health Plan to make up
Role Description Perform general patient access and registration duties in EPIC Practice Management, including: - Answer telephones - Make appointments - Process referrals - Maintain provider templates and appointment schedules - Verify patient demographics and insurance coverage Perform general patient account management duties, such as: - Obtain prior authorization for services - Process items in the appropriate work queues to complete registration - Enter service capture data - Ensure patient accounts and coverage structures meet Kaiser Permanente standards and billing requirements - Function as liaison to Patient Financial Services and the Health Plan - Communicate with external government payors and employers as necessary - Work directly with patients on billing-related matters - Provide fee estimates to patients for Kaiser Permanente services - May perform duties related to cash collection and depositing - Demonstrate strong customer service and communication skills - Adhere to HIPAA and patient confidentiality requirements - May act as the patient's first point of contact with Kaiser Permanente Qualifications - Minimum one (1) year of experience in a business office within a medical care delivery, hospital, insurance, or large contact center environment OR a minimum two (2) years of experience providing excellent customer service in a fast-paced environment - High School Diploma OR General Education Development (GED) required - Experience in electronic patient accounting, scheduling, or customer information systems - Basic PC skills in MS Windows environment, 10-key, and typing (35 WPM) - Customer service skills and strong organizational skills Requirements - Three (3) years of additional experience in a patient care setting (preferred) - Use of Epic Cadence/Prelude/Resolute or other patient scheduling and accounting systems (preferred) - Understanding of Kaiser Permanente billing protocols and cash posting systems (preferred) - Familiar with medical terminology (preferred) - Knowledge of delivery system business operations processes (preferred) - Working knowledge of health care insurance practices and billing (preferred) - Knowledge of health care payer/insurer types (preferred) - Understanding of Kaiser Permanente insurance products and benefits (preferred) - Proven ability to establish credibility and respect with patients (preferred) - Proven ability to problem solve and take initiative (preferred) - Ability to provide feedback and education to other staff regarding correct procedures (preferred) - Six (6) months experience in processing various types of billing (preferred) - Demonstrate a high degree of adaptability, productivity, and reliability (preferred) - Effective interpersonal, communication, and customer service skills (preferred) - Positive, open-minded, and focused on continuous improvement (preferred) - Ability to learn new processes, procedures, and software programs quickly (preferred) - Vocational training in medical office procedures and billing (preferred) - Coursework or practical training and experience in ICD-9 and CPT coding (preferred) Company Description
Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth.
Role Description Lumicera Health Services is seeking a Reimbursement Specialist I to join our team! Under direction from the Assoc. Manager, Specialty Pharmacy Services, Reimbursement Team Lead, and pharmacists in the Specialty Pharmacy, the Reimbursement Specialist I is primarily responsible for following standard operating procedures to obtain and process manufacturer copay assistance program reimbursement. The Reimbursement Specialist I shall have knowledge of billing procedures and work to reduce discrepancies, inaccuracy, and outstanding balances. The Reimbursement Specialist I may also assist in contacting patients with an outstanding balance to communicate billing options. Responsibilities - Responsible for ongoing monitoring of claims activity for accuracy and successful submission - Responsible for ensuring that patient billing information is set up appropriately in the pharmacy software - Participate, as necessary, in conferences and meetings related to reimbursement/billing - Responds to employee/patient/client questions or complaints regarding reimbursement and/or billing - Works with internal teams to review and resolve claim issues - Maintains accurate reference information relating to reimbursement and copay assistance - Responsible for accurate and thorough documentation of information, insurance and prescriptions/orders within the patient profile - The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee - Other duties as assigned Qualifications - High School Diploma or equivalent GED. Some college preferred - CPhT preferred - Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure - Experience with pharmacy, health plan or clinical insurance claims billing, benefit assessments, billing/claims documentation, or claims auditing is preferred - Participate in, adhere to, and support compliance program objectives - The ability to consistently interact cooperatively and respectfully with other employees Benefits - Top of the industry benefits for Health, Dental, and Vision insurance - 20 days paid time off - 4 weeks paid parental leave - 9 paid holidays - 401K company match of up to 5% - No vesting requirement - Adoption Assistance Program - Flexible Spending Account - Educational Assistance Plan and Professional Membership assistance - Referral Bonus Program – up to $750!
Role Description We are seeking a highly organized, systematic, and articulate Virtual Prior Authorization Specialist to lead the clinical administrative gateway for a fast-paced medical practice. This role is specifically designed for a dedicated insurance navigation expert who understands how to bridge the gap between complex payer guidelines, clinical documentation, and seamless patient scheduling. The primary anchor of this position is Obtaining Prior Authorizations and Managing Denial Appeals. You will be responsible for ensuring that all upcoming procedures, specialty medications, and advanced diagnostics are fully authorized before services are rendered. Because you will be communicating extensively with Texas-based insurance providers, clinical staff, and patients, you must possess exceptional, accent-free verbal English clarity, an authoritative command of insurance jargon, and a polished, professional phone demeanor. Core Responsibilities - Prior Authorizations & Denial Appeals (Primary Focus) - End-to-End Authorization Management: Submit and successfully secure prior authorizations for complex procedures, specialty medications, high-level imaging, and specialty referrals. - Clinical Review Coordination: Review clinical charts within ModMed/EMA to ensure medical necessity documentation perfectly supports specific payer requirements prior to submission. - Proactive Payer Follow-Up: Manage authorization tracking pipelines aggressively, following up with insurance medical directors and utilization management teams to prevent treatment delays. - Appeals & Denials Processing: Research, write, and submit technical appeals for denied authorizations, leveraging provider clinical notes to overturn adverse determinations. - Insurance Verification & Utilization Tracking - Front-End Benefit Auditing: Execute deep-dive eligibility checks and verify coverage limitations, tracking specific deductibles and policy exclusions. - Expiration Safeguarding: Track pending authorization expiration dates, utilization caps, and required renewal cycles to protect the practice from retroactive claim rejections. - Patient Communication & Administrative Alignment - High-Clarity Phone Support: Manage outbound and inbound call workflows via the Optum phone system, conveying delicate coverage updates to patients with empathy and extreme professionalism. - Provider & Clinic Synergy: Partner directly with on-site clinicians and providers to secure required clinical notes, peer-to-peer review scheduling data, and updated CPT/ICD-10 codes. - Precision Charting: Document all authorization confirmation numbers, approved lines of service, and payer correspondence paths within the patient’s permanent EMR record. Qualifications - Domain Expertise: Minimum 2+ years of dedicated prior authorization and insurance appeals experience inside a U.S. medical practice. - Linguistic Excellence: High-level bilingual fluency (English/Spanish). Must possess clear, highly articulate English verbal communication with little-to-no accent, tailored for our Texas-based patient demographic and provider market. - Coding Literacy: Solid, operational understanding of CPT codes, ICD-10 codes, and standard medical necessity documentation rules. - Remote Accountability: Agreement to work under a mandatory automated time-tracker, maintaining a quiet, highly secure home office setup compliant with HIPAA regulations. Strongly Preferred Experience - Direct, daily operational familiarity with ModMed (Modernizing Medicine) / EMA EHR. - Prior experience managing communication queues through the Optum VoIP phone system. - Specialized background reviewing clinical charts for surgical specialties or advanced diagnostic imaging authorizations.
Recruiting and training solutions for amazing careers in the Skilled Trades.
• Coordinate and complete Health Risk Assessments (HRAs) through telephone outreach. • Collect, review, and document patient/member health history, medications, chronic conditions, social determinants of health, and preventive care needs. • Maintain accurate and timely documentation in electronic health record (EHR) systems and internal databases. • Support care coordination efforts by scheduling Annual Wellness Visits (AWVs). • Monitor and track HRA completion metrics, productivity goals, and quality standards (expected completion of 7 HRAs per day). • Ensure compliance with HIPAA, CMS, Medicare, and organizational policies and procedures. • Collaborate with interdisciplinary teams including nurses, providers, case managers, and quality improvement staff. • Educate patients/members on available healthcare resources, wellness programs, and preventive services.
No matter your mobility and accessibility needs, NSM is here to provide you with 360-degree Complete Mobility Solutions.
Role Description The Reimbursement Specialist supports the Reimbursement team by identifying and correcting claims submission/payment errors. The Reimbursement Specialist is responsible for the accurate and timely follow-up of unpaid claims, by assigned payers and defined aging criteria to meet or exceed collection targets and minimize write-offs. This position ensures proper reimbursement was received according to payer contracts and fee schedules, correcting billing issues, and billing secondary claims. Duties and Responsibilities / Essential Functions - Performs timely and accurate follow-up on claims to payers and patients following prescribed policies and procedures. - Responsible for preparing and submitting timely and accurate rebilled claims and initial billed secondary/tertiary claims to payers following prescribed policies and procedures. - Enters certain demographic data into the billing and collections software following prescribed policies and procedures. - Generates claims for both electronic and/or hard-copy submission. - Generates Missing Information Requests (MIR) following prescribed policies and procedures. - Identifies variances between booked revenue and expected reimbursement to facilitate accurate reimbursement of claims as defined by contracts, and state and federal law. - Identifies and reports violations of NSM Credit Policy. - Participates in collecting and documenting payer specific claims processing rules, practices and guidelines to contribute to, and maintain, the currency and accuracy of payer requirements for NSM personnel. - Complies with and supports department and organizational policies and procedures. - Assumes other duties and responsibilities as assigned. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee is regularly required to sit; use hands repetitively to operate standard office equipment. The employee is frequently required to reach with hands and arms. Qualifications - High School Diploma or equivalency certificate. - Experience in working with billing and collections software highly desirable. - Knowledge of medical billing and insurance claim filing, communications skills. - Proficient in Microsoft Excel, Word, and Outlook. Adobe Acrobat is a plus. - Strong data entry skills - keyboarding/accuracy/speed. - Working knowledge of Microsoft suite of products (i.e. Outlook, Word and Excel) and Adobe Acrobat.
We empower students & institutions to create meaningful connections to achieve their goals.
Role Description As a Inbound/Outbound Enrollment Specialist, you’ll guide prospective families through K–12 online schooling options through a blend of inbound and outbound calls. You’ll serve as a trusted advisor by: - Assessing family needs - Recommending best-fit programs - Supporting families through the enrollment process, including documentation, school requirements, and deadlines - Delivering an exceptional experience and meeting performance goals A Day in the Life - Making outbound calls and taking inbound calls from families interested in enrolling - Determining best options and sharing details about various online schooling options - Developing relationships with parents as an educational advisor and consultant - Requesting and closing the sale of parents/primary caregivers relative to the best solution for their situation - Meeting key performance indicators for: - Employee attendance - Phone productivity - Enrollments - Call quality - Customer satisfaction - Customer loyalty - Schedule adherence - Escalating issues in a timely manner - Assessing family needs, recommending the best-fit program, and driving enrollment by effectively communicating value and next steps - Closing sales while delivering exceptional experience and meeting key performance goals Qualifications - Excellent English in written and oral communication proficiency (equivalent to CEF C1 level or above) - Computer knowledge and multi-tasking with internet navigation skills - 18 years or older with a High School diploma or equivalent combination of education and experience - Willing to accept Full time, 40 hours a week - Must reside within approved state* - Able to work from home with Home Internet that meets the following requirements: - 30 Mbps download - 15 Mbps upload - 100ms ping or less - Cable, Fiber, or DSL only (no mobile broadband, hotspot, satellite, or point-to-point) - WiFi is allowed; wired connection required if WiFi becomes unstable - Successful candidates will be required to complete and pass a CLEAR™ identity verification as part of the pre-employment screening process - Must be able to enroll in and use Multi-Factor Authentication (MFA) via Okta with Microsoft Authenticator for secure access to company systems Requirements - College degree or some college completed (preferred) - 1 or more years of customer service experience (preferred) Benefits - Receive paid training and ongoing support - Full Benefits Full time - Gain hands-on experience in customer experience and tech-enabled services - Support a mission-driven environment serving students and educators - Strengthen core skills like communication, customer service, and multitasking Company Description Encoura’s mission is to empower students and institutions to create meaningful connections so everyone can make the most informed decisions to achieve their goals. Since 1972, the Company has evolved its products and services to better represent the link between students and higher education institutions and to create the highest probability of student success. - Encoura’s expertise spans enrollment, research, marketing, student success, and advancement - Provides an unmatched combination of higher education experience and innovative solutions for colleges and universities - Offers Encourage® — the nation’s largest free college and career planning program used by millions of high school students and educators nationwide
Based in Dublin, Leinster, Ireland, Experian is a global information services company that operates in 40 countries around the world and has additional headquar
Title: Home Advisor - Remote Location: United States, United States United States, United States, United StatesEmployees can work remotely Full-time Employee Status: Regular Pay Range: $45,000 -$75,000 Role Type: Home Job Posting - Salary Range: See Pay Range Department: Sales & Business Development Flexible Time Off: 15 Days Schedule: Full Time Compensation: USD 45,000 - USD 75,000 - yearly Job Description: Job Description About Own Up, a part of Experian Own Up, a part of Experian, is a mission-driven financial technology company dedicated to making homeownership more accessible and affordable. By combining proprietary technology with deep industry expertise, Own Up provides a transparent mortgage marketplace that helps consumers find the best rates and terms for their financial needs. Through its data-driven platform, Own Up connects borrowers with a curated network of vetted lenders, creating a streamlined, and stress-free mortgage shopping experience. Role Overview The Home Advisor handles high-volume customer interactions to produce qualified leads for lending partners. You will focus on delivering customer experiences while meeting performance goals across call volume, conversion, and quality. Responsibilities - Manage a high volume of inbound and outbound calls to produce qualified leads - Engage with customers by phone, email, and text to answer inquiries and guide next steps - Deliver a positive, professional customer experience balancing speed and quality - Follow structured call flows and best practices to support pre-approval conversations - Partner with our teams to support lead submissions and program execution - Communicate with real estate agents to coordinate and support customer needs - Meet performance metrics, including call volume, contact rate, and conversion Qualifications Required - 1+ years of experience in mortgage, lending, or financial services with a focus on sales, lead generation, and conversion in a high-volume call center environment - NMLO licensing, or demonstrate the willingness to obtain certification within 6 months of hire. Shift Expectations - Availability to work weekend shifts (Saturday: 9:00 AM EST - 8:00 PM EST and Sunday 9:00 AM EST - 7:00 PM EST) - Flexibility to work shorter shifts during weekdays (Monday-Friday), including split and full shifts, 40 hours per week. - Willingness to support a schedule in consideration of high-volume contact center operations, including peak coverage times Additional Information Our uniqueness is that we celebrate yours. Experian's people first, inclusive and purpose driven culture is multi award-winning; World's Best Workplaces 2025 (Fortune Global Top 25), Great Place To Work in 26 countries to name a few. Check out Experian Life on social or explore our Careers Site to understand why. Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay range for this position is listed above. Within this range, individual pay is determined by work location and additional factors such as job-related skills, experience, and education. You will be also eligible for a variable pay opportunity. Experian is proud to be an Equal Opportunity Employer for all groups protected under applicable federal, state and local law, including protected veterans and individuals with disabilities. If you have a disability or special need that requires accommodation, please let us know at the earliest opportunity. Benefits/Perks: - Great compensation package including uncapped commission - Core benefits including medical, dental, vision, and matching 401K - Flexible work environment, ability to work remote, hybrid or in-office - Flexible time off including volunteer time off, vacation, sick and 12-paid holidays - Explore all our exciting benefits here: https://myexperianbenefits.com/ #LI-Remote
Role Description Service Center Assistants are responsible for servicing all queries relating to MasterCard associated programs and services via telephone and/or email to cardholders based in the United States, Latin America, and the Caribbean. - Ensure every cardholder receives the highest quality of service and reach resolution within MasterCard’s designated Service Level Agreements (SLAs). - Take advantage of every cardholder interaction as an opportunity to create customer loyalty, reduce cardholder attrition, and increase the client’s competitive advantage within the industry. Qualifications - Fluency in English and a native spoken Core Language(s) will be cross-trained to support the North American region. - Core languages to recruit for: English (required), Spanish, and Brazilian Portuguese. - Excellent verbal and written communication skills in languages targeted for recruitment. Requirements - Call Center experience required (minimum 1 year experience required). - Ability to multi-task and work in a fast-paced environment. - Ability to problem solve in real-time. - Ability to understand and capture required information during customer interactions. - Ability to properly manage escalations to supervisors. - Ability to manage multiple priorities without supervision. - Team player and engaged individuals. - Ability to respect company & compliance standards, processes, and procedures always. Benefits - Health care and 401(k) savings plans.
Provider Connected, Patient Centered, and Personally Coordinated
• Conduct outbound and inbound patient calls to obtain program enrollment consents • Clearly explain program benefits, address patient questions, and overcome objections • Accurately document enrollment activities and consent records in the system of record • Maintain compliance with all documentation, scripting, and consent requirements • Meet or exceed individual enrollment productivity and quality standards • Model effective call techniques, scripting adherence, and patient experience best practices • Support onboarding and ongoing training for Enrollment Specialists • Provide peer mentoring, coaching, and real-time feedback • Reinforce enrollment standards, workflows, and documentation quality • Identify skill gaps and deliver targeted refresher training • Assist with schedule alignment to support enrollment demand and coverage • Partner with leadership to assess enrollment readiness and performance risks • Maintain and update training materials, scripts, and job aids as needed • Serve as a point of contact for enrollment-related training and process questions • Share best practices and performance insights with the Enrollment team • Contribute frontline feedback to improve enrollment workflows and patient experience • Support quality improvement initiatives tied to enrollment outcomes
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