Assists with medical record documentation requests and leverages medical management system to initiate case and/or authorization to support clinical processes.
Conducts fax and telephonic outreach; and written communications to members and/or providers to communicate status of UM/CM processes.
Actively participates in supporting department compliance and performance through administrative activities such as report monitoring/distribution, and other tasks as assigned by leadership.
Capital Blue Cross promises to go the extra mile for their team and community. Employees consistently vote it one of the “Best Places to Work in PA”.
Provide general medical office administrative support.
Answer telephone calls and take and route messages.
Interface with physicians and patients.
Stony Brook Surgical Associates, UFPC supports the operation of the hospital and provision of health care and is the co-employer as is necessary to conduct its responsibilities.
Act as the primary point of contact for new patients calling and emailing in.
Efficiently register and onboard a high volume of new patients.
Precisely verify patient insurance information to confirm active coverage and eligibility.
Form Health is a virtual obesity medicine clinic delivering multi-disciplinary evidence-based obesity treatment through telemedicine. Founded in 2019, Form Health is a venture-backed innovative startup with an experienced clinical and leadership team that values its employees.
Be the primary point of contact for all providers.
Provide professional, accurate and timely responses to all provider inquiries.
Maintain a current knowledge of all contract requirements and objectives.
Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans.
Answer high volume of incoming calls and place outbound calls, responding to patient inquiries related to healthcare services. Act as primary point of contact for patients via phone, email and chat systems. Convert calls to scheduled appointments for CHOICE clinics.
CHOICE is the largest provider of pediatric dental care in the Southwest United States, and we pride ourselves on delivering high quality care to children in our communities.
Manages referrals both into and out of the clinic, including prior authorizations and medical records.
Efficiently calls patients, schedules appointments, verifies insurance, and confirms demographics.
Requires excellent customer relationship skills and the proven ability to communicate effectively and accurately.
Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents.
Accept incoming phone calls and return calls from patients involving clinical inquiries.
Review schedule daily to ensure pre-visit preparations are complete.
Call patients at risk for a “no-show” prior to their appointment; contact "no-show" patients and inquire as to their status.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care. They enhance existing care teams, providing extra support with compassion and commitment.
Assists in coordinating patient care with medical staff by reviewing and maintaining provider schedules.
Ensures patient-specific needs are met by arranging interpretation services as needed.
Prepares patients for virtual appointments by ensuring the patient has what is needed for their appointment.
Ascend Healthcare provides fully integrated, quality psychiatric and behavioral health services. They foster a professional, collaborative, and rewarding workplace culture, dedicated to making a profound impact on diverse communities through exceptional patient care.
Answer incoming inquiries from patients, answer questions, and schedule appointments
Make outbound phone calls to patients, pharmacies, and insurance companies
Create and triage tickets in ServiceNow
Talkiatry transforms psychiatry with accessible, human, and responsible care. They’re a national mental health practice co-founded by a patient and a triple-board-certified psychiatrist to solve the problems both groups face in accessing and providing the highest quality treatment.
This role acts as a 'Telehealth Concierge'. Interviews patients to collect required data including demographic and financial information. Communicates mandated patient information and verifies all information for accuracy.
Rochester Regional Health is an integrated health services organization serving the people of Western New York, the Finger Lakes, St. Lawrence County, and beyond.
Oversee the daily operations of the Enrollment Specialist team, including planning daily team coverage for various tasks.
Ensure the efficient and accurate execution of all new patient onboarding processes, including effective management of incoming communications.
Lead, coach, and develop a team of Enrollment Specialists, providing ongoing performance feedback, conducting regular one-on-one meetings, and completing annual performance evaluations to ensure high-quality service and productivity.
Form Health is a virtual obesity medicine clinic delivering multi-disciplinary evidence-based obesity treatment through telemedicine. Form Health is a venture-backed innovative startup with an experienced clinical and leadership team deeply invested in our core value to put patients first, and also deeply committed to creating a culture where every employee is valued and we learn and improve together.
Process transactions on insurance accounts and interact with insurance companies.
Communicate with staff and third-party customers to ensure accurate processing.
Prioritize accounts to maximize aged AR resolution, and research documentation.
Oregon Health & Science University values a diverse and culturally competent workforce. They are proud of their commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status.
Acts as key point of contact for the processing of enrollment applications for all providers. Works with System Credentialing and local medical staff contacts. Responsible for completing the ongoing review and attestation of all Munson Healthcare provider enrollment records.
Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents.
Manages client denials and concerns through analytic review of clinical documentation.
Delivers final determination based on skillsets and partnerships with Humana parties.
Investigates and resolves member and practitioner issues via phone or face to face to support quality goals.
Humana Inc. is committed to putting health first for teammates, customers, and the company. Through Humana insurance services and CenterWell healthcare services, they strive to make it easier for millions to achieve their best health, delivering needed care and service.
Be a first point of contact and deliver exemplary service to our members and providers through multiple channels including phone, email and live chat
Support members in account set up, enrollment, pharmacy coordination, and booking appointments with providers
Provide first-line technical support and escalate technical and member experience issues following standardized operating procedures
Maven Clinic is the world's largest virtual clinic for women and families, aiming to make healthcare accessible for everyone. They provide clinical, emotional, and financial support via their digital platform, serving over 2,000 employers and health plans; they have a flexible and inclusive work environment and have received over 30 workplace and innovation awards.
Deliver comprehensive care navigation and access support for Sana members, ensuring they receive the right care at the right time, place, and cost.
Collaborate with cross-functional teams, including our virtual care practice and customer support, to provide seamless care navigation services.
Educate members on their care referral options, empowering them to make informed healthcare decisions.
Sana Benefits is building affordable health plans designed around Sana Care, their integrated care model connecting members with unlimited primary care and expert care navigation at no additional cost to them. They've compiled an innovative team with top talent from across the healthcare and technology industries to deliver engaging, modern, concierge-style healthcare for their members.
Responsible for accurately and respectfully responding to inquiries from employees/members, providers and clients in a high volume call center.
Seamlessly navigate multiple system applications/screens and resources to accurately respond to inquiries.
Thoroughly and accurately document all inquiries and actions taken using applicable software applications.
Luminare Health helps clients and brokers design custom self-funded healthcare plans providing innovative solutions, flexibility, complete data transparency, and member-centered support. They rely on their decades of industry experience and proven, data-driven results to deliver optimal benefits solutions, customized to meet our clients’ needs.
Provides data management support services to Dignity Health’s CI/ACO Networks, Employer Relations and Valued Based Operations (VBO).
Within the Salesforce platform, this individual gathers and maintains accurate provider data, performs periodic provider data reconciliations with multiple data sources.
Maintains and transmits fee schedules, as necessary, to third-party administrators (TPA's) and other appropriate stakeholders.
Dignity Health MSO builds a system-wide integrated physician-centric, full-service management service organization structure. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers.
Prepare and submit credentialing and enrollment packets.
Maintain accurate provider files and track expirations.
Provide assistance to the billing team during staff absences.
Modena Health and Modena Allergy & Asthma are leading medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona and plans for national expansion. They are physician-led and technology-enabled, committed to transforming allergy care while advancing clinical research and expanding access to cutting-edge medicine.