Receive, Track, Identify and analyze claims data and clinical information as appropriate for the pre-renewal, medical underwriting, and cost containment processes.
Accurate setup of incoming and outgoing referral and review documents, utilizing medical underwriting and cost containment platforms including intake logs, Conexure, Access, Sharepoint, OneDrive, etc.
Communicate verbally and in writing of all activities and problems within assigned area of responsibility with team and manager.
Manage a caseload of in-progress applications through the underwriting process
Coordinate and follow up on medical exam bookings with vendors and clients
Handle inbound calls and respond to client emails
PolicyMe is Canada’s leading digital insurance solution, offering straightforward and affordable financial protection for families. They operate with a remote-first culture, attracting top talent from across Canada, with employees who are ambitious, yet humble.
Contacts insurance companies for status on outstanding claims.
Processes and follows up on appeals to insurance companies.
Works outstanding accounts receivable from assigned work queues.
US Anesthesia Partners is a company focused on revenue cycle management. They provide equal employment opportunities to all employees and applicants and value diversity based factors.
Data management of all processes for the Open Enrollment period.
Processing waiver approvals via data downloads and sending emails.
Updating students’ accounts in Banner and the tracking system.
Georgetown University comprises two unique campuses in the nation’s capital, offering rigorous academic programs and unparalleled opportunities to engage with Washington, D.C. It is a close-knit group of remarkable individuals driven by intellectual inquiry and a commitment to making a difference in the world.
Provide reporting of claims on behalf of brokerage clients
Communicate with carrier adjusters and clients to facilitate successful handling and resolution of claims
Prepare customer claim summaries
Lamb Insurance Services is a commercial insurance broker dedicated to non-profits and social services organizations nationwide. We are a socially conscious organization with an amazing culture of relentless grit and continuous improvement.
Conduct research and provide problem-solving support to the Customer Service Department, Brokers and Sales.
Provide efficient, courteous, professional quality service to Groups, Plan personnel and Brokers/Sales in a timely manner.
Ensure compliance with organizational and regulatory requirements.
They promise to go the extra mile for their team and community. Capital Blue Cross values your professional and personal growth by investing heavily in training and continuing education.
Analyze and evaluate worker’s compensation claim payments using EnableComp’s proprietary software, systems and tools.
Research, request and acquire all pertinent medical records, implant manufacturer’s invoices and any other supporting documentation necessary and then submit with hospital claims to insurance companies to ensure prompt correct claims reimbursement.
Conduct timely and thorough telephone follow-up with payers to ensure claims with supporting documentation have been received and facilitate prompt reimbursement.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM ™ intelligent automation platform to improve financial sustainability. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024.
Guiding them toward scheduling their care assessments.
Giving them the encouragement they need to take that next step.
Carenet Health turns everyday conversations into meaningful connections that help people take charge of their health. They value the expertise and dedication of their team members and show it through a competitive and supportive package.
Using excellent communication and multitasking skills, responds timely to customer inquiries and process requests
Research customer issues and find workable solutions
Provide response to inquiries including scheduling appointments, referral inquiries
Carenet Health pioneers advancements for an experience that touches all points across the healthcare consumer journey. They interact with 1 in 3 Americans every day, delivering positive healthcare experiences and improving outcomes.
Perform data mapping activities, translating client data into defined global and consumer data standards according to Cotiviti requirements.
Collaborate with internal stakeholders to analyze, understand, and document data requirements and transformation rules.
Explore large and complex datasets to identify trends, patterns, and anomalies.
Cotiviti transforms information into actionable insights that fuel business growth and innovation. They offer a dynamic environment where priorities can shift quickly based on business needs, but specific employee numbers are not mentioned in the job description.
Manage daily data entry requirements and Intake process for new and existing patients
Oversee daily operations of incoming document fax server along with identify and file documentation within customer relationship management (CRM) system
Provide review and quality check of incoming documents, associated data entry and organization
Cala Health is dedicated to freeing people from the burden of chronic disease by creating non-invasive prescription therapies. They have a pioneering technology that can be applied across neurology, cardiology, and so much more.
Work with the Global Operations regional managers to develop and oversee group benefit programs.
Coordinate benefit processing and create strong partnerships with the benefits broker and vendors.
Assist employees with benefits & compensation and evaluate & design new corporate benefit plans.
Remote is solving modern organizations’ biggest challenge – navigating global employment compliantly with ease. They make it possible for businesses of all sizes to recruit, pay, and manage international teams. With innovation as one of their core values, they have built Automation and AI capabilities into the requirements for every role.
Support Excess and Casualty Underwriters with new business submissions, renewals, endorsements, and cancellations.
Prepare, review, and process underwriting documentation, including binders, policies, endorsements, and invoices.
Communicate with brokers and agents regarding missing information, policy status, and routine inquiries.
Paragon is a rapidly growing MGA that supports retail agents and insurance carriers and reinsurers. They are dedicated to diversity and agility, offering better pay, benefits, and growth opportunities, and actively investing in talent.
Enjoy making outbound calls and reaching out to patients, members, and customers.
Have a passion for helping patients make decisions that will enhance their healthcare experience.
Make welcome calls and assist members and patients with benefits and insurance information.
Carenet Health pioneers advancements for an experience that touches all points across the healthcare consumer journey. They interact with 1 in 3 Americans every day, delivering positive healthcare experiences and improving outcomes. Carenet Health fosters collaboration, creativity and innovation and looks for people who want to work with an entrepreneurial spirit and deliver market-leading performance!
Perform quality review and evaluation of all claim submissions.
Determine the eligibility of assigned claim by applying appropriate contractual provisions.
Document rationale of claim decisions based on review of the contractual provisions.
Berkley Accident and Health designs innovative risk management solutions. They have an entrepreneurial culture with a strong emphasis on analytics, helping employers better manage their risk, and is backed by a Fortune 500 company.
Provide accurate assistance to support the administrative needs of Brokers and Admins across phone and email.
Assist with the administrative side of onboarding and system needs for new and renewing Sana plans.
Address and resolve complaints or problems, such as billing discrepancies and coverage denials.
Sana is a health plan solution built for small and midsize businesses designed around their integrated primary care service, Sana Care. They have been remote-first since day one, with a fully distributed team across the U.S., and value curiosity, ownership, and speed.
Draft new contacts and amendments and related customer documentation.
Serve as the single point of contact for internal and external Customers regarding sales contract activities.
Work within Salesforce CPQ to assist Field Sales through the configuration, pricing, and quoting processes.
PROCEPT BioRobotics is committed to revolutionizing treatment for benign prostatic hyperplasia (BPH) through innovation in surgical robotics. They are focused on creating an evolving landscape for your career, brimming with transformative opportunities that provide continuous career growth opportunities.
Execute transactional tasks, manage complex appeals, draft decline letters, and resolve application discrepancies or medical impairment inquiries.
Lead Post Issue Audits (PIA), manage MIB (Medical Information Bureau) reporting, and conduct partner reviews to ensure adherence to carrier and regulatory guidelines.
Review applications for accuracy prior to FNOL (First Notice of Loss) submission, manage claim status changes in the Admin Portal, and maintain consolidated claims reporting.
Bestow is a leading vertical technology platform serving some of the largest and most innovative life insurers, unifying the fragmented, legacy value chain. They are backed by leading investors and trusted by major carriers, focusing on speed, powered by AI and automation.
Build relationships and partnerships with key business stakeholders, staying current on their needs, challenges and strategies.
Gather, synthesize, and analyze complex data to recognize trends and extract insights across the business to support informed decisions.
Define operational support requirements and inputs by working with system solution owners and implementation teams to understand workflow strategic design and processes.
Ryan Specialty provides innovative solutions for insurance brokers, agents, and carriers. It is home to some of the brightest talent in the insurance industry and a multi-time winner of Newsweek’s Most Loved Workplaces and Insurance Business’s Top Insurance Employers.