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Work Life Balance

Patient Accounts Specialist - REMOTE

Ohio's Hospice Columbus, OH

Job Description Job Description What You Should Know About the Patient Accounts Specialist Role: This is a full time remote position but MUST live within the state of Ohio. Schedule will include Monday - Friday with hours of 8:00am - 5:00pm. This position requires previous medical billing experience and physician billing experience is a plus The Patient Accounts Specialist Essential Duties Are: The purpose of this position is to bill all insurance plans within timely filing requirements, collection of all outstanding account receivables, report all spend downs to Medicaid, submission notice of elections ensuring timely payment, collections and follow up. Patient Accounts Specialist Qualifications: Preferred associate's degree (A. A.) or equivalent from two-year college or technical school (or); Two years related experience and/or training; or equivalent combination of education and experience Understanding of basic math skills to calculate figures and amounts such as discounts, interest, commissions, and percentages Maintain knowledge of all federal and state regulations, timely filing restrictions of all insurance plans Knowledge of insurance terminology to resolve billing issues and coordination of benefits Benefits & Perks: Competitive Pay (we actually mean it!) Competitive Health, Dental, and Vision Insurance Short- & Long-Term Disability Life Insurance Paid Time Off Matching Retirement Plans Tuition Reimbursement Organizational preceptor to assist with orientation and ongoing education Educational programs geared toward career advancement Career growth And much, much, more! Ohio’s Hospice offers opportunity, advancement and a great foundation for growth to energetic people looking to serve our mission. Those who join our team are committed to providing superior care and service so our patients and their families can celebrate life. We provide our staff members with the resources and support to contribute and make a difference in the lives of patients and families every day. Come join a group of people that are wildly passionate about taking care of our patients and each other! As a member of our team, you'll have a chance to impact many lives. You may find a deeper meaning in your work or rediscover why you chose your profession in the first place. The passion you may have been missing in previous workplaces can be found at Ohio's Hospice of Dayton. Ohio’s Hospice complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Ohio’s Hospice is proud to be platinum certified through SAGECare, which provides training and consulting on LGBT aging issues to service providers. Ohio’s Hospice welcomes those in the LGBT community to join our team.

Dynamic Environment

Licensed Advocate-Remote OH

Origin8Cares Columbus, OH

Job Description Job Description Salary: 25$ Advocate Job Description You are a licensed insurance agent, and you want to make a good living helping people protect their families through life insurance. They need you. We need you. Lets do this! What is an Origin8 Advocate? Not a traditional insurance agent, thats what. Talking about death is uncomfortable, and life insurance applications can be complicated. An Origin8 Advocate explains life insurance to a prospective customer using simple, human language. They explore the customer's unique needs, deliver a personalized solution, and get them protected right away. The Best Part If you love problem-solving, efficiency and selling but cant stand hunting for your next lead, this is the place for you. We will generate and supply the leads for you. In fact, well give you access to 100 leads each week. Your focus will be on the important task of getting them protected. At a Glance We want you to make a good living. You are not 100% commissioned because we pay you for working to protect every customer. Plus, get an additional bonus monthly for your protections. This job is fully remote, so you can work from the comfort of your home office and say goodbye to commuting. Work a minimum of 30 hours a week with the ability to work more if you want. You get to set your schedule every two weeks. Then youll just need to follow it. Well help you get appointed in additional states beyond your current license (NPN required). After a successful three-week training program, youll be all set to go. Grow with a group of diverse colleagues in a safe space. Join us on the ride as the company continues to grow to the moon! Our goal is for Advocates to make as much as $70,000 a year if you work 40 hours a week. Getting you there is simple: Access, at least, 125 prospective customers per week using the Origin8 platform. The application journey is designed to be about 30 minutes. Discover their needs, present the solution, and get them protected. Get compensated based on how far you progress in the conversation. Plus, get a monthly protection reward based on the customers you protect! Advocates Are Proficient In: Communication: Excellent verbal and written communication skills, able to explain complex insurance concepts in simple terms. Empathy: Genuinely cares about clients' needs and builds strong relationships based on trust and mutual respect. Negotiation: Skilled in negotiating terms and conditions to find win-win solutions for both the client and the company. Prerequisite & Application Details You should apply if... You are passionate about making a positive impact on families. You have a proven track record of success in selling. You achieve your goals, even exceed them. You love problem-solving and view objections as a fun challenge and a natural part of the sales process. Working with a mentor to accelerate your growth excites you. Working in an innovative company is exhilarating because it provides access to cutting-edge tools and the chance to explore and adopt the latest technologies. You are independent and responsible. You follow through on your commitments. You thrive in a remote work environment, demonstrating self-discipline and drive to maintain focus and productivity. You have access to reliable home Wi-Fi and you are comfortable with technology (proficient with CRM systems, online meeting tools, and carrier systems). You are a licensed agent. And if youre not a licensed agent but want to become an Advocate, contact us. We can help. ChatGPT (plus Beth edit) Advocate Job Description Are you a licensed insurance agent passionate about helping families secure their futures? Great! Lets be honest, the toughest part of the job is getting sales leads. At Origin8, we provide warm leads so you can focus on helping people get insured. Together, we can make a difference! What is an Origin8 Advocate? An Origin8 Advocate is not your typical insurance agent. We understand that discussing life insurance can be uncomfortable and that the application process can be overwhelming. As an Advocate, you will simplify this experience for leads by using clear, relatable language (not insurance jargon!). You will explore their unique needs, provide personalized solutions, and help them secure the protection they need, without the stress. Why Join Us? If you thrive on problem-solving, efficiency, and sales but dislike the constant search for leads, you've found your ideal position. At Origin8, we generate and provide you with 100 leads each week , allowing you to concentrate on what truly matters: protecting customers . Key Benefits: Earning Potential : We want you to succeed! Our compensation structure means youre not 100% commission-based; youll earn a base salary while receiving bonuses for each customer you protect. Flexibility : Work remotely from the comfort of your home office. Say goodbye to long commutes! Set your schedule every two weeks, with a minimum commitment of 30 hours per week . You have the option to work more if desired. Supportive Environment : Join a diverse team that fosters growth and innovation. We will help you get appointed in additional states beyond your current license (NPN required) after completing our comprehensive three-week training program. Financial Goals: We aim for our Advocates to earn up to $70,000 annually when working 40 hours per week. Here's how to achieve that: Access at least 100 prospective customers per week through the Origin8 platform. Complete the application journey, designed to take about 30 minutes , by understanding customer needs, presenting solutions, and ensuring they are protected. Earn compensation based on your progress in customer conversations, plus receive a monthly protection reward for each customer you assist! Ideal Attributes: Our Advocates excel in the following areas: Communication : Exceptional verbal and written skills, with the ability to simplify complex insurance concepts for clients. Empathy : A genuine desire to understand clients needs, fostering strong relationships built on trust and respect. Negotiation : Proficient in negotiating terms to create mutually beneficial solutions for clients and the company. Who Should Apply: We encourage you to apply if you: Are passionate about positively impacting families lives. Have a proven track record in sales and consistently meet or exceed your goals. View objections as opportunities for problem-solving and enjoy the challenge of the sales process. Are excited about working with a mentor to accelerate your growth. Thrive in an innovative environment that provides access to cutting-edge tools and technologies. Are self-motivated and responsible, committed to following through on your obligations. Are comfortable working remotely, demonstrating focus and productivity. Have reliable home Wi-Fi and are proficient with technology, including CRM systems and online meeting tools. Are a licensed insurance agent. If you're not yet licensed but are interested in becoming an Advocate, reach out to uswe can help! Join us on this exciting journey as we continue to grow and make a difference in the lives of families across the nation. Lets protect what matters most, together! remote work

High salary

Patient Advocate

Acadia Healthcare Columbus, OH

Patient Advocate Job Duties: Patient AdvocacyActs as the Patient Advocate for the hospital, providing timely logging, investigation, and closure of patient complaints and grievances.Assis with planning and implementation of quality improvement initiatives.ProjectsAssist with planning and implementation of quality improvement initiatives.OtherMay assist in training employees in compliance, risk, or quality subjects.May provide assistance in reviewing compliance opportunities and monitoring progress and deadlines.May serve as a liaison for designated compliance and quality improvement initiatives.May assist with the investigation of incidents.Perform other duties and responsibilities associated with position as needed. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Patient Care Advocate

Serenity Healthcare Columbus, OH

PCA (Patient Care Advocate) Serenity Healthcare is seeking a Patient Care Advocate to add to our team of clinical support staff that will help guide our patients in taking back their lives. As a Patient Care Advocate, you are the catalyst for helping patients qualify for interventional treatments and helping them understand the benefits of Serenity’s treatment options. An ideal candidate will have experience with direct customer service and thrive in a positive, results-driven atmosphere. Trigger Warning :Working with suicidal patients, listening to trauma from PTSD patients, and having the responsibility to support these patients may be triggering for some people. Benefits Shortened work week (13-hours shifts) PTO and paid Holidays Medical, Dental, & Vision Insurance (We take care of 90% of your cost!) Career Advancement Opportunity to make a difference What You’ll Do Act as a liaison between patients and their providers. Deliver a stellar face-to-face patient experience at our clinics. Assist patients in understanding their treatment options. Consult with members to gather pertinent information regarding current symptoms, mental health status, and medication history. What We are Looking For High School Diploma or GED At least 2+ years of full-time work experience in a service-oriented role. Strong interpersonal and communication skills Excellent problem-solving and critical thinking abilities. About We have helped thousands of patients take back their lives with specialized clinical expertise and the foremost cutting-edge technology available in healthcare today. Serenity’s approach to treating patients is to offer alternative options and treat the whole person by providing an atmosphere of positivity, support, and healing in an outpatient setting. We believe people should live their best lives, and mental health is a substantial segment of total well-being. Learn More About Us About Serenity Healthcare Serenity’s Provided Services Meet our Patients *This position is contingent on successfully completing a criminal background check upon hire. In accordance with Colorado's EqualPay for Equal Work Act this position pays $22/hour. #J-18808-Ljbffr

Patient Account Representative-Collections (REMOTE)

St. Francis-Emory Healthcare Columbus, GA

Description We have an exciting opportunity to join our Revenue Cycle team as Patient Account Representative II - Collections . This is a remote position supporting two of ScionHealth's facilities. The Patient Account Representative II - Collections prioritizes and completes A/R collections in accordance with departmental policies and procedures within established deadlines for hospital and/or physician claims. Update and document financial data, utilizing excellent customer service skills to contact patients and insurance carriers to ensure accurate reimbursement. Must have computer skills with basic knowledge of Microsoft Word, Microsoft Excel, and Microsoft Outlook. Basic knowledge of general accounting/bookkeeping skills. Adheres to policies, procedures, and regulations to ensure compliance and patient safety. Examples of Responsibilities: Responsible for working A/R collection opportunities on unpaid claims through provided work queues. Maintains required levels of productivity and quality while managing tasks to ensure timeliness of analytic report resolution. Uses identified and known resources to accomplish collection-related tasks, including but not limited to payor websites, provider service lines, analytics, and correspondence. Based on aging thresholds, obtains the status of claim payment, payment amount, and date of payment from the insurance company (government or managed). Works to identify payment resolution when an insurance company does not provide payment information for a claim (this may include steps such as working with billing, coding, cash or other areas to resolve). Responsible for escalating problem claims to management with a clear explanation of the problem, if multiple claims are impacted and possible resolution. Responsible for voiding invalid claims through the payer portal, uploading to a payor portal mailing requested documentation (such as medical records or itemized bills), researching the payor provider manual or other steps to move the claim forward to payment status. Responsible for filing an appeal according to department protocols and guidelines. Responsible for filing reconsideration requests for insurance contractual underpayments. Responsible for reviewing and submitting notifications of overpayments (patient or insurance) according to department protocols and guidelines. Participates in A/R clean-up projects or other projects identified. Takes ownership of assignments; and other duties as assigned or requested. Communicates and listens effectively with internal and external customers; effectively understands instructions and shares knowledge. Cooperates and interacts with supervisors, peers, other departments, and all customer groups demonstrating our commitment to service. Provides training to new or existing staff as directed by leadership, when necessary. Works to identify the root cause of claim denials, underpayments, and overpayments to help improve efficiencies and expedite cash on future claims. Demonstrates leadership qualities and initiative amongst peers and coworkers. Other duties as assigned. Starts at 16.34/hr Qualifications Education and Experience: · High School Diploma or GED Equivalent (required) · One or more of the following systems or applications: Epic, SSI, Microsoft Excel, and Microsoft Word (preferred) · Two (2) years of previous hospital and/or physician business office experience (preferred) Knowledge/Skills/Abilities: · Ability to communicate effectively verbal and written. · Ability to work independently. · General Accounting and bookkeeping skills. · Strong customer service and interpersonal skills. · Knowledge of medical billing and medical terminology. #J-18808-Ljbffr

Patient Account Representative-Collections (REMOTE)

Nrharural Columbus, GA

Description We have an exciting opportunity to join our Revenue Cycle team as Patient Account Representative II - Collections . This is a remote position supporting two of ScionHealth's facilities. The Patient Account Representative II - Collections prioritizes and completes A/R collections in accordance with departmental policies and procedures within established deadlines for hospital and/or physician claims. Update and document financial data, utilizing excellent customer service skills to contact patients and insurance carriers to ensure accurate reimbursement. Must have computer skills with basic knowledge of Microsoft Word, Microsoft Excel, and Microsoft Outlook. Basic knowledge of general accounting/bookkeeping skills. Adheres to policies, procedures, and regulations to ensure compliance and patient safety. Examples of Responsibilities: Responsible for working A/R collection opportunities on unpaid claims through provided work queues. Maintains required levels of productivity and quality while managing tasks to ensure timeliness of analytic report resolution. Uses identified and known resources to accomplish collection-related tasks, including but not limited to payor websites, provider service lines, analytics, and correspondence. Based on aging thresholds, obtains the status of claim payment, payment amount, and date of payment from the insurance company (government or managed). Works to identify payment resolution when an insurance company does not provide payment information for a claim (this may include steps such as working with billing, coding, cash or other areas to resolve). Responsible for escalating problem claims to management with a clear explanation of the problem, if multiple claims are impacted and possible resolution. Responsible for voiding invalid claims through the payer portal, uploading to a payor portal mailing requested documentation (such as medical records or itemized bills), researching the payor provider manual or other steps to move the claim forward to payment status. Responsible for filing an appeal according to department protocols and guidelines. Responsible for filing reconsideration requests for insurance contractual underpayments. Responsible for reviewing and submitting notifications of overpayments (patient or insurance) according to department protocols and guidelines. Participates in A/R clean-up projects or other projects identified. Takes ownership of assignments; and other duties as assigned or requested. Communicates and listens effectively with internal and external customers; effectively understands instructions and shares knowledge. Cooperates and interacts with supervisors, peers, other departments, and all customer groups demonstrating our commitment to service. Provides training to new or existing staff as directed by leadership, when necessary. Works to identify the root cause of claim denials, underpayments, and overpayments to help improve efficiencies and expedite cash on future claims. Demonstrates leadership qualities and initiative amongst peers and coworkers. Other duties as assigned. Starts at 16.34/hr Qualifications Education and Experience: High School Diploma or GED Equivalent (required) One or more of the following systems or applications: Epic, SSI, Microsoft Excel, and Microsoft Word (preferred) Two (2) years of previous hospital and/or physician business office experience (preferred) Knowledge/Skills/Abilities: Ability to communicate effectively verbal and written. Ability to work independently. General Accounting and bookkeeping skills. Strong customer service and interpersonal skills. Knowledge of medical billing and medical terminology. #J-18808-Ljbffr

Work Life Balance

Patient Care Representative remote hybrid onsite

KeyBridge Medical Revenue Care Columbus, OH

About Us We are seeking intelligent individuals with diverse backgrounds — people, who like to ask questions, solve problems and find better ways to do things. At KeyBridge, we believe we're only as good as our reputation; after all, we are a respected leader in our industry and 16-time winner of Best Places to Work awards! We want you to like where you work, too. And, if you join KeyBridge, we think you will. Here are just a few of the perks: Business casual work environment Profit sharing and 401k with employer contributions Health, prescription, vision and life insurance Vacation and paid time-off Culture of caring for our employees, our clients and their patients while having fun along the way Promoting team-building with fun; annual family picnic, holiday party, interactive games, luncheon carry-in and even an amusing Halloween costume contest On-site fitness center Wellness initiatives that have included fresh fruit and veggie Wednesdays, walking & hydration challenges, smoking cessation and even a visiting massage therapist. Position Summary: Patient Care Representatives work for our state-of-the-art call center in Lima, OH, representing hospitals and healthcare providers while caring for their patients by processing payments and assisting them to resolve their patient account balances. We offer a team-driven work experience with flexible scheduling and monthly performance-based bonus plan. Spanish-speaking and previous medical billing experience are both a plus. We want the best and brightest to join our family. If you are great with people, organized, detail-oriented, possess a positive attitude & drive to be successful; we want to hear from you! Other perks to expect are: Flexible scheduling 125 hours of on-the-job training Monthly performance-based bonus plan Team-driven work experience, where together we can grow to our full potential We are hiring full-time Patient Care Representatives. Our employees have the ability to work in our home office or work from home. Team members located within a 45 mile radius of our home office are requested to work on site one day per week. Qualifications Ability to understand and communicate with patients to assist them in resolving their patient account balances Basic keyboarding and the ability to learn & navigate our proprietary software Good listening & communication skills to successfully assist patients on the phone Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form Write simple correspondence and effectively present information in one-on-one communications with responsible parties, clients, and other employees of the organization Ability to pass the ACA certification tests when you become eligible Ability to multi-task at a high level Ability to understand and communicate with Spanish-speaking patients is a plus Previous experience with medical insurance billing is a plus #J-18808-Ljbffr

High salary

Patient Care Representative (remote, hybrid, on-site)

KeyBridge Medical Revenue Care Columbus, OH

About Us We are seeking intelligent individuals with diverse backgrounds — people who like to ask questions, solve problems, and find better ways to do things. At KeyBridge, we believe we’re only as good as our reputation; after all, we are a respected leader in our industry and 17-time winner of Best Places to Work awards! We want you to like where you work, too. Here are just a few of the perks: Business casual work environment Profit sharing and 401k with employer contributions Health, prescription, vision, and life insurance Vacation and paid time-off Culture of caring for our employees, our clients, and their patients while having fun along the way Promoting team-building with fun; annual family picnic, holiday party, interactive games, luncheon carry-in, and even an amusing Halloween costume contest On-site fitness center Wellness initiatives that have included fresh fruit and veggie Wednesdays, walking & hydration challenges, smoking cessation, and even a visiting massage therapist. Position Summary: Patient Care Representatives work for our state-of-the-art call center in Lima, OH, representing hospitals and healthcare providers while caring for their patients by processing payments and assisting them in resolving their patient account balances. We offer a team-driven work experience with flexible scheduling and a monthly performance-based bonus plan. Spanish-speaking and previous medical billing experience are both a plus. We want the best and brightest to join our family. If you are great with people, organized, detail-oriented, and possess a positive attitude & drive to be successful; we want to hear from you! Other perks to expect are: Flexible scheduling 125 hours of on-the-job training Monthly performance-based bonus plan Team-driven work experience, where together we can grow to our full potential We are hiring full-time Patient Care Representatives. Our employees have the ability to work in our home office or work from home. Team members located within a 45-mile radius of our home office are requested to work on-site one day per week. Qualifications: Ability to understand and communicate with patients to assist them in resolving their patient account balances Basic keyboarding and the ability to learn & navigate our proprietary software Good listening & communication skills to successfully assist patients on the phone Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form Write simple correspondence and effectively present information in one-on-one communications with responsible parties, clients, and other employees of the organization Ability to pass the ACA certification tests when you become eligible Ability to multi-task at a high level Ability to understand and communicate with Spanish-speaking patients is a plus Previous experience with medical insurance billing is a plus #J-18808-Ljbffr

Medical Biller - Patient Support Call Center - Remote (Short-term Contract)

IQVIA LLC Columbus, OH

Medical Biller - Patient Support Call Center - Remote (Short-term Contract) As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product’s value to payers, physicians, and patients. A significant part of our business is providing patient support programs on behalf of our customers. With the right experience, you can help provide support to patients in need of available therapies. IQVIA has the world’s largest Commercial Sales & Medical Solutions (CSMS) organization dedicated to the launch and marketing of pharmaceutical and medical products. With a focus on providing talent for patient support, field/inside sales, medical device support, clinical support, and medical affairs, our CSMS division has 10,000+ field professionals in more than 30 countries addressing physician and patient needs. We are excited to announce that currently we are looking for a 100% remote (work from home—WFH) contact Patient Support Medical Claims Processing Representative to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The Patient Support Call Center Representative is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific business rules to determine if the claim should be paid or rejected. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee. Job Responsibilities: Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate supporting documentation has been provided, interpreting the EOB/CMS1500, vetting the claim against program specific business rules, and ultimately determining if the claim should be paid or rejected. Exceptional organizational skills are required. May provide support as needed for customer requests via telephone, email, fax, or other available means of contact to the Support Center. Requires the ability to recognize operational challenges and suggest recommendations to management, as necessary. Ability to work 40 hours per week (two shifts: 8:30 am EST – 5:30 pm EST or 11:00 am EST – 8:00 pm EST) under moderate supervision. Minimum Education & Experience: High School Diploma or equivalent. Experience in claim processing required. Medical Billing and Coding Certification required. Ability to interpret Explanation of Benefits (EOB). HIPAA certified. Customer Service Experience preferred. Pharmacy Technician experience preferred. IQVIA is an Equal Opportunity Employer. We cultivate a diverse corporate culture across the 100+ countries where we operate, celebrating and rewarding teamwork and inclusiveness. By embracing our differences, we create innovative solutions that are good for IQVIA, our clients, and the advancement of healthcare everywhere. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee. The pay range for this role is $23.00 per hour. #J-18808-Ljbffr

Patient Care Representative remote hybrid onsite

KeyBridge Medical Revenue Care Columbus, OH

About Us We are seeking intelligent individuals with diverse backgrounds — people, who like to ask questions, solve problems and find better ways to do things. At KeyBridge, we believe we're only as good as our reputation; after all, we are a respected leader in our industry and 16-time winner of Best Places to Work awards! We want you to like where you work, too. And, if you join KeyBridge, we think you will. Here are just a few of the perks: Business casual work environment Profit sharing and 401k with employer contributions Health, prescription, vision and life insurance Vacation and paid time-off Culture of caring for our employees, our clients and their patients while having fun along the way Promoting team-building with fun; annual family picnic, holiday party, interactive games, luncheon carry-in and even an amusing Halloween costume contest On-site fitness center Wellness initiatives that have included fresh fruit and veggie Wednesdays, walking & hydration challenges, smoking cessation and even a visiting massage therapist. Position Summary: Patient Care Representatives work for our state-of-the-art call center in Lima, OH, representing hospitals and healthcare providers while caring for their patients by processing payments and assisting them to resolve their patient account balances. We offer a team-driven work experience with flexible scheduling and monthly performance-based bonus plan. Spanish-speaking and previous medical billing experience are both a plus. We want the best and brightest to join our family. If you are great with people, organized, detail-oriented, possess a positive attitude & drive to be successful; we want to hear from you! Other perks to expect are: Flexible scheduling 125 hours of on-the-job training Monthly performance-based bonus plan Team-driven work experience, where together we can grow to our full potential We are hiring full-time Patient Care Representatives. Our employees have the ability to work in our home office or work from home. Team members located within a 45 mile radius of our home office are requested to work on site one day per week. Qualifications Ability to understand and communicate with patients to assist them in resolving their patient account balances Basic keyboarding and the ability to learn & navigate our proprietary software Good listening & communication skills to successfully assist patients on the phone Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form Write simple correspondence and effectively present information in one-on-one communications with responsible parties, clients, and other employees of the organization Ability to pass the ACA certification tests when you become eligible Ability to multi-task at a high level Ability to understand and communicate with Spanish-speaking patients is a plus Previous experience with medical insurance billing is a plus

Immediate Start

Remote Inpatient Denials and Appeals Nurse

Aspirion Health Resources LLC Columbus, GA

What is Aspirion? For over two decades, Aspirion has delivered market-leading revenue cycle services. We specialize in collecting challenging payments from third-party payers, focusing on complex denials, aged accounts receivables, motor vehicle accident, workers’ compensation, Veterans Affairs, and out-of-state Medicaid. At the core of our success is our highly valued team of over 1,400 teammates as reflected in one of our core guiding principles, “Our teammates are the foundation of our success.” United by a shared commitment to client excellence, we focus on achieving outstanding outcomes for our clients, aiming to consistently provide the highest revenue yield in the shortest possible time. We are committed to creating a results-oriented work environment that is both challenging and rewarding, fostering flexibility, and encouraging personal and professional growth. Joining Aspirion means becoming a part of an industry leading team, where you will have the opportunity to engage with innovative technology, collaborate with a diverse and talented team, and contribute to the success of our hospital and health system partners. Aspirion maintains a strong partnership with Linden Capital Partners, serving as our trusted private equity sponsor. What do we need? We are seeking a compassionate and proficient Clinical Denials and Appeals Nurse to join our growing team of professionals. The Clinical/Utilization Review Nurse advocates for reimbursement for services provided by the hospital through their review and analysis of complex medical issues. Accountable for carrying a queue of assigned accounts. Review and analyze medical records to formulate complex clinical arguments. Support Operations and Client Management by providing feedback on medical trends, issues, and denials. What will you provide? Manages complex and robust queue according to Aspirion and client needs. Queue size varies weekly. Reviews insurance denials, including but not limited to, medical necessity denials, patient status denials (i.e., Inpatient vs. Outpatient Observation), level of care denials (i.e., bed type), length of stay denials (including stays over a month long), readmission denials, experimental denials, clinical validation denials, and/or authorization denials. Reviews and utilizes clinical criteria, including but not limited to, InterQual, Milliman Care Guidelines (“MCG”), UpToDate, Medicare Policies, and State Specific Clinical Criteria. Drafts clinical summaries, including but not limited to, arguing against an insurance denial, confirming an insurance denial, or reviewing a clinical determination. When performing clinical reviews, monitors hours expended on a single account to ensure the time invested is commensurate with the account’s potential reimbursement and check in with Managing Attorney when time expended exceeds average hours for type of review Identifies and tracks common trends and issues for reporting to the clients. Collaborates with Aspirion attorneys via in person meetings, phone, and/or email. Attends Clinical Team Meetings, All Company Meetings, Education Opportunities, Trainings, and other potential meetings Requirements Proficient with Word, Excel, PowerPoint, Outlook, Zoom, Microsoft Teams Analytical skills and the ability to make appropriate decisions independently Problem solver with the ability to identify issues, provide feedback and follow-up to resolution Work independently in a rapidly changed and growth-oriented environment with regularly changing priorities Prioritize assignments to complete work in a timely manner, adjusting quickly as circumstances dictate Efficient at handling and prioritizing multiple tasks and projects in a time-sensitive environment Maintains strict confidentiality of protected medical information and adherence to all HIPAA and Aspirion policies and regulations Must possess interest in healthcare and medical insurance claims Education and Experience Requires an AS/BS in nursing. Minimum of one (1) year of clinical experience with an understanding of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license required. Preferred experience with Utilization Review, Health Insurance Denials and Appeals, Payer Audits, or Case Management. Familiarity with Millman and InterQual guidelines preferred. Benefits At Aspirion we invest in our employees by offering unlimited opportunities for advancement, a full benefits package, including health, dental, vision and life insurance upon hire, matching 401k, competitive salaries, and incentive programs. The US base pay range for this position starts at $68,000 annually. Individual pay is determined by a number of factors including: job-related skills, experience, education, training, etc., and, where applicable, licensure or certifications obtained. Market and organizational factors are also considered. In addition to base salary a competitive benefits package is offered. AAP/EEO Statement Equal Opportunity Employer/Drug-Free Workplace: Aspirion is an Equal Employment Opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, age, sex, pregnancy, religion, national origin, ancestry, medical condition, marital status, gender identity citizenship status, veteran status, disability, or veteran status. Aspirion has a Drug-Free Workplace Policy in effect that is strictly adhered to. #J-18808-Ljbffr

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