This is a full‑time remote position working from home anywhere in the US, managing PAR Provider Post Service payment disputes and appeals for Medicare.
Locations (2)
Hartford, Connecticut, United States
United States
Compensation
The typical pay range for this role is: $66,575.00 - $142,576.00
Responsibilities
Request and research submitted provider clinical information to support case review and determination processes.
Review documentation to identify relevant clinical details and apply CMS guidelines, regulatory requirements, and applicable supplemental policies.
Based on clinical review findings, prepare a comprehensive nurse summary for medical director evaluation or finalize appeal determinations in accordance with pre‑approved workflows.
Navigate and manage multiple computer systems and applications to ensure timely, accurate, and compliant processing of cases.
Work independently with a high degree of self‑motivation while contributing to teamwork and collaboration in a virtual environment.
Answers incoming phone calls, responds to inquiries, and directs calls appropriately.
Welcomes patients; updates, verifies, and enters patient demographics, insurance, and billing information and processes forms into appropriate systems.
Registers patients for services, ensures accuracy, facilitates timely discharge, and maximizes reimbursement.
Ensures all financial assessments, eligibility, and benefits memos are clear, updated, and thorough to support post-care financial needs.
Maintains a working relationship with clinical partners to ensure open communication between clinical, ancillary, and patient access departments, enhancing patient experiences.
Requirements
High School Graduate or Equivalent
Associate's Degree in Health Services Administration or other related medical or business field
Nice to have: Certified Healthcare Access Associate (CHAA)
The Referral and Insurance Specialist obtains authorizations from insurance companies for referrals to physicians and/or procedures/testing, verifies eligibility/coverage, schedules appointments, enters charge information, posts payments, and assists patients with billing questions.
Compensation
Minimum: $18.11 Maximum: $27.17
Responsibilities
Obtains authorizations from insurance companies for referrals to physicians/medical facilities and/or procedures/testing
Schedules appointments for testing at medical facilities or appointments with physicians
Verifies eligibility/coverage for referral/testing via phone/fax/Internet
Investigates billing problems and denials
Notifies patients of referral process whether authorized or denied in a timely manner
Responsible for executing receiving and merchandising standards while ensuring Associates are processing efficiently and effectively, and working as a team.
Compensation
This position has a starting pay range of USD $16.75 to $17.25 per hour.
Responsibilities
Executing receiving and merchandising standards
Ensuring Associates process efficiently and effectively
Maintaining a clean and organized store
Promoting a culture of honesty and integrity
Orchestrating truck delivery and processing merchandise onto the sales floor
Actuarial Associate / Sr Actuarial Associate in the Actuarial Development Program (ADP) focusing on data analytics, modeling, and regulatory reporting.
Compensation
Total Compensation Range: $79,200 - $170,700 (inclusive of Base and Bonus). Compensation is commensurate with number of exams passed.
Responsibilities
Acquire, aggregate, and develop data for experience studies
Assess client information to construct mortality, lapse, and pricing assumptions
Develop financial projections using modeling software
Develop, maintain, and run models for profit testing, reserving, and economic capital
Validate, format, and present results
Requirements
Bachelor's degree from an accredited college or university
Design, develop, evaluate, and modify end-to-end systems and system-oriented products through their entire life cycle, ensuring compliance with client and government standards.
Compensation
$112,000 - $179,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual’s experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.
Responsibilities
Designs, develops, evaluates, and modifies end-to-end systems and system-oriented products
Generates quantifiable requirements based on customer description, system planning and design, and acquisition logistics
Ensures requirements comply with client requirements and government standards through formal verification methods
Translates high level product development strategies into system requirement specifications
Establishes and coordinates development of standards, practices, and procedures
Requirements
Bachelor's degree
Master's degree
Nice to have: Basic coding skills in Python or Java
Nice to have: Experience with automation pipelines
Nice to have: Familiarity with U.S. Government information sharing frameworks, policies, and interoperability requirements
Junior Project Manager or Project Coordinator responsible for managing cross-organizational software development projects from initiation through delivery.
Compensation
Pay: $40/hr-$50/hr on w2
Responsibilities
Develop and report on metrics for engineering development
Manage cross-organizational software development projects
Lead and influence program timelines
Ensure delivery quality and code standards
Requirements
Bachelor’s degree in computer science or a related field
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