The Claims and Eligibility Specialist supports the Arizona Refugee Resettlement Program (RRP) by processing medical, dental, and vision claims and determining eligibility for Refugee Medical Assistance (RMA) benefits.
Responsibilities
Process and adjudicate medical, dental, and vision claims using CMS-1500, UB-04, and ADA Dental claim forms
Review benefit eligibility and process prior authorization and dental pre-treatment estimate requests
Enter and verify high volumes of claims data from paper documents into electronic systems
Research complex claims, review payment history for duplicates, identify third-party liability, and obtain missing documentation
Request medical records, consent forms, explanations of benefits, and other supporting information from providers
English-fluent Scheduler based in Latin America, responsible for creating, assigning, and managing client visits in WellSky for skilled nursing, therapy, and aide staff.
Compensation
The salary range offered for this position varies from (USD) $1,000 - $1,500 per month, depending on seniority and skillset.
Responsibilities
Create, assign, and manage all client visits in WellSky
Build and maintain accurate visit schedules for skilled nursing, therapy, and aide staff
Enter and update visit authorizations based on payer source
Process physician orders tied to visit frequency and duration within WellSky
Monitor the scheduling dashboard daily for unscheduled, missed, or conflicting visits
Requirements
High school diploma or GED
Associate's degree in Healthcare Administration, Business Administration, or a related field (preferred)
Lead clinical operations, support business development, and serve as Deputy Administrator and backup Administrator of Record for a home care agency in South Florida.
Compensation
Base Salary: Competitive and commensurate with qualifications; range discussed during screening.
Performance Bonus: Based on clinical quality, census growth, and referral development.
Responsibilities
Supervise field caregivers, CNAs, and home health aides across Broward and Palm Beach counties
Conduct and oversee client assessments, care plans, supervisory visits, and ongoing clinical evaluations
Ensure accurate, timely WellSky documentation and compliance with AHCA and CHAP standards
Lead quality assurance, incident investigations, infection control, grievance resolution, and QAPI initiatives
Serve as Deputy Administrator and designated backup Administrator of Record
This unique role combines administrative duties with hands-on caregiving support, managing office operations, scheduling, and providing direct care support to clients when needed.
Responsibilities
Manage office operations, scheduling, and caregiver coordination
Provide direct care support to clients when needed
Utilize care management platforms (WellSky and/or ClearCare) to document and track services
Assist with caregiver onboarding, compliance, and HR documentation
Support billing, payroll, and client service requests as needed
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