Trabajos work from home medical coding en Atlanta, GeorgiaCrear alertas

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Nurse Practitioner, Advanced Practice Provider Company: Oak Street Health Role Description: The purpose of a Nurse Practitioner at Oak Street Health is to provide effective and equitable value-based primary care to adults on medicare to keep them happy, healthy, and out of the hospital. Nurse Practitioners see patients independently and collaborate with physicians, depending on the patient’s specific situation. Nurse Practitioners provide longitudinal care and build meaningful patient relationships; this creates trust and helps our patients understand and feel connected to their care plan. Nurse Practitioners practice in our outpatient practices on a collaborative care team composed of a physician, nurse practitioner or physician assistant, medical assistants, a dedicated medical scribe, and support from registered nurses and care managers. We partner with a network of elite specialists and hospitals for specialty and acute care. As such, our healthcare providers can focus on care within the clinic: primary care, care coordination, and population health. Core Responsibilities: • Provision of exceptional primary care., • Conduct office visits for routine and acute issues., • Administer Annual wellness visits and health risk assessments, which require a holistic view of health and a focus on thoughtful, accurate, and specific documentation., • Care coordination with other providers, specialists, testing facilities, and agencies., • Population health leadership, in coordination with the Care Team (e.g., making sure all eligible females get their evidence-based breast cancer screening every 2 years), • Assisting the care team with phone triage and outreach., • Educating patients on their health conditions, care plans, and treatments., • Participating in Oak Street Health promotional activities., • Conducting home visits as needed. Required Qualifications: • Master of Science in Nursing, Doctor of Nursing Practice, or NP Certificate Program graduate, • National certification in at least one of the following specialties:, • Family Nurse Practitioner, • Adult-Gerontology Primary Care Nurse Practitioner, • Adult Nurse Practitioner, • Gerontological Nurse Practitioner, • Active, non-probationary state Nurse Practitioner license, • Active DEA license, • Experience in primary care: internal medicine, geriatrics, or family medicine, • Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International Classification of Diseases-10) Coding, and Health Risk Assessments (HRAs)., • Passion for teamwork and the opportunity to collaborate cross-functionally, • Desires to be a part of an innovative model focused on empirically-guided population health, • Bilingual proficiency in applicable areas Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $87,035.00 - $187,460.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: * Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. * No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. * Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ___ We anticipate the application window for this opening will close on: 12/31/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Credit Acceptance is proud to be an award-winning company with local and national workplace recognition in multiple categories! Our world-class culture is shaped by dedicated Team Members who share a drive to succeed as professionals and together as a company. A great product, amazing people and our stable financial history have made us one of the largest used car finance companies nationally. Our Engineering and Analytics Team Members utilize the latest technology to develop, monitor, and maintain complex practices that help optimize our success. Our Team Members value being challenged, are encouraged to express their ideas, and have the flexibility to enjoy work life balance. We build intrinsic value by partnering with all functions of our business to support their success and make strategic business decisions. We focus on professional development and continuous improvement while enjoying a casual work environment and Great Place to Work culture! We are seeking a highly motivated and experienced Leader of ML and AI Engineering within the AI team. The ideal candidate will have a strong technical background in decision science, machine learning, and generative AI with a proven track record in solving business problems and implementing large-scale automated solutions in partnership with the respective engineering teams. The leader will partner with business and engineering stakeholders to formulate the vision to achieve the company’s strategic goals and co-lead the roadmap to deliver innovative solutions for dealers, consumers, and team members. As a Senior Manager, MLE at Credit Acceptance, you will play a pivotal role in the success of this mission as you will lead the development of AI-powered solutions across different business areas. This involves understanding the business processes, identifying new opportunities to add value using ML/AI algorithms, and harnessing data sources to build state-of-the-art ML/AI solutions. Outcomes and Activities: This position will work from home; occasional planned travel to an assigned Southfield, Michigan office location may be required. However, this position is permitted to work at a Southfield, Michigan office location if requested by the team member Lead the vision and the strategic execution with a strong focus on continuous and long-term value creation across all participants of our flywheel Collaborate with management and stakeholders to define strategic roadmaps and translate them into actionable quarterly plans. Drive execution and delivery of ML/AI solutions by managing priorities, deadlines, and deliverables, leveraging your technical expertise. Design and deliver scalable, secure systems using state-of-the-art AI/ML technologies and industry best practices, and nurture the culture of creating high-quality, well-tested systems to address critical product and business needs. Troubleshoot and resolve complex technical issues to improve system reliability, scalability, and operational efficiency. Ensure the security, scalability, and architectural integrity of feature designs through reviews across teams. Deliver hands-on solutions while mentoring other data professionals (including MLEs) within the organization Explore and apply advanced machine learning techniques, including large language models (LLMs), deep learning, and graph neural networks, to solve complex challenges across the organization. Guide a team of MLEs across different areas: Mentoring: Mentor team members on design principles, coding standards, and the adoption of AI productivity tools. Recommendations – Personalize guidance across different surfaces using deep learning methods; personalize layouts with Bayesian contextual multi-armed bandits Growth: Foster long-term growth through data-driven causality and incrementality Gen-AI: Power existing applications with Gen AI models and engineering to improve downstream experience and decisions Lifecycle - Using ML models (such as XGBoost & Causal Meta-Learner-based model, etc), proactively guide business teams across different areas Engineering - With engineering partners, build ML and Gen-AI platform and inference pipelines for different types of models Competencies: The following items detail how you will be successful in this role. Customer Empathy: Customer Empathy is the ability to understand the perspectives, pain points, and experiences of customers. It involves actively putting oneself in the customer’s shoes, comprehending their needs and challenges, and using that understanding to provide a better, more customer-centric experience. Engineering Excellence: Engineering Excellence is about bringing great craftsmanship and thought leadership to deliver an outstanding product that delights customers and solves for the business. This involves the pursuit and achievement of high standards, best practices, innovation, and superior solutions. One Team: A One Team mindset refers to a collaborative approach across the organization, where individuals work together seamlessly, without boundaries, as a single, cohesive team. Shared goals, open communication and mutual support create a sense of collective purpose. This enables teams to navigate challenges and pursue shared objectives more effectively. Owner’s Mindset: Owner’s Mindset involves adopting a set of behaviors that reflect a sense of responsibility, accountability, strategic thinking, and a proactive approach to managing your domain. As an owner, you understand the business and your domain(s) deeply and solve for the right outcome for the domain(s) and the business. Requirements: PhD in Computer Science, Stats, Economics, or a relevant technical field with at least 8+ years of relevant experience or MS with at least 10+ years of experience in machine learning and software engineering 8+ years of hands-on experience designing, building and deploying AI (ML, DL, Gen-AI) models, including Reinforcement Learning algorithms, Recommendation systems, Transformers, fine-tuned LLMs, Regressions, etc., with a solid understanding of mathematics, statistics, and engineering needed to build such infrastructure Hands-on expertise in scaling and maintaining production-grade ML services, with a strong focus on ML/LLM Operations (versioning, automation, observability, automated training and monitoring, etc.) and ability to balance ML model complexity with production requirements Passion for identifying new business opportunities and experience of using a test and learn approach to bring scalable and efficient solutions integrating AI algorithms, ML/LLM Ops, and s/w engineering Experience partnering with the engineering, product, business operations, legal and other teams while designing, building, and executing solutions Strong problem-solving skills with bias for action Preferred Experience in automative industry, especially in building ML/AI systems while ensuring local and central regulations Experience in model interpretability and responsible AI practices. Expertise in data science, advanced experimentation and visualization techniques. Experience in designing and implementing pipelines using DAGs (e.g., Kubeflow, DVC, Ray) Ability to construct batch and streaming microservices exposed as gRPC and/or GraphQL endpoints Experience with Databricks MLflow for ML lifecycle management and model versioning Hands-on experience with Databricks Model Serving for production ML deployments Proficiency with GenAI frameworks/tools and technologies such as Apache Airflow, Spark, Flink, Kafka/Kinesis, Snowflake, and Databricks. Demonstrable experience in parameter-efficient fine-tuning, model quantization, and quantization-aware fine-tuning of LLM models Hands-on knowledge of Chain-of-Thoughts, Tree-of-Thoughts, Graph-of-Thoughts prompting strategies Target Compensation: A competitive base salary range from $184,354 – $270,386. This position is eligible for an annual variable bonus of cash and equity, between 15-30%. Bonus amounts are based on individual performance. Final compensation within the range is influenced by many factors including role-specific skills, depth and experience level, industry background, relevant education and certifications. Candidates who reside in the following major metropolitan areas may be eligible for a premium on top of the posted range based on their specific zone: San Francisco, Seattle, Boston, New York City, Los Angeles and San Diego. #zip #LI-Remote Benefits Excellent benefits package that includes 401(K) match, adoption assistance, parental leave, tuition reimbursement, comprehensive medical/ dental/vision and many nonstandard benefits that make us a Great Place to Work Our Company Values: To be successful in this role, Team Members need to be: Positive by maintaining resiliency and focusing on solutions Respectful by collaborating and actively listening Insightful by cultivating innovation, accumulating business and role specific knowledge, demonstrating self-awareness and making quality decisions Direct by effectively communicating and conveying courage Earnest by taking accountability, applying feedback and effectively planning and priority setting Expectations: Remain compliant with our policies processes and legal guidelines All other duties as assigned Attendance as required by department Advice! We understand that your career search may look different than others. Our hiring team wants to make sure that this would be a fit not just for us, but for you long term. If you are actively looking or starting to explore new opportunities, send us your application! P.S. We have great details around our stats, success, history and more. We’re proud of our culture and are happy to share why – let’s talk! Required degrees must have been earned at institutions of Higher Education which are accredited by the Council for Higher Education Accreditation or equivalent. Credit Acceptance is dedicated to providing a safe and inclusive working environment for all. As part of our Culture of Compliance, we are proud to be an Equal Opportunity Employer and value our culturally diverse workforce. All qualified applicants will receive consideration for employment regardless of the person’s age, race, color, religion, sex, gender, sexual orientation, gender identity, national origin, veteran or disability status, criminal history, or any other legally protected characteristic. California Residents: Please click here for the California Consumer Privacy Act (CCPA) notice regarding the personal information Credit Acceptance may collect from you. Play the video below to learn more about our Company culture.

Job Description About the job We are seeking a Full-Stack Engineer to develop, architect, and be a central part in both new and existing Full-Stack applications built around React and Node with Typescript. The ideal candidate is a developer of complete applications, with specific technical knowledge in Node/React, and professional experience applying it. The candidate will work alongside other engineers as well as directly with client representatives. This is a unique opportunity to work on large-scale products alongside an experienced team that excels at building, scaling, and sustaining digital products. This position reports to a Software Development Team Lead. Qualifications Essential skills: • Extensive Node and React engineering experience with a deep understanding of the frameworks, • Experience developing with one or more modern back-end languages/frameworks (ROR/Node helpful), • Extensive Typescript engineering experience, • Excels at cross-functional collaboration and proactive communication, • Ability to establish and iterate coding standards for a team, • Familiarity with Amazon Web Services, Step Functions, Lambdas, AWS tools, and Cloud Native Architectures, • Experience developing and maintaining NPM packages, • Experience building CI/CD pipelines, • Experience developing modern applications with Node, React, and Postgres Key Responsibilities include: • Maintain coding standards to assist other engineers in achieve common tasks while sustaining a high bar for code quality, • Mature the project’s existing testing strategies to strengthen the reliability of the application, • Provide guidance on optimization strategies to build a fast and scalable application, • Educate and collaborate with other engineers on modern software development best practices, • Build reusable components and hooks to expedite feature delivery, • Languages: Typescript, HTML, SCSS, JavaScript, • Libraries: React, React Query, NodeJS, • Testing: Jest, React Testing Library, Cypress, • Has 3+ years of front-end software engineering experience with strong awareness of Full Stack architecture This position requires mandatory travel to attend two key company-wide events annually. These events are essential for our organizational goals and provide valuable opportunities for team engagement and collaboration. The company will arrange and cover all travel and accommodation expenses. Additional travel related to the role may also be required to travel. This role is based in Atlanta and requires frequent meetings with clients at their offices and in public places (typically 2 days per week, plus on-site quarterly planning 4x per year). Occasional local meetings with key team members are expected, the role is otherwise remote / work from home. Benefits • Remote role, • 401K, • Open PTO, • Subsidized Medical, Dental, and Vision Insurance, • Short/Long Term Disability, • Profit Sharing, • Referral Bonuses Bellwood is a dynamic Digital Product Development Consultancy. We're a team of developers, designers, product analysts and entrepreneurs that companies turn to when they want to take a software product from conception to creation and beyond. Our Mission Bellwood seeks to be and be known as the most trusted partner to Build and Scale software products. Our Core Values • We Embrace Your Goals, • We Own our Commitments, • We Succeed through Empathy Powered by JazzHR p5Lr0Tq5GZ

Job DescriptionThe world’s largest organizations rely on Evident to help them protect their business and brand from third-party risk. Our game-changing technology - which enables the secure exchange of risk data like proof of insurance, identity, business registration, and other information - helps our customers verify that their partners have all of the required credentials to do business. In today’s new remote-first, ever-changing regulatory environment, our secure, privacy-first enterprise platform, accessible via web portal or API, provides a highly scalable and configurable solution to manage communications, storage, decisioning, and ongoing monitoring of credentials. Evident is a VC-backed technology startup, headquartered in Atlanta, GA. Learn more at evidentid.com. We’re looking for a VP of Software Engineering to lead and scale our software engineering organization as we build ambitious SaaS products in an AI-first way. You’ll join an existing engineering team and be responsible for engineering execution, organizational effectiveness, technical direction, and the systems and practices that allow us to build and ship great software at high velocity. You’ll help shape an environment where AI is not treated as a side initiative, but as a natural part of how modern software gets built. This role is ideal for someone who combines strong technical judgment with the ability to build high-performing teams and leaders. You should be energized by the challenge of scaling both product and organization at the same time: improving execution, raising the bar on engineering quality, and building an operating model that helps the company move faster as technical and product complexity increase.Key Responsibilities • Engineering Leadership & Organizational Scale, • Lead and grow the software engineering organization, including hiring, org design, leadership development, and performance management., • Build a high-accountability, high-trust engineering culture centered on ownership, speed, quality, and customer impact., • Establish clear operating rhythms, decision-making frameworks, and delivery discipline so teams can execute effectively as the company scales., • Develop engineering managers and senior technical leaders who can extend your impact across the organization., • Technical Leadership & Product Delivery, • Own engineering execution across the product and platform, ensuring teams ship high-quality SaaS capabilities with speed, predictability, and strong operational performance., • Guide architectural decisions and technical strategy across application, platform, data, and integration layers., • Set and uphold strong engineering standards around code quality, testing, observability, reliability, security, and maintainability., • Make pragmatic technology and investment choices that balance near-term delivery, long-term scalability, and business impact., • AI-First Software Development, • Define and lead an AI-first engineering model in which AI is embedded into day-to-day software development workflows across the SDLC., • Evaluate, implement, and standardize the use of AI tools across the SDLC (e.g., coding assistants, LLM-based code review, test generation, documentation, incident analysis, developer productivity tooling)., • Design workflows where AI is “in the loop” for:, • Requirements refinement and spec drafting, • Architecture exploration and design docs, • Code generation, refactoring, and modernization, • Test case creation and regression detection, • Documentation, runbooks, and onboarding material, • Production troubleshooting and operational analysis, • Establish guidelines, best practices, and guardrails for safe and effective AI use (e.g., security, privacy, IP, data handling, quality standards)., • Measure the impact of AI-enabled workflows and scale the practices that meaningfully improve throughput, quality, and team effectiveness., • Org & Process Leadership, • Partner with product and company leadership to define how we plan, build, and ship software in an AI-first environment., • Introduce and refine processes, operating cadences, and tooling that increase throughput, improve predictability, and reduce cycle time., • Build an engineering organization that can scale without losing quality, urgency, or technical rigor., • Create mechanisms for experimentation, continuous improvement, and shared learning across engineering., • Coaching & Mentorship, • Coach engineering managers and senior technical leaders on organizational leadership, execution, and engineering quality., • Help teams evolve their workflows from basic AI-assisted development to more sophisticated use of AI in complex engineering tasks., • Provide guidance through architecture reviews, design reviews, operating reviews, and technical decision-making., • Foster an environment of high standards, strong feedback, and continuous growth., • Collaboration & Strategy, • Collaborate closely with product, design, and other stakeholders to ensure we’re solving the right problems and investing in the right technical capabilities., • Help define the roadmap for platform, developer tooling, and engineering investments that unlock greater leverage over time., • Communicate clearly with leadership about progress, risks, organizational health, and opportunities to increase engineering impact., • Must have 8+ years of professional software engineering experience, including significant leadership experience in SaaS or cloud software environments., • Proven experience leading engineering teams and organizations in a scale-up environment, where both product complexity and organizational complexity are increasing., • A track record of building and shipping sophisticated software products in a modern stack (e.g., cloud-native services, microservices/SaaS, APIs, data-heavy systems, workflow-driven platforms)., • Demonstrated experience leading organizational and technical evolution — e.g., scaling teams, improving engineering execution, platform migrations, process redesign, or adoption of new development practices and tools., • Hands-on familiarity with AI/LLM tools for software development and strong judgment about where AI materially improves leverage, quality, and speed., • Strong system design and architectural skills, with the ability to guide scalable, maintainable architectures and communicate trade-offs clearly., • Excellent communication skills and the ability to lead through growth, complexity, and changing ways of working., • Experience integrating AI- or LLM-based capabilities into production systems or internal engineering workflows., • Background in developer productivity, platform engineering, or building internal tools and systems for engineers., • Experience in a high-growth or scale-up environment where speed, ambiguity, and prioritization are central to success., • Familiarity with data privacy, security, and compliance considerations in the context of SaaS platforms and AI-enabled tooling.

Job Description Remote Medical Biller & Coder (Entry-Level & Experienced) Company: Rooted Talent Solutions Location: Remote (Work From Home) Job Type: Independent Contractor (1099) Schedule: Flexible | Part-Time and Full-Time Opportunities ???? About the Role Rooted Talent Solutions is actively seeking remote medical billers and coders to join our healthcare support team. This is a remote, independent contractor opportunity involving medical claim processing, coding, and administrative support for healthcare providers. We’re hiring both experienced professionals and motivated individuals looking to enter the field. If you’re detail-oriented, organized, and eager to work from home, this could be the right opportunity for you. ???? Responsibilities • Process and submit medical claims accurately and on time, • Assign appropriate ICD-10, CPT, and HCPCS codes, • Review documentation for coding compliance, • Follow up on denied or unpaid claims as needed, • Communicate with providers, payers, or clients when necessary, • Maintain HIPAA compliance and data security standards ???? Qualifications ✅ Preferred: • Experience with medical billing, coding, or claim processing, • Familiarity with EHR or billing software, • Strong attention to detail and accuracy, • Basic understanding of insurance guidelines and terminology, • Certifications such as CPC or CBCS are a plus ???? Entry-Level Applicants: If you do not have experience, that’s okay. We will consider highly motivated candidates who demonstrate strong interest in the field. Additional details regarding onboarding and training will be discussed during the interview process. ???? Position Details • Location: 100% Remote, • Schedule: Flexible – hours vary based on client/project needs, • Compensation: Varies depending on experience and client placement, • Type: Independent Contractor (1099) ???? To Apply Submit your resume and a short message about your experience or interest in medical billing. Selected applicants will be invited to attend an interview session to learn more about current opportunities and next steps. ???? Rooted Talent Solutions is an equal opportunity contractor network. We welcome applicants of all backgrounds and are committed to fostering a supportive, remote-first work environment.

Job Description Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $67,813 - $89,004 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential CMS audits and medical record retrieval efforts., • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards., • Participate in CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits., • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process., • Support in the identification of document improvement opportunities for provider education in both MA and ACA line of business., • Identify process improvements to enhance medical encounter review efficiency., • Compliance with all applicable laws and regulations, • Bachelor's degree in a relevant field of study or commensurate work experience., • Certified professional coder (CPC), • Certified Risk Adjustment Coder (CRC) or similar certification At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Job Description Description We're hiring a Retail Operations Supervisor to join our team in the Atlanta, GA area! Monday-Friday, weekends off! The Retail Operations Supervisor will report to the Grocery Field Manager and is responsible for effectively managing Retail Merchandisers. KEY RESPONSIBILITIES • Work closely with Central Pet Merchandising Representatives., • Work closely with 3rd Party Merchandisers and Supervisor., • Drive execution of retail programs in support of annual growth plan and objectives., • Work closely with Grocery Merchandising Supervisors, Store Managers and Receivers on any issues or concerns with service., • Develop relationships with key associates in field management., • Ability to travel within the Atlanta, GA area to visit stores, cover routes, perform remodels., • Coordinate schematic and assortment changes with team to ensure schematic integrity., • Work in stores executing resets, remodels, audits and updates. Sometimes must cover a store or route for vacations, vacancies, transitions or emergencies. Must be able to have flexible hours when needed., • Work closely with merchandising staff regarding shelf maintenance, ordering and appropriate merchandising standards., • Consistently monitor e-mail and voice mail for communication requests and information from the business unit., • Monitor and approve payroll on a regular basis, • Communicate weekly activity reports in a timely manner., • Learn Prelude, our internal system for warehousing, inventory, orders, and shipping., • Learn mobile and Web versions of Movista, our ordering app, • Work closely with Central Logistics Manager to optimize routing and adjust schedules when needed., • Organize and plan monthly schedule on upcoming activities including scheduled time working with merchandising reps, reset activity and promotional activity., • Initiate communication with management on market development and in store opportunities., • Develop a team atmosphere., • Interview/Hire/Train incoming merchandising staffQUALIFICATIONS, • Ability to manage, influence and direct a team., • 3 - 5 years previous retail experience requested., • Ability to read schematics and store POGs., • Ability to work independently., • Attention to detail., • Basic computer knowledge of excel, word and outlook., • Good communication skills on phone, email and in person., • Be able to adapt and adjust on the fly. Multitasking is a must., • Hours vary by day., • Must have valid Driver’s License, reliable transportation and proof of insurance., • Responsible, reliable and dependable work habits a must., • Knowledge of Pet Supplies and Grocery industry a plus., • Ability to bend, pull, and lift up to 30 lbs. consistently throughout the course of a normal work day., • Ability to bend, pull, and lift up to 50 lbs. occasionally throughout the course of a normal work day., • Ability to use box cutters, bar-coding scanners, push carts and dollies safely., • Ability to work in a constant state of alertness and safe manner. WORKING CONDITIONS, • Some expense paid travel is required., • Work is conducted at retail grocery stores in loading/unloading area and on sales floor, • Driving to/from and between retail locations is done in personal vehicle POSITION INFORMATION:, • This position pays $20.00 - 21.00 per hour based on experience.BENEFITS PACKAGE & EMPLOYEE PROGRAMS, • Comprehensive Medical, Dental, and Vision Insurance, • Free Life and Disability Insurance, • Health and Dependent Care Flexible Spending Accounts, • 401k with 3% company match and annual employer discretionary contribution, • Paid vacation, holidays and sick time, • Employee Assistance Program, • Access to thousands of free online courses, • Discounts on cell phones, movie tickets, gym memberships, and more!, • Education Assistance (both college degrees and professional certifications), • Referral Program with cash bonus, • Access to on-demand pay

Job DescriptionDescription: Soleo Health is seeking a Billing Specialist to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care! Home infusion billing experience required. • Competitive Wages, • 401(k) with a Match, • Referral Bonus, • Paid Time Off, • Great Company Culture, • Annual Merit Based Increases, • No Weekends or Holidays, • Paid Parental Leave Options, • Affordable Medical, Dental, and Vision Insurance Plans, • Company Paid Disability and Basic Life Insurance, • HSA and FSA (including dependent care) Options The Billing Specialist will primarily be responsible for insurance and self-pay billing, excluding Medicare. This role is also responsible for submitting electronic and paper claims. Follows up with clearing house vendors on accepted and working rejections. Responsibilities include: • Preparation of accurate medical claims based on contracted agreements for services to various payers (e.g. Commercial Payers, Government Payers, Employer/ Institutional Payers)., • Reviewing and identifying claims pricing discrepancies based on updates/changes to fee schedules., • Creates and submits secondary electronic pharmacy and medical claims in a timely manner., • Billing of manufacturer copays, which includes entering the necessary information into portal or billing via paper at time of initial billing., • Monitors billing requirements pursuant to contracts with third party payers or government programs., • Answer insurance/billing questions from branch staff and help educate., • Review information from electronic medical records in patient account (IE: auth, benefit verification, orders, accounts receivable, etc.) to ensure preparation and submission of clean claims., • Perform routine revenue review of claims billed within the current month., • Answering incoming calls and triage if necessary., • Create claim batches and process them via electronic submission., • Manually process any claims that are not eligible for electronic billing. Identify any claims that need attention, make corrections, and resubmit., • Ensure coding to the highest level of specificity and for maximum reimbursement by third party payers., • Daily review and follow up of unbilled delivery tickets in billing review and ready to bill queues., • Accurately notate patient accounts to reflect all actions made including marginal, split claim notes, missing COGS, etc., • Coordinates with the pharmacy team daily to ensure any PBM issues are addressed and resolved, accepted into revenue and billed timely, • Effectively utilize time and resources to meet performance goals., • Provides exceptional Customer service to internal and external customers., • Ensures compliance with federal, state, and local governments, third party contracts, and company policies., • Clearly communicate any billing related issues to all appropriate parties including: Intake, collections, RBL, and manager., • Monitoring the unbilled-pending invoices queues and communicate to the branch on missing or needed documents or information., • 8:30a-5p, Monday-FridayRequirements:, • 2 years or more of home infusion billing required, • High School Diploma or equivalent, • Knowledge of HCPC coding and medical terminology, • Experience providing customer service to internal and external customers, • Must be computer literate, • Must be dependable. Excellent phone and email communication skills. Soleo’s Core Values: • Improve patients’ lives every day, • Be passionate in everything you do, • Encourage unlimited ideas and creative thinking, • Make decisions as if you own the company, • Do the right thing Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor. Keywords:billing representative, accounts receivable, collections, claims, medical coding and billing

Job DescriptionDescription: RevCycle's Healthcare Business Services business is growing, and we’re excited to welcome new team members! With over 30 years in business, we focus on developing our employees and helping them reach their full potential. Work remotely from an approved private home office location or from our Marshfield, WI office, with opportunities to start immediately or join a late-April training class. We rely heavily on TEXT MESSAGING throughout our selection and onboarding process. To ensure timely communication and faster consideration, make sure you opt in to text messages during your application and complete all required application steps. Position Summary: • Delivers exceptional and consistent customer experiences by demonstrating excellence in understanding and resolving requests with patience, empathy, compassion, and sincerity. Handles customer inquiries through inbound and outbound calls as well as written communication., • Paid Medical insurance includes personalized assistance to select from any qualified options in the marketplace. This enables you to select a plan which is most likely to enable you keeping coverage for things most important to you (i.e., Dr., clinic, meds)., • Additional options for Dental/Vision, paid short-term disability and life insurance benefits., • Generous PTO (3 weeks per year) plus holiday pay and make-up time benefits begin within month three of employment, • 401K, • Maintain perfect attendance during training for first six weeks of employment (unless pre-approved prior to start)., • Responsibly and plan-fully use time off when accrued so that our customers can rely on you to be here for them as scheduled, with rare, unplanned absences., • Give full attention and focus to quality delivery of responsibility during scheduled hours of work just as if you were in the office., • Maintain and manage a secure and private and personal home office space free of distractions during working hours., • Operate with integrity, honesty and transparency in all work-related matters., • Personify and exemplify company Core Values and Strategic Anchors which include "Can Do, Selfless and Evolutionary", • Take calls from patients, law offices, insurance companies, and other outside facilities to resolve complex billing and insurance issues, • Make outbound calls and take inbound calls from patients to resolve balances on accounts with a status that may be aging but has not been sent for collections, • Answer complex billing and insurance questions (i.e. deductibles, co-insurance, co-pays, complex denials and charge disputes, claim resubmissions, eligibility issues, and coding disputes), • Review financial information and recommends payment options and/or assistance programs in accordance with client guidelines, • Manage both common and challenging objections and concerns from consumers, • Discuss and help consumer think through payment resources and makes necessary referrals to the client, • Use required scripts/verbatims, skillfully navigating guidelines to maximize potential recovery on each call, • Maintain working understanding of account requirements, leveraging related documentation and resources as needed, • Independently and efficiently perform account documentation including notes and codes, making few errors and requiring minimal assistance, • Skillfully work within multiple internal and client systems, • Prior work experience on the phones in a call center and healthcare customer service setting is preferred, • Familiarity with Artiva and Cerner Soarian application is preferred. EPIC is a plus., • Working knowledge of medical billing and coding is preferred, certifications welcome (i.e. AAPC Ahima, EPIC, eCN, Artiva, Cerner, FACS)., • Prior work experience in a medical office and/or general understanding of health insurance is preferred, • Able to communicate clearly, both verbally and in writing, and utilize proper grammar and telephone etiquette and provided electronic tools, • Able to navigate multiple computer applications and databases, • Moderate to advanced computer keyboard typing and navigation skill, • Able to communicate on the phone and navigate multiple computer systems simultaneously, • Able to overcome patient objections and obstacles to negotiate payment successfully, • Reliable and responsible. Arrives on time and uses time productively and efficiently, • Manages self effectively in a work from home environment, remaining focused on work and delivering required outcomes, • Possesses and demonstrates professional judgement and operates with client business acumen., • Understands sensitive personal information (SPI) and sensitive consumer information (i.e., Protected Health Information (PHI)) and maintains confidentiality of this information, • Able to use tools provided to compute basic math calculations using addition, subtraction, multiplication, division, and percentages, • Self-motivation and committed to career success, • High School Diploma or equivalent (i.e., GED) required

Job DescriptionThe world’s largest organizations rely on Evident to help them protect their business and brand from third-party risk. Our game-changing technology - which enables the secure exchange of risk data like proof of insurance, identity, business registration, and other information - helps our customers verify that their partners have all of the required credentials to do business. In today’s new remote-first, ever-changing regulatory environment, our secure, privacy-first enterprise platform, accessible via web portal or API, provides a highly scalable and configurable solution to manage communications, storage, decisioning, and ongoing monitoring of credentials. Evident is a VC-backed technology startup, headquartered in Atlanta, GA. Learn more at evidentid.com. We’re looking for a highly skilled Lead Software Engineer who will be a hands-on builder of the product and lead a small team (2–3 engineers) in an AI-first development environment. The core of this role is using AI tools as a primary force multiplier across the software lifecycle to accelerate delivery of SaaS products without sacrificing quality. You’ll set direction, raise engineering standards, and guide the team through modern, AI-enabled ways of building. The role will be based in our office in Atlanta (hybrid work model with two days in the office and three days remote).Key Responsibilities • Hands-On Product Engineering, • Design, build, test, and ship high-impact SaaS features and services, • Drive architecture decisions and technical execution from requirements to production, • Set and uphold standards for code quality, reliability, observability, and security, • AI-First Development Leadership, • Evaluate, implement, and standardize AI tools across the SDLC (coding, review, testing, docs, incident analysis), • Build “AI-in-the-loop” workflows for:- requirements/spec drafting- design exploration and architecture docs- code generation, refactoring, and migrations- test creation and regression detection- documentation, runbooks, and onboarding, • Define guardrails for safe and effective AI use (security, privacy, IP, data handling), • Team Leadership & Coaching, • Lead and mentor a team of 2–3 engineers through planning, execution, and delivery, • Coach engineers on strong fundamentals and high-leverage AI-assisted workflows, • Provide technical guidance through design reviews, code reviews, and pairing, • Cross-Functional Collaboration, • Partner with product, design, and leadership to deliver the right solutions quickly, • Communicate progress, risks, and opportunities clearly and proactivelyRequired Skills & Qualifications, • 5+ years of professional software engineering experience, including leading small teams or acting as a player/coach, • Proven ability to build and ship SaaS products end-to-end in fast-moving environments, • Strong system design and problem-solving skills; able to articulate tradeoffs clearly, • Deep, practical experience using AI/LLM tools in daily engineering work, with clear opinions on what drives real leverage, • Excellent communication and mentorship skills; comfortable leading changePreferred Qualifications, • Experience integrating LLM-based features into production systems, • Background in developer productivity, platform engineering, or SDLC automation

Job DescriptionCompany Description WHO IS GUIDEHEALTH? Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients. Job Description As outlined below, provide quality improvement focused work for all delegated entities and support for ACO quality reporting for all contracted ACOs. WHAT YOU’LL BE DOING • Work in a partially remote environment, collaborating with team members virtually each day., • Serve as a Subject Matter Expert (SME) on quality improvement measures, customer needs, and payer‑specific quality initiatives across commercial and government programs., • Travel to provider offices to support quality efforts, including completing on‑site eye exams (training provided), scanning records, and coordinating medical record management., • Conduct proactive patient outreach to identify and close quality gaps—educating patients, scheduling screenings, supporting treatment plan adherence, and improving outcomes., • Collect and abstract quality data using EMRs, claims information, and provider engagement., • Use multiple platforms daily, including EMR systems, payer portals, vendor tools, GuideHealth applications, and Microsoft 365 (Excel, Word, PowerPoint, Teams)., • Work with various health data sources, including patient lists, gap lists, and medical records., • Apply all available quality resources—NCQA/HEDIS® specifications, coding materials, and Guides—to ensure accuracy and completeness., • Prioritize tasks to meet strict reporting timelines and quality program requirements., • Communicate performance trends, barriers, and improvement strategies to internal teams and external partners., • Follow established QI workflows, processes, and best practices., • Collaborate daily with customers, payers, and internal teams., • Participate in payer and departmental trainings, webinars, and support calls., • Represent GuideHealth professionally and build positive working relationships with providers and staff. Qualifications WHAT YOU'LL NEED TO HAVE • Associate degree or higher, or a clinical license/certification (CMA, LPN)., • 1–3 years of healthcare experience, including EMR use, medical terminology, chart review, and familiarity with quality measures or billing/coding., • Minimum 2 years of Medicare Advantage quality data abstraction and patient outreach experience., • Strong technical ability—comfortable working with health data, Excel, PowerPoint, and multiple digital systems., • Excellent verbal and written communication skills., • High attention to detail, strong organization, and the ability to meet strict deadlines., • Ability to work collaboratively across teams and with external partners., • Certified/licensed professional-CMA, LPN, • Knowledge or experience in quality improvement initiatives and data submissions required by various health insurance payers., • Extensive experience with quality database entries and reporting., • Experience in interpreting and reporting quality information, as well as training staff., • Use your skills to make a meaningful impact in healthcare., • Work with a great team in an awesome work environment., • Competitive compensation., • Great benefits like flextime time off. Additional Information The base pay range for this role is between $28-$32 per hour paid bi-weekly ALIVE with Purpose: How We Thrive at Guidehealth At Guidehealth, our values come to life in everything we do. • We are Driven by Accountability — grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike., • Always Growing, Always Learning — staying curious and continuously improving inspires us to shape a better future for healthcare., • With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve., • At Guidehealth, Every Voice Matters — we believe our collective strength is rooted in the unique perspectives of each team member., • And through Empathy in Action, we build stronger connections with those who count on us. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include: • Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs., • Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered., • Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution., • Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected., • Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times., • Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals., • Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need. COMPENSATION: The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications. OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment. OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager. As a remote-first organization handling sensitive healthcare data, Guidehealth verifies candidate identity at multiple stages of the hiring and onboarding to safeguard patient privacy, data security, and compliance requirements. REMOTE WORK TECHNICAL REQUIREMENTS Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements.

Job Description Are you an RN looking for a career opportunity in healthcare technology? Do you have experience in adult health? Vatica Health is seeking clinically experienced and detailed-oriented nurses to join our team. As a Nurse Consultant, you will collect, review and analyze patient data to improve care coordination, quality metrics, and medical cost savings. The ideal candidate has a track record of critical thinking strong attention to detail, expertise in navigating various electronic medical record (EMR) systems and building strong work relationships with providers and office staff. And of course, a GREAT PERSONALITY! As this role is considered hybrid, you will have the opportunity to work remotely from home and have expectations to go onsite to practices locally. The distance to commute to a providers office is typically no more than 60 miles, but can be more if the need arises. While this posting location may be noted as Atlanta, GA; we welcome applicants from ALL MARKETS to apply. Responsibilities • Create detailed and comprehensive patient medical records. Research and gather information from multiple sources and consolidate into one comprehensive and detailed view. Use clinical judgement and data to reconcile conflicting information from various sources., • Build strong relationships with providers and staff; ability to embed yourself in multiple practices and be a contributing and valuable member of each team, • Become an expert in our technology, train and support providers and practice staff on process., • Follow-up: ability to persuade and persist with providers to meet deadlines., • Share best practices and clinical knowledge with your fellow Clinical Consultants Requirements • Minimum of 3 years of recent adult health clinical experience as a Registered Nurse (RN)- preferably in critical care (i.e., ICU/CCU/MICU) and/or ED), • Proficiency with Diagnosis, Billing, and Quality Measures Coding a plus, • Excellent interpersonal skills that include the ability to effectively communicate with physicians, advanced practice providers and medical office personnel such as Practice and Billing Manager, both verbally and written, • Understanding of health insurance benefit structure; especially Medicare and Medicaid, • Must be technically savvy; this is critical to the role. Understanding and interest in software and technology a must, • Solid clinical skills, • Flexible, energetic self-starter with the ability to work in a non-structured environment, • Willingness to travel/commute to various locations for training and support; comfortable with a work from home setting, • Strong ability to organize, prioritize, make decisions and work independently, • Must possess and have proven problem resolution skills, • Excellent organizational skills with the ability to multi-task VATICA HEALTH ADVANTAGES • Every single person at Vatica Health is working to fight the good fight every single day. What we do matters, a lot. If you are looking for a job that has real meaning and you’d like to work with people who care deeply about what they do, we’ve got that., • We work hard (see point above), but we don’t forget to have fun. “I want a job that is dull,” said no one ever., • We believe in fostering a culture of servant leadership – command and control is so 1990s. We look for brilliant people that are great at what they do because they love what they are doing., • We know that teams are exponentially more successful than the sum of their individuals. Our teams value what each member brings to the table and also values continuous improvement of each team member as well as the whole team., • Competitive salary based on your experience and skills – We believe the top talent deserves the top dollar, • Bonus Potential (based on role and is discretionary) – If you go above and beyond, you should be rewarded, • 401k match– We want to empower you to prepare for your future, • Comprehensive Medical, Dental, and Vision insurance plans, • Tax-free Dependent Care Account and Flexible Spending Account, • 4 weeks of PTO (Everyone deserves a vacation now and then), • M-F work week (No working weekends, overnights, on call shifts, or holidays) We believe family comes first!, • Reimbursement for RN license and Continuing Education Credits, • Strong supportive teams- There is always a helping hand when you need it! The salary for a position is typically determined by multiple factors such as the individual's qualifications, experience, skills, and location. The projected compensation range for the position may vary based on these factors and could range from $65,000 to $85,000 (annualized USD). However, this estimate represents just one aspect of our total compensation package offered. Are you up to the challenge? What are you waiting for? Apply today!

Job Description Are you interested in joining a company with a great culture, and rated a "Best Place to Work" and "Healthiest Employer" by the the Atlanta Business Chronicle? If you answered yes, this may be the opportunity for you! Currently, Alliant Health Solutions is seeking a Review Nurse, Utilization and Compliance Review (UCR) and Medical Claims. This position is hybrid, and candidate must be located in the state of Georgia. The Review Nurse, UCR & Medical Claims Nurse is a member of a professional multi- disciplinary work team, and responsible for the analysis and monitoring of policy compliance for Medicaid providers. This position will determine an estimate of recoverable amounts by reviewing coding and billing patterns and identifying payment errors of these previously identified providers for the Department of Community Health (DCH), Office of Inspector General, Program Integrity Unit. Position is also responsible for conducting medical claim reviews of suspended, pre-pay and reconsideration/appeals/provider inquiries/retrospective claims that require a medical review prior to adjudication. This position is hybrid (office/onsite and remote). In this role, the ideal candidate will do the following: • Conducts on-site or desktop reviews through claims analysis. Review levels include initial, corrective action plan (CAP), and administrative., • Inform providers in advance of upcoming on-site visits. Conducts entrance and exit interviews with providers informing them of purpose of visit; on-site targeted and non-targeted reviews for the specified Medicaid providers, which includes some but not all of the following: entrance and exit sessions with the appropriate management and clinical staff from the provider location, staff interviews, and scanning of document(s) to be reviewed., • Initiates case activity log in developing the appropriate approach for the on-site review., • On-site facility tours and adhere to DCH policies., • Performs member assessments/reviews of services provided and billed either on-site or telephonically., • Make recommendations based on medical judgment and experience for the necessity of the services and the appropriateness of the setting while substantiating recommendations with clinical rationale., • Analyze, interprets and documents appropriate determination of estimated recoverable amounts from specified Medicaid providers through review and identification of policy compliance, coding/billing patterns and payment errors., • Prepare timely, accurate, written letters to providers/DCH on initial and final desktop review and on-site findings., • Correction Action Plan (CAP) review of the deficiencies identified during the initial review. The provider should include a plan to correct the issues and a target date., • Perform administrative reviews if requested by the provider. Review additional information related to requests for reconsideration after initial findings and makes a recommendation based on medical judgment and experience for the necessity of the service and the appropriateness of the setting., • Provide support and expert testimony at Administrative Law Judge Hearings as requested by DCH’s Legal Services in support of Administrative Review findings., • Serve occasionally on panel of peers to provide medical expertise regarding standards of medical care., • Provide assistance in preparing referrals for submission to the Medicaid Fraud and Patient Protection Division (MFPPD)., • Case Management Reviews of Independent Care Waiver Program (ICWP), Community Care Service Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE) programs., • Home Community Based Services (HCBS) Quality Reviews of the waiver programs for adhere to the DCH State Transition Plan., • Adjudicate suspended claims in the Gainwell Interchange system that require a medical review to ensure quality of care and appropriateness of services based on current standards of care., • Adjudicate claims for providers placed on pre-payment review., • Process Medical claim appeals/provider inquires in the Alliant appeal/provider inquiries system that requires a medical review of a system denial edit or an appeal of a denial adjudicated claim, to include dental appeals., • Perform reviews accurately and efficiently within time requirements as specified and performs accurate data entry of required review-specific information., • Evaluate submitted information and review claims that meet criteria and determine up-coding; make recommendation on appropriate level/ code based on record documentations., • Render appropriate decisions based on the information/clinical documentation received using the established criteria; and clearly and concisely documents the rationale for all decisions rendered., • Utilize Gainwell Interchange claims system to resolve suspended claims for adjudication and utilizes Alliant appeal/provider inquiry system to resolve reconsiderations/appeals/provider inquiries., • Work in collaboration with Medical Review Team to oversee and support surveillance utilization review functions., • Identify and documents suspected cases of fraud and abuse to Supervisor, for further referral to Deputy Director, Program Integrity, and Medical Review., • Working knowledge of ICD-10-CM, CPT codes, and InterQual criteria preferred., • Strong organizational skills with ability to demonstrate the work priorities., • Demonstrated ability to perform work with considerable independence by use of creative thinking, thorough analysis of problems, and use of innovative approaches to problem resolution., • Computer literate with intermediate level knowledge of Microsoft Office (Word and Excel) and proven ability to type 35 WPM or more., • Excellent interpersonal, written, and verbal communication skills required., • Excellent telephone skills, including ability to handle difficult calls/callers. Required: • Registered Nurse - Current Georgia License, • Bachelor’s degree in nursing, case management experience; and/or certified case manager, • Previous Utilization, Case Management, Quality Assurance and/or claims auditing experience., • Coding Certification, • Knowledge of Department of Community Health (DCH), • Prior telecommuting/remote work experience Alliant knows people thrive when they feel supported, so we offer flexibility, work/life balance and great benefits including medical, dental life, disability, paid-time off, retirement with match and contribution, disability, employee assistance program, parental life, and more. If interested, click the apply icon above to apply. Alliant Health Group ("the Company) is an Equal Opportunity Employer and Drug Free Workplace. In compliance with the American's with Disability Act (ADA) and Amendments Act (ADAAA), all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, gender identity, national origin, disability or veteran status. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, please let us know. Likewise, if you are limited in the ability to access or use this online application process and need an alternative method for applying, we will determine an alternative method for you to apply. Please contact 678-527-3000.

Telecommute (you can work from home, work or school). A paid Product Tester position is perfect for those looking for an entry-level opportunity, flexible or seasonal work, temporary work or part-time work. Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contrac

Telecommute (you can work from home, work or school). Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies. A paid Product Tester position is perfect for those looking for an entry-level opportunity, flexible or sea

Telecommute (you can work from home, work or school). Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies. A paid Product Tester position is perfect for those looking for an entry-level opportunity, flexible or sea

Telecommute (you can work from home, work or school). Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies. A paid Product Tester position is perfect for those looking for an entry-level opportunity, flexible or sea

Telecommute (you can work from home, work or school). Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies. A paid Product Tester position is perfect for those looking for an entry-level opportunity, flexible or sea

Telecommute (you can work from home, work or school). A paid Product Tester position is perfect for those looking for an entry-level opportunity, flexible or seasonal work, temporary work or part-time work. Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contrac

Telecommute (you can work from home, work or school). A paid Product Tester position is perfect for those looking for an entry-level opportunity, flexible or seasonal work, temporary work or part-time work. Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contrac

We’re looking for Data Entry Specialists for Customer Products across the US to work from home and help top brands improve their products before they hit the market.

We’re looking for Data Entry Specialists for Customer Products across the US to work from home and help top brands improve their products before they hit the market.

We’re looking for Data Entry Specialists for Customer Products across the US to work from home and help top brands improve their products before they hit the market.

We’re looking for Data Entry Specialists for Customer Products across the US to work from home and help top brands improve their products before they hit the market.

We are looking for individuals who: • Have strong customer service skills • Are motivated and growth-oriented • Enjoy working with people and helping others • Are interested in professional and personal development This is a great opportunity to join a fast-growing company and build a long-t

Responsibilities: Respond to customer inquiries via live chat in a timely and professional manner Provide accurate information about products, services, and company policies Troubleshoot and resolve customer concerns or escalate when necessary Maintain clear and professional communication with custo

K plus commission work from home- no travel CRM software work on existing accounts and acquire new accounts minimum three (30 years experience with inside sales and CRM software manufacturing or consumer products experience are a plus and are not required work from any state in America work EST hour

Call Center / Customer Service / Fully Remote] - Anywhere in U.Competitive pay - As a Customer Support Rep you'll: Manage large amounts of incoming phone calls; Identify and assess customers' needs to achieve satisfaction; Build sustainable relationships and trust with customer accounts through open

Up to $23 per hour / Medical, dental & vision / 401k / PTO - As a Call Center Rep at SCA Health, you will: Take inbound calls from patients and make outbound calls to patients; Provide one call resolution to patient inquires whenever possible and perform timely follow up on inquiries requiring escal

Competitive pay / Medical, dental & vision / 401k / PTO - As a Customer Service Rep at Knipper Health, you will: Promote meaningful relationships and brand loyalty through engaged and informed conversation with customers (health-care providers, office staff, patients, pharmacists, and pharmaceutical

Competitive pay / $500 retention bonus / Medical, dental, and vision / 401K / PTO / Equipment provided / Paid training - As a Call Center Support Rep you'll: Receive a large volume of inbound phone calls; Assist with outbound call campaigns; Answer general questions and transfer calls to other depar