Respond to member and provider inquiries regarding health benefits and precertification via phone and email. Negotiate with out-of-network providers and document all interactions in the system call log.
Remote Jobs & Work From Home Positions in United States (122,019)
Remote in = United States
Lead the collegiate chapter support team in managing risk, membership, and finance to enhance the member experience. Serve as a key resource for volunteers and university partners while overseeing strategic planning and educational development.
Own and evolve the revenue tech stack by maintaining tools like Salesforce and HubSpot. Identify operational gaps and build integrations to improve GTM efficiency and data reliability.
Prototype and train learning-based models using a data-centric approach and design auto-labeling systems for multimodal data. Develop and maintain efficient data extraction pipelines and optimize SQL queries for data analysis and ingestion.
Provide accurate reconditioning estimates for body, detail, and mechanical services for various customer types. Coordinate with procurement for pricing and monitor repair status and completion timelines.
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Collaborate with cross-functional teams to design, automate, and optimize data loading and analytics processes for integrated business planning. Provide technical leadership in implementing AI-driven resource allocation and predictive modeling to enhance data architecture performance.
The specialist is responsible for managing a target list of physicians in the Cleveland area to grow pharmaceutical sales and build disease awareness. Key duties include developing territory plans, managing sales budgets, and collaborating with partners to support patient access and reimbursement.
Conduct expert-level vehicle condition inspections on client lots and provide accurate documentation of vehicle status. Build and maintain client relationships while mentoring junior inspectors and reporting activity via Salesforce.
Strategic Access Support - Business Analyst
Vanderbilt University Medical Center
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Full Time
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5 hours ago
Vanderbilt University Medical Center
The role supports patient access business intelligence by identifying trends and anomalies to drive process improvements. It involves performing data analysis, creating reports, and managing knowledge content to support operational decision-making.
Independently prepare loan offerings and risk ratings by analyzing credit, collateral strength, and financial worthiness. Serve as a subject matter expert for specific asset classes and manage ongoing credit risk for assigned portfolios.
Data Scientist - Materials R&D - Remote-Travel
Intertape Polymer Group (IPG)
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Full Time
·
5 hours ago
Intertape Polymer Group (IPG)
The Senior Data Scientist will apply advanced data science and machine learning to experimental and process data to accelerate innovation in bio-polymers and sustainable materials. They will partner with scientists and engineers to develop predictive models and optimize material performance and formulation design.
The specialist is responsible for reviewing trip records to ensure accurate payment posting, contractual adjustments, and payer details. This includes correcting posting errors, investigating missing payments, and conducting quality assurance checks.
The Billing Manager oversees the A/R Management team to ensure accurate follow-up on outstanding accounts, denials, and appeals to maximize reimbursements. They are responsible for maintaining KPIs, managing employee performance, and optimizing the overall revenue cycle process.
The Billing Resolution Specialist ensures EMS claims are coded and billed accurately to maximize collections and maintain compliance. The role focuses on resolving issues that prevent claims from being released to payors and performing quality assurance reviews.
Data Scientist - Materials R&D - Remote-Travel
Intertape Polymer Group (IPG)
·
Full Time
·
5 hours ago
Intertape Polymer Group (IPG)
The Senior Data Scientist will apply advanced data science and machine learning to bio-polymer and sustainable materials research to accelerate innovation. They will develop predictive models for material performance and collaborate with cross-functional teams to optimize formulations and processes.
Design and build the next generation big data compute platform to support ETL, analytics, and machine learning. Manage the reliability, performance, and cost efficiency of the platform while contributing to open source software.
The role involves owning vulnerability management, AWS security posture, and implementing security controls for AI-powered products. You will partner with Engineering and IT to maintain HIPAA and SOC 2 compliance while building scalable security safeguards.
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Lead and coach a group of product managers focusing on Downballot and Trust initiatives to deliver strategic product visions. Manage the full software development lifecycle from planning to go-to-market while collaborating with engineering and operations leadership.
Lead and develop a high-performing IT support organization by designing and executing a tiered service delivery model (Tier 0-2). Oversee technology operations, manage a $5M budget, and partner with PMO, GRC, and Security teams to align with enterprise strategy.
The Medical Coder is responsible for assigning accurate ICD-10, CPT, and HCPCS codes based on physician documentation. They also manage billing data, communicate with physicians for clarification, and ensure department goals and HIPAA regulations are met.
The role focuses on owning end-to-end mobile application deployments for iOS and Android and managing infrastructure-as-code using Ansible and Terraform. Additionally, the engineer will optimize IIS hosting in Windows environments and support the transition toward containerized workloads.
Prospect and engage potential clients to match them with appropriate alternative funding solutions. Manage the sales pipeline via CRM and close deals to help entrepreneurs grow their businesses.
Lead strategic advisory engagements to optimize supply chain operations for Retail Hard Lines customers. Develop high-level designs, strategic recommendations, and drive the expansion of SaaS deals through cross-functional collaboration.
Oversees the full Authorization department to ensure timely and accurate processing of prior authorizations across private practice and hospital-based clinics. Leads strategic operational improvements, manages departmental KPIs, and collaborates with cross-functional teams to reduce claim denials.
Registered Nurse (RN) - Transfer Center Specialist - Conduit Health Partners
Bon Secours
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Full Time
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6 hours ago
Bon Secours
Coordinates patient transfer logistics and bed placement by collaborating with referring facilities, physicians, and hospital staff. Ensures accurate clinical presentation and documentation to facilitate appropriate levels of care and patient throughput.
Manage and grow sales of assigned products within a defined geographic territory to meet revenue and growth objectives. Build trusted relationships with surgeons and clinicians while providing clinical support and product demonstrations.
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Drive territory revenue growth through strategic account planning, prospecting, and building relationships with healthcare decision makers. Provide on-site clinical support, product demonstrations, and customer education within hospitals and physician offices.
Manage and grow sales of assigned products within a defined geographic territory to meet revenue and growth objectives. Build trusted relationships with surgeons and clinicians while providing clinical support and product demonstrations.
Independently perform complex professional coding across multiple specialties and settings to ensure compliant reimbursement and audit defensibility. Resolve coding edits and denials while providing guidance to peers and supporting documentation improvement workflows.
Live-Stream Lead Social Media Community Moderator
Social Factor
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Part Time
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6 hours ago
Social Factor
Develop and grow digital communities for active live stream events while managing a team of moderators. Act as the first line of defense for shift coverage and manage client workflows and escalations.
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