Qureos Mentor

Elevate Patient Financial Solutions

<div><div><div><b>Elevate Patient Financial Solutions</b> is seeking detail-oriented and proactive professionals to join our team as a <b>Workers Compensation Claims Representative</b>. This <b>remote, full-time</b> opportunity offers a consistent schedule of<b> Monday - Friday (8AM - 5PM)</b>. If you're passionate about making a meaningful impact and growing your career in a purpose-driven environment, this is your opportunity to shine!</div>
<div></div><div>In 2024, our Workers Compensation department resolved over 175,000 claims on behalf of our hospital clients and their patients.</div>
<div></div><div>In this role, you&rsquo;ll play a key part in helping hospitals and medical providers get paid for care as a result of work-related injuries. You&rsquo;ll gather important workers&rsquo; compensation details and insurance information by working closely with hospitals, employers, patients, and other sources. You&rsquo;ll also handle submitting claims and documentation to insurance carriers, reviewing payments and denials, and writing appeals when needed. Throughout the process, you&rsquo;ll stay in touch with insurance companies, employers, attorneys, and patients to make sure everything moves smoothly and providers receive the payments they&rsquo;re owed.</div><br>
<br>
<b>Job Summary</b><br>
<br>
The purpose of this position is to assist hospitals and medical providers in resolving accounts that are a result of work-related injuries. Specifically, this position is focused on the effort to obtain Workers&rsquo; Compensation injury details and insurance information from hospital, employers, patients and from other sources; submission of insurance bills and documentation to Workers&rsquo; Compensation insurance carriers; review of payments and denials for potential appeal; writing and submitting appeals; and communication with insurance carriers, employers, attorneys and patients during the claims adjudication process to ensure that the hospital and/or medical providers receive appropriate payment on submitted bills and denied claims.<br>
<br>
<b>Essential Duties and Responsibilities</b></div>
<ul><li>Maintain a queue of Workers&rsquo; Compensation accounts as assigned by management.</li>
<li>Maintain quality and productivity levels set by management once full job proficiency has been achieved.</li>
<li>Contact patient&rsquo;s employer, Workers&rsquo; Compensation carrier, and injured worker via telephone and mail to obtain injury information and insurance information.</li>
<li>Support patients by answering any questions about the Workers&rsquo; Compensation process.</li>
<li>Coordinate with appropriate client personnel to ensure appropriate filing guidelines are met for reimbursement.</li>
<li>Request appropriate information, both verbally and written, from appropriate parties to ensure proper claim disposition.</li>
<li>Perform manual data entry of patient accounts and/or claim forms.</li>
<li>Submit hospital and physician bills to insurance companies for payment.</li>
<li>Maintain contact with insurance adjusters/carriers, employers, and patients during the claim adjudication process to ensure that the hospital and physician bills are paid timely and in full.</li>
<li>Obtain claim status and gather supporting documentation to submit appeals.</li>
<li>Make written or verbal appeals to payers on denied claims.</li>
<li>Provide strong customer service to clients and provide responses to client inquiries within 24 hours.</li>
<li>Provide detailed updates to Elevate PFS&rsquo;s account management system and hospital/provider practice management system as account work is completed.</li>
<li>Assist in training both new and existing employees, which may include contributing specific training material.</li>
<li>Escalate complex, complicated, or challenging accounts to management to ensure accounts are progressing effectively.</li>
<li>Identify and discuss root cause issues with management.</li>
<li>Maintain and updates proper account documents in multiple systems.</li>
<li>Assist management with ad hoc inventory initiatives and other projects, as needed.</li>
<li>Review and manage patient accounts to ensure that proper documentation, payments, and necessary letters of authorization are entered correctly.</li>
<li>Maintain and adhere to compliance policies and procedures</li>
<li>Other duties as assigned.</li>
</ul>
<div><br>
<b>Qualifications and Requirements</b><br>
<br>
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.</div>
<ul><li>High School Diploma or GED</li>
<li>Some college coursework preferred</li>
<li>Positive and encouraging attitude</li>
<li>Strong customer service background</li>
<li>Professional, accurate, clear, and concise communication, both verbal and written, including the ability to write routine business correspondence</li>
<li>Detailed and thorough</li>
<li>Adaptable</li>
<li>Organized and excel in time management. Ability to manage and move quickly and accurately through a large workload</li>
<li>Proven ability to be assertive in order to proactively resolve issues.</li>
<li>Demonstrated ability to organize and set priorities according to changing situations and demands</li>
<li>Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.</li>
<li>Required computer skills: must have experience with data entry and word processing, be capable of operating routine office equipment, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications</li>
<li>1-5 years of related experience in the field or in a related area such as:</li>
<li>Medical billing and coding</li>
<li>Medical appeals</li>
<li>Claims Adjudication</li>
<li>Insurance</li>
<li>Workers&rsquo; Compensation</li>
<li>Legal work</li>
</ul>
<div><br>
<b>Benefits</b><br>
<br>
ElevatePFS believes in making a positive impact not only within our industry but also with our employees &ndash;the organization&rsquo;s greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.</div>
<div></div><ul><li>Medical, Dental &amp; Vision Insurance</li>
<li>401K (100% match for the first 3% &amp; 50% match for the next 2%)</li>
<li>15 days of PTO</li>
<li>7 paid Holidays</li>
<li>2 Floating holidays</li>
<li>1 Elevate Day (floating holiday)</li>
<li>Pet Insurance</li>
<li>Employee referral bonus program</li>
<li>Teamwork: We believe in teamwork and having fun together</li>
<li>Career Growth: Gain great experience to promote to higher roles</li>
</ul>
<div><br>
The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.<br>
<br>
The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.<br>
<br>
<b>Elevate, PFS is an Equal Opportunity Employer</b></div></div>

Workers Comp Claims Representative

<div><div><b>Elevate Patient Financial Solutions</b> has an exciting career opportunity available as a/an Third Party Liability Representative. This position will be a remote-based role. The Full-Time schedule for this role will be 8 am-5 pm Monday-Friday.</div>
 <div><b>Bilingual speaking skills in English and Spanish is strongly preferred.</b></div>
<div><b>Job Summary</b><br>
The purpose of this position is to assist hospitals in resolving accounts that are related to an accident. Specifically, this position is focused on the effort to obtain accident details and insurance information from hospital patients and from other sources (all contact being made over the telephone), to request hospital liens and bills to be submitted to identified insurance carriers, and to communicate with both insurance adjusters and personal injury attorneys during the claims adjudication process to ensure that the hospital receives payment on submitted bills and/or liens.<br>
<br>
<b>Essential Duties and Responsibilities</b></div>
<ul><li>Maintain a queue of Third-Party Liability accounts as assigned by management.
</li><li>Maintain an average of 100 unique accounts worked per day once full job proficiency has been achieved.
</li><li>Contact hospital patients via telephone to obtain accident details and insurance information. Support hospital patients by answering any questions about the Third-Party Liability process.
</li><li>Obtain accident reports from law enforcement agencies in the event that the patient cannot provide the necessary accident details and/or insurance information.
</li><li>Submit hospital bills to insurance companies for payment, and request hospital liens to be filed, as applicable.</li>
<li>Maintain contact with insurance adjusters and/or personal injury attorneys during the claims adjudication process to ensure that the hospital bill/lien is paid timely and in full.
</li><li>Provide updates to Elevate PFS&rsquo;s account management system as account work is completed; this is done by selecting the applicable option from an account status menu and writing a detailed note explaining what information was obtained and what transpired during the act of working each account.</li>
<li>Assist management with ad hoc inventory initiatives and other projects, as needed.</li>
<li>Other duties as assigned.</li>
</ul><div><b>Qualifications and Requirements</b></div>
<ul><li>To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.</li>
<li>Fluent Spanish communication skills necessary</li>
<li>High school diploma or GED required</li>
<li>Minimum one-year experience working hospital revenue cycle processes preferred
</li><li>Knowledge of and compliance with State and Federal regulations that govern collection practices, such as HIPAA and FDCPA. Knowledge of or experience working with hospital lien statutes, or paperwork pertaining to other statutory regulations, is a definitive advantage</li>
<li>Intermediate knowledge of Outlook, Word, and Excel
</li><li>High commitment to customer service and high levels of empathy and understanding.</li>
<li>Dependable and highly detailed individual with strong organizational skills</li>
<li>Remote and Hybrid positions require a home internet connection that meets the company&rsquo;s upload and download speed criteria.</li>
</ul><div><b>Benefits:</b><br>
ElevatePFS believes in making a positive impact not only within our industry but also with our employees &ndash;the organization&rsquo;s greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.</div>
<ul><li>Medical, Dental &amp; Vision Insurance</li>
<li>401K (100% match for the first 3% &amp; 50% match for the next 2%)</li>
<li>15 days of PTO</li>
<li>7 paid Holidays</li>
<li>2 Floating holidays</li>
<li>1 Elevate Day (floating holiday)</li>
<li>Pet Insurance</li>
<li>Employee referral bonus program</li>
<li>Teamwork: We believe in teamwork and having fun together</li>
<li>Career Growth: Gain great experience to promote to higher roles</li>
</ul><div>The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.</div>
 <div>The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.<br>
<br>
<b>ElevatePFS is an Equal Opportunity Employer</b></div></div><div></div>

TPL Claims Representative-Bilingual/Spanish Preferred

<div><div><div><b>Elevate Patient Financial Solutions </b>has an exciting career opportunity available as an Onboarding Specialist. This position will be a remote based role. The Full Time schedule for this role will be <b>Monday through Friday 8 AM to 5 PM. The temporary role is expected to last 3 to 6 months. There may be a potential for the role to transition to permanent at the end of the assignment.</b></div>
</div><div><b>Job Summary</b></div>
<div></div><div>The Credentialing Specialist serves as the subject matter expert for pre-employment credentialing and compliance processes, providing front-line support to recruiters, hiring managers, candidates, and client partners. This role partners closely with Recruiting, HR, and client stakeholders to ensure all employees meet company and client-specific credentialing, background screening, and occupational health requirements prior to start.<br>
<br>
The primary function of this role is to oversee and ensure the timely and accurate completion of all credentialing activities, maintaining compliance with company policies, client requirements, and regulatory standards. Success in this position requires exceptional organization, attention to detail, and strong communication throughout each stage of the credentialing process.</div>
<div></div><div><b>Essential Duties and Responsibilities</b></div>
<div></div><ul><li>Coordinate and manage all pre-employment credentialing activities, including background checks, drug screens, occupational health requirements, and client-specific compliance items.</li><li>Ensure timely completion of all credentialing requirements to meet established start date expectations.</li><li>Review, track, and validate completion of all required screening components, including secondary checks, health screenings, and compliance documentation.</li><li>Files onboarding and employment documents into Document Management System from sources including ATS, Background check provider, and client document submissions.</li><li>Conduct detailed reviews of candidate documentation to detect inconsistencies, falsification, or potential fraud, ensuring all findings are documented and escalated in accordance with company and client compliance standards.</li><li>Serve as the primary point of contact for recruiters, hiring managers, candidates, and internal teams regarding credentialing status and updates.</li><li>Communicate proactively on delays, issues, or required escalations impacting candidate start dates or compliance timelines.</li><li>Partner with internal teams and external vendors to resolve credentialing discrepancies and ensure process efficiency.</li><li>Monitor credentialing workflows to ensure consistency, accuracy, and adherence to service level expectations.</li><li>Support compliance with federal, state, and client-specific requirements related to background screening and occupational health standards.</li><li>Builds and fosters relationships with Recruiters, Hiring Managers, employees, applicants, and client contacts to ensure a positive onboarding experience.</li><li>Provide administrative and operational support to the Talent Acquisition and Credentialing teams.</li><li>Assist with reporting, and special projects related to credentialing and onboarding compliance.</li><li>Participates in SOX/SOC internal and external audits.</li><li>Other duties as assigned.</li></ul>
<div><b>Qualifications and Requirements</b></div>
<div></div><div>To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities required.<br>
<br>
<ul><li>High School Diploma or GED required; Associate or Bachelor's degree preferred.</li><li>3+ years of experience in credentialing, onboarding, or pre-employment compliance processes.</li><li>2+ years of experience supporting background screening and occupational health requirements in a high-volume environment.</li><li>Strong knowledge of credentialing processes, compliance requirements, and screening workflows preferred.</li><li>Experience with Applicant Tracking Systems (ATS) and credentialing or vendor screening platforms preferred.</li><li>Proficiency in Microsoft Office (Word, Excel, Outlook).</li><li>Demonstrated ability to maintain confidentiality and professionalism in all interactions.</li><li>Strong problem-solving and critical thinking skills.</li><li>Proven ability to prioritize tasks, manage multiple deadlines, and follow through effectively.</li><li>Excellent communication skills with the ability to interact across all levels of the organization and with external partners.</li><li>Highly detail-oriented with strong organizational and time management skills.</li><li>Proactive team player with a strong work ethic and ability to adapt in a fast-paced, compliance-driven environment.</li><li>Ability to meet designated deadlines is also a critical qualification.</li><li>Must be able to work in solitary work environment, with a self-starter mentality.</li><li>Remote and Hybrid positions require internet connectivity speeds that meet the Company's minimum upload and download requirements.</li></ul></div><br>
<div></div>
<div></div><div>The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.</div>
<div></div><div>The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.<br>
<br>
<b>ElevatePFS is an Equal Opportunity Employer</b></div>
<div></div><div><b>#IND123</b></div></div><div></div>

Temporary Credentialing Specialist

<div><div><b>Elevate Patient Financial Solutions </b>has an exciting career opportunity available as a <b>Bilingual Scheduling and Authorization Coordinator.</b> This position will be a remote role <b>required to live in the Pacific or Mountain time zones</b>. The Full-Time schedule for this role will be <b>Monday through Friday 8 AM to 5 PM (PST or MST required).</b></div>
<div></div><div><b>Job Summary</b></div>
<div></div><div>The Scheduling and Authorization Coordinator delivers exceptional customer service when communicating with patients over the phone to provide the necessary information for applicable scheduling and imaging. They request information related to the coordination and scheduling of diagnostic imaging and other procedures and treatments for hospitals contracted with ElevatePFS&reg;. The Scheduling and Authorization Coordinator interacts directly with the patients, referring physicians, Hospital Services</div>
<div>, and internal company associates to guarantee smooth coordination of procedures and exams.</div>
<div></div><div><b>Essential Duties and Responsibilities</b></div>
<div></div><div><b>Insurance Authorization/Verification</b></div>
<div></div><ul><li>Thoroughly completes the insurance verification process to ensure the accuracy of insurance information.</li>
<li>Obtains insurance authorizations, referral, and treatment consults as needed for all scheduled patients prior to receiving services.</li>
<li>Obtains benefit coverage from insurance companies and accurately enters information into the appropriate computer system.</li>
<li>Obtains diagnosis information and/or CPT code from the physician/office or the outpatient department, as necessary for completing the insurance authorization process.</li>
<li>Maintains proficiency in the various systems utilized during insurance verification and authorization process including various on-line payor eligibility programs.</li>
<li>Monitors appropriate work lists to ensure timely insurance verification processing.</li>
<li>Maintains documentation necessary for compliance with state, federal, and other regulatory agency requirements.</li>
<li>Maintains proficiency in the various systems utilized during insurance verification and authorization process including various on-line payor eligibility programs.</li>
</ul>
<div></div><div><b>Scheduling</b></div>
<div></div><ul><li>Schedules all types of complex exams with attention to detail.</li>
<li>Ability to manage high outbound and inbound calls to schedule patients for imaging services to ensure the best possible customer service by properly educating the patient on exam preparation and answering questions.</li>
<li>Screens and verifies all HIPPA information to ensure accuracy with scheduling and speaking with patients, patients approved representatives and or physicians.</li>
<li>Schedules and documents notes in hospital and ElevatePFS&reg; operating systems.<br>
</li></ul><div><b>Clerical</b></div>
<div></div><ul><li>Monitors and manages the e-mail inbox or fax machine for assigned practices throughout the day.</li>
<li>Works any requests received via e-mailed or fax.</li>
<li>Checks and responds to voicemails.</li>
<li>Creates, maintains and monitors log of patients and procedures scheduled for assigned physician practices.</li>
<li>Monitors appropriate work lists to ensure timely insurance verification processing.</li>
<li>Utilizes multiple commuter application, scheduling software, network, drives to schedule multiple exams within multiple modalities and entities across the hospitals system.</li>
</ul>
<div></div><div><b>Additional Responsibilities</b></div>
<div></div><ul><li>Effectively communicates operational activities and issues with Supervisor and Manager.</li>
<li>Interfaces courteously and effectively with internal and external customers. Must consistently present a positive departmental and organizational image, as well as commitment to departmental goals, objectives, standards, policies and procedures.</li>
<li>Demonstrates proficiency within assigned area of responsibility and a general understanding of the entire Patient Access process.</li>
<li>Adheres to the hospitals and until level policies and procedures and safeguards set forth by each facility.</li>
<li>Identifies and recommends process improvements for RMA services.</li>
<li>Other duties as assigned.</li>
</ul>
<div></div><div><b>Qualifications and Requirements</b></div>
<div></div><ul><li>High school diploma or GED</li>
<li>Associate degree or 2+ years in patient scheduling, registration, or healthcare billing is preferred</li>
<li>Over one (1) year working in a customer service or client relations type role</li>
<li>Effectively communicate both orally and written, to a variety of individuals utilizing fluent Spanish and English.</li>
<li>Office or hospital environment experience is preferred</li>
<li>High volume call center experience is preferred</li>
<li>Strong Literacy (grammar, spelling, math)</li>
<li>Strong Microsoft Products experience, including word, excel, outlook, windows</li>
<li>Familiarity with HCA/Parallon IT systems is preferred</li>
<li>Strong sales and customer service skills</li>
<li>Excellent interviewing and telephone communication skills</li>
<li>Outstanding interpersonal and people‑oriented skills</li>
<li>Excellent written and verbal communication abilities</li>
<li>Ability to communicate assertively and professionally while maintaining confidence and credibility.</li>
<li>Strong analytical, problem‑solving, and decision‑making skills</li>
<li>High level of organization, attention to detail, and time management</li>
<li>Ability to multitask and prioritize effectively in a fast‑paced environment</li>
<li>Proven ability to work independently with minimal supervision</li>
<li>Strong stress management and adaptability skills</li>
<li>Goal‑driven with a strong action and results orientation</li>
<li>Demonstrates initiative, persistence, and a strong work ethic</li>
<li>Team‑oriented with the ability to collaborate effectively</li>
<li>Flexible and adaptable to changing priorities</li>
<li>High standards of honesty, integrity, and professionalism</li>
<li>Profit‑ and performance‑oriented mindset</li>
<li>Remote and hybrid positions require internet connectivity that meet the Company&rsquo;s upload and download requirements.</li></ul><br>
<div>
</div><div></div><div><br>
<b>Benefits</b></div>
<div></div><div>ElevatePFS believes in making a positive impact not only within our industry but also with our employees &ndash;the organization&rsquo;s greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.</div>
<ul><li>Medical, Dental &amp; Vision Insurance</li>
<li>401K (100% match for the first 3% &amp; 50% match for the next 2%)</li>
<li>15 days of PTO</li>
<li>7 paid Holidays</li>
<li>2 Floating holidays</li>
<li>1 Elevate Day (floating holiday)</li>
<li>Pet Insurance</li>
<li>Employee referral bonus program</li>
<li>Teamwork: We believe in teamwork and having fun together</li>
<li>Career Growth: Gain great experience to promote to higher roles</li></ul><br>
<div></div><div>The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.</div><br>
<div></div>
<div></div><div><i>The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.</i></div>
<div></div><div><b>Elevate, PFS is an Equal Opportunity Employer</b></div></div>

Bilingual Scheduling and Authorization Coordinator (PST or MST location required)

<div><div><b>Elevate Patient Financial Solutions has an exciting career opportunity available as a Part Time Bilingual </b><b>Front Desk Coordinator</b><b>. This position will be 100% onsite at our office in Orange, CA . The Part Time schedule for this role will be Monday 8AM-5PM and Tuesday - Friday 12PM-5PM .</b></div>
<p><b>Job Summary</b></p>
<div>The purpose of this position is to provide general clerical and administrative office duties.</div>
<p><b>Essential Duties and Responsibilities</b></p>
<ul> <li>Answer and route all incoming calls</li>
 <li>Provide excellent customer service to clients and patients</li>
 <li>Perform general administrative support, including filing, photocopying, and scanning</li>
 <li>Order and maintain supply inventories for office products, mailing supplies, toner, etc.</li>
 <li>Process all incoming and outgoing mail and packages, including researching bad addresses</li>
 <li>Maintain office visitor logs</li>
 <li>Complete daily dip tables and compile report for particular vendors</li>
 <li>Act as liaison with vendors and building management to address issues as the arise</li>
 <li>Keep the front office area, executive kitchen, and conference rooms neat and tidy</li>
 <li>Assist with luncheons, and meeting preparation as needed</li>
 <li>Assist with preparing month-end reports</li>
 <li>Assist marketing with the shipping of orders</li>
 <li>Participate and help coordinate Fun Committee activities, including track expenses</li>
 <li>Special projects as assigned by Administrative Manager</li>
 <li>Other duties as assigned.</li>
</ul>
<p><b>Qualifications and Requirements</b></p>
<p>To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.</p>
<ul><li>Must fluently read, write, and speak both English and Spanish</li>
<li>Minimum of 6 months&rsquo; experience as receptionist or administrative support</li>
 <li>Dependable and punctual</li>
 <li>Excellent verbal and written communication skills</li>
 <li>Organized, detail-oriented, and able to multi-task</li>
 <li>Strong computer skills and proficiency with Microsoft Office suite</li>
 <li>Positive and outgoing personality</li>
 <li>High school diploma or equivalent</li>
<li>Remote and Hybrid positions require a home internet connection that meets the company&rsquo;s upload and download speed criteria.</li>
</ul>
<div><div>The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.</div>
<div></div><div>The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.<br>
<br>
<b>Elevate PFS is an Equal Opportunity Employer</b></div></div></div>

Part Time Bilingual Front Desk Coordinator