Qureos Mentor

Elevate Patient Financial Solutions

<div><div><b>Elevate Patient Financial Solutions </b>has an exciting career opportunity available as a <b>Medicare Specialist.</b> This position will be located in _____________. The Full Time schedule for this role will be _______________.</div>
<div><br>
<b>Job Summary</b><br>
As a Medicare Specialist, you will be instrumental in helping resolve aged medical claims, outstanding claims and denied claims to determine the appropriate course of action. A Medicare Specialist is responsible for the Medicare accounts for multiple hospital or physician groups. These accounts will be assigned by the manager for review and resolution with the use of the Medicare DDE system and Part B websites such as Connex and C-Snap</div>
<div><br>
<b>Essential Duties and Responsibilities</b></div>
<ul><li>Resolve cash generating accounts expeditiously to bring in revenue for the client and the company.</li>
<li>Able to review Medicare claims to determine status (UB/HCFA)</li>
<li>Able to post adjustments on various facility systems</li>
<li>Must have the ability to work denials and appeals in a timely manner</li>
<li>Experience in billing electronic claims</li>
<li>Driven to resolve claims on first touch</li>
<li>Proficiently navigate through CMS.Gov websites as well as the intermediary websites</li>
<li>Working knowledge of ICD-9 and ICD-10, CPT, revenue codes, HCPCS and modifiers</li>
<li>Able to work in the Medicare DDE/FISS (Direct Data Entry) system: (Hospital only)
<ul><li>Check Claim status in DDE</li>
<li>Know the condition codes for adjusting and canceling claims</li>
<li>Enter/correct/adjust/cancel claims</li>
<li>Able to rekey a claim directly into the DDE system</li>
<li>Make correction to RTP claims (returned to provider)</li>
<li>Able to interpret eligibility information on CWF and HIQA</li>
 <li>Develops a solid understanding of assigned client processes in order to review and analyze claims and account receivable functions.</li>
</ul></li><li>Include key information in account notes consistently</li>
<li>Able to ask questions, if unclear, on facility specifics or company processes.</li>
<li>Able to use the appropriate reason and status codes in the company software for each account</li>
<li>Able to request the correct information from the appropriate entity when attempting to resolve the account.</li>
<li>Maintain the minimum production criteria for the various client assigned</li>
<li>Maintain a 5% or less error ratio</li>
<li>Regular and timely attendance.</li>
<li>Other duties as assigned.</li>
</ul><div><b>Qualifications and Requirements</b><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 preferred or college degree.</li>
<li>Minimum 1-2 years&rsquo; experience in working traditional Medicare claims.</li>
<li>Minimum of 1-2 years&rsquo; experience in working in DDE Direct Data Entry system.</li>
<li>Able to type 50 wpm</li>
<li>Team-oriented but also able to work independently</li>
<li>Strong organizational skills.</li>
<li>Excels at time-management.</li>
<li>Able to adapt to change.</li>
<li>Proven success at building strong working relationships with coworkers and management.</li>
<li>Beneficial to have worked in one or more Health Information Systems: Epic physicians or hospital, Meditech, Invision, AS400, Citrix, IDX, Nextgen, Allscript Physicians or hospital, Centricity, Soarian, Series &amp; HBOC Star, Cerner, Practice Plus, TMHP and other Medicaid sites.</li>
<li>Remote and Hybrid positions require internet connections that meet the Company&rsquo;s upload and download speed criteria.</li>
</ul><div><b>Benefits:</b></div>
<div><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.<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>ElevatePFS is an Equal Opportunity Employer</b></div></div>

Medicare Specialist

<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 Specialist</b>. This <b>remote, full-time</b> opportunity offers a consistent schedule of<b> Monday-Friday 8AM-4:30PM</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>
<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>
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:
<ul><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></li><li>Remote and Hybrid positions require a home internet connection that meets the company&rsquo;s upload and download speed criteria</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><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></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>

Workers Comp Claims Representative

<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

Join Elevate Patient Financial Solutions and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Elevate Patient Financial Solutions

About Company

Medicare Specialist

Workers Comp Claims Representative

Part Time Bilingual Front Desk Coordinator