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client services representative managed care

IQVIA

<div>Houston, United States of America | Full time | Hybrid | R1534888</div>
 <div><div>About Cedar Gate Technologies</div><div>
Cedar Gate Technologies, an IQVIA business, enables payers, providers, employers, and service administrators to excel at value-based care with a unified technology and services platform delivering analytics, care, and payment technology on a single data management foundation. At Cedar Gate, you&rsquo;ll be part of a collaborative, innovative environment where great ideas thrive. We invest deeply in our people through ongoing training, comprehensive benefits, and a strong culture of teamwork, offering the chance to grow your skills while contributing to high impact initiatives for some of the world's most dynamic companies.</div><div>
Position Summary</div><div>
Join Cedar Gate Technologies, an IQVIA business, as a Managed Care Services Representative! We&rsquo;re looking for a dynamic new employee to help shape and manage our provider, payer, and facility contracts. In this role, you&rsquo;ll develop, negotiate, implement, monitor, and optimize managed care agreements that support our growth and quality of care. You&rsquo;ll stay on top of industry trends, communicate contract changes across the organization, and analyze performance data to ensure agreements deliver the expected results.</div><div>
As a Managed Care Services Representative, you&rsquo;ll also collaborate closely with internal teams, clients, payers, and providers, building strong relationships and preparing presentations &ndash; with the chance to lead or co-present on key initiatives.</div><div>
Roles &amp; Responsibilities</div><ul><li>
Serve as a primary liaison between internal teams, providers, and payers to resolve managed care issues, support provider communications, and research claims.</li><li>
Support clients, providers, and payers by ensuring timely, effective inquiry resolution.</li><li>
Build and maintain strong relationships with providers, payers, and internal stakeholders to support seamless operations.</li><li>
Collaborate with team members to manage and support Center of Excellence programs, including member education, helpline operations, enrollment, and reporting.</li><li>
Research managed care trends and benchmarks and provide analysis and recommendations.</li><li>
Prepare data, insights, and summaries to support negotiations with payers, employers, and providers; present findings to senior leadership.</li><li>
Assist with the review of payer and provider agreements and support negotiation strategy development.</li><li>
Prepare and present quarterly payer account summaries to departmental leadership.</li><li>
Collaborate with department leadership to prepare accurate and compliant documentation for Committee and Board meetings.</li><li>
Partner cross‑functionally to ensure accurate contract, provider, and workflow information and to support client onboarding.</li><li>
Track contract status, including expirations, amendments, and notice requirements, and proactively communicate required actions.</li><li>
Maintain accurate contract and provider data and documentation across systems, monitor payer policy updates, and coordinate execution of agreements with provider offices.</li></ul><div>
Job Location</div><div>
Houston, TX
</div><div>Work Arrangement</div><div>
Hybrid (3 days in office, 2 days remote)
</div><div>Experience / Qualifications</div><ul><li>
BS/BA in healthcare administration, business, finance, or related field; relevant work experience may be considered</li><li>
3 or more years of experience in healthcare contracting or business operations is required, including reporting, managed care contracting, and patient account resolution with a provider or payer.</li><li>
Working knowledge of CPT, HCPCS and ICD-10 coding is highly preferred</li><li>
Advanced skills with PowerPoint and Excel with knowledge of pivot tables, Power Queries, and complex formulas</li><li>
Experience with claims payment resolution</li><li>
Superior written and verbal communication skills</li><li>
Ability to work well under pressure by efficiently prioritizing and managing multiple tasks to meet performance expectations and deadlines</li><li>
Strong critical thinking and analytical skills, preferably with experience analyzing and interpreting reports for financial trends in the provider contracting arena</li><li>
Exceptional customer service skills with a professional, businesslike image to clients, visitors, internal staff, and the public</li><li>
Prefer experience with healthcare systems or platforms, such as symplr, practice management systems, SSQ, or other reporting tools</li><li>
Experience working in a Cardiology setting, Cardiology terminology and coding is highly preferred</li><li>
To be eligible for this position, you must reside in the same country where the job is located.</li></ul><div>
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at https://jobs.iqvia.com</div><div>
IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe</div><div>
IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.</div>
The potential base pay range for this role is The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.</div>

Client Services Representative, Managed Care

Pride Health

<div>
 
 
 Position Summary
 
 
 
 We are seeking a customer-focused and detail-oriented
 
 Customer Service Representative
 
 with experience in managed care, insurance, or call center environments. The ideal candidate will possess strong communication skills, medical terminology knowledge, and the ability to multitask effectively in a fast-paced setting.
 
 
 
 
 
 
 Key Responsibilities
 
 
 <ul>
 <li>
 Provide high-quality customer service via phone and desktop support applications
 </li>
 <li>
 Address member or customer inquiries accurately and efficiently
 </li>
 <li>
 Identify and resolve issues using problem-solving skills
 </li>
 <li>
 Document interactions and maintain accurate records
 </li>
 <li>
 Navigate call center systems and applications effectively
 </li>
 <li>
 Work collaboratively within a team while managing individual responsibilities
 </li>
 <li>
 Maintain professional phone etiquette and customer-first approach
 </li>
 </ul>
 
 
 
 
 
 Required Qualifications
 
 
 <ul>
 <li>
 High School Diploma or GED (Required)
 </li>
 <li>
 Minimum 1 year of customer service experience in:
 </li>
 <li>
 Managed care or insurance industry
 
 OR
 
 </li>
 <li>
 Call center environment (any industry)
 </li>
 <li>
 Knowledge of medical terminology
 </li>
 <li>
 Typing speed of at least 35 WPM
 </li>
 <li>
 Strong verbal communication and listening skills
 </li>
 <li>
 Ability to multitask and problem-solve efficiently
 </li>
 <li>
 General computer literacy
 </li>
 </ul>
 
 
 
 
 
 Preferred Qualifications
 
 
 <ul>
 <li>
 Bilingual (English-Spanish)
 </li>
 </ul>
 
 
 
 
 
 Benefits:
 
 
 
 
 Pride Health offers eligible employee&rsquo;s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life &amp; disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.
 
 
 
 
</div>

Call Center Representative

Skin Laundry

<div>Aesthetician

Location: Houston, TX - Uptown Park

Job Type: Part-Time

Compensation: This role is a fully based commission role, with a $30 per hour guarantee rate.

Schedule/Availability:
<ul>
<li>Must be available and able to work weekends (sat AND sun) regularly.</li>
</ul><ul><li>Must have a minimum of 3 days available to work per week. One of those days must be a Friday or Monday, with both highly preferred.</li>
</ul><ul><li>Must be available to work during Clinic Operating Hours (as posted on website *subject to change). You will be scheduled 11 hours, working 10 hours after breaks.</li>
</ul><ul><li>Must be able to work a minimum of 1 day per week but will regularly work 1-2 days per week and must have the ability to work up to 3 days per week.</li>
</ul><ul><li>You must be able to commit to a schedule made 60 days in advance.</li>
</ul>
Ability to commute/cover other clinics: Reliably commute to home clinic location &amp; periodically travel to other clinics to provide coverage as needed.

Job Summary

The Aesthetician is responsible for delivering safe and effective treatments to clients while providing an exceptional customer experience. This role includes performing laser-based or aesthetic procedures, educating clients on skincare and post-treatment care, and maintaining compliance with medical and organizational standards. The NP collaborates with the clinic team to ensure a welcoming and professional environment while upholding the highest standards of safety and care. Success in this role requires clinical expertise, a passion for client care, and the ability to support the clinic in achieving its overall performance goals.

Reports To: Clinic Manager

Requirements:

License and Certifications:
<ul>
<li>Licensure: Active and unrestricted Aesthetician license in the state of employment.</li>
<li>Laser Certification (as required by state regulations).</li>
</ul>
Physical:
<ul>
<li>This role requires long periods of sitting &amp; standing. Individuals are required to lift and move inventory and other clinic assets.</li>
</ul>
Preferred Experience:
<ul>
<li>Experience with appointment scheduling platforms such as Zenoti or comparable tools.</li>
<li>Experience in aesthetics, dermatology, customer service, or sales.</li>
<li>Continuing education in aesthetics or skincare preferred.</li>
<li>Prior experience in a clinical or aesthetic setting is preferred but not required.</li>
<li>Knowledge of skin types, treatment indications, and pre/post-care requirements.</li>
<li>Advanced interpersonal skills to create a positive and comfortable client experience while delivering treatments.</li>
<li>Strong verbal and written communication skills to educate clients.</li>
<li>Ability to effectively problem solve in order to assess client needs and address concerns promptly and professionally.</li>
<li>Strong team collaboration to work seamlessly with clinic staff to achieve shared goals.</li>
<li>Clinically competent, professional, compassionate, and able to provide safe and therapeutic services.</li>
<li>Attention to detail in following medical protocols and prioritize client safety.</li>
<li>Strong listening and conversational skills.</li>
</ul>
Responsibilities Include:

Treatment Delivery
<ul>
<li>Perform non-invasive treatments, including laser therapies, under the direction of medical protocols and company standards (all treatment types, and timeframes required).</li>
</ul><ul><li>Assess client eligibility for treatments by reviewing medical history, obtaining informed consent, and addressing client questions or concerns.</li>
</ul><ul><li>Administer treatments with precision and care, ensuring client comfort and satisfaction throughout the procedure.</li>
</ul><ul><li>Maintain detailed and accurate client treatment records in compliance with legal and organizational requirements.</li>
</ul>
Client Education and Experience
<ul>
<li>Educate clients on the benefits, risks, and expected outcomes of treatments, as well as post-treatment care instructions.</li>
</ul><ul><li>Build trust and rapport with clients, ensuring they feel confident and well-informed about their care plan.</li>
</ul><ul><li>Deliver exceptional customer service, creating a positive and professional client experience.</li>
</ul><ul><li>Address client concerns promptly and professionally, escalating issues to medical or clinic leadership</li>
</ul>
Team Collaboration
<ul>
<li>Partner with the clinic team to maintain a clean, organized, and efficient treatment environment.</li>
</ul><ul><li>Communicate effectively with clinic staff to ensure seamless client care and clinic operations.</li>
</ul><ul><li>Support clinic goals by promoting additional services, skincare products, or treatment packages to clients.</li>
</ul>
Safety and Compliance
<ul>
<li>Follow all safety protocols and infection control standards, ensuring compliance with company policies and regulatory guidelines.</li>
</ul><ul><li>Regularly inspect and maintain equipment, documenting and reporting any issues to clinic leadership.</li>
</ul><ul><li>Stay updated on industry best practices, new procedures, and safety standards through continuing education.</li>
</ul>
Occasional Tasks
<ul>
<li>Participate in training sessions or continuing education to learn new treatments or technologies.</li>
</ul><ul><li>Assist with special events or promotional activities to support client acquisition and retention.</li>
</ul><ul><li>Provide mentorship or guidance to new nurses or clinic staff as needed.</li>
</ul>
Support for the Team
<ul>
<li>Assist with administrative tasks, such as inventory checks or restocking treatment supplies.</li>
</ul><ul><li>Support other team members during peak times or unexpected staffing shortages.</li>
</ul>
Contributing to Broader Goals
<ul>
<li>Collaborate with clinic leadership to provide feedback on treatment protocols or client needs.</li>
</ul><ul><li>Participate in quality assurance initiatives to ensure the highest level of care and service.</li>
</ul>
Travel as an Opportunity

Travel is not a requirement for this role but may occasionally involve providing support to neighboring stores during peak times or special events.

Flexibility as a Strength

This role requires flexibility in working hours, including evenings, weekends, and holidays, to meet the demands of high-volume clinic environments. This provides opportunities to lead during peak times, oversee key events, and support new initiatives.

 In-Person Connections

The Aesthetician role is an on-site role, requiring a strong presence during assigned shifts to lead operations, engage with clients, and support team success.

 Employee Benefits &amp; Perks:
<ul>
<li>Skin Laundry Employee Treatment &amp; Product Discount Program</li>
</ul>
5 ways we give back to YOU

We are committed to your growth

You are our priority. Skin Laundry has a team of individuals who are responsible for building out a roadmap that makes your success and development guaranteed - as long as you are willing to put in the work.

Work/Life Balance

We believe that all our team members should be cared for as a HUMAN first and foremost. We have an extensive Holiday Policy and are working relentlessly to release new initiatives that support your mental health in and out of work.

You will be led, not managed

The days of being managed are over. We believe that success comes from working alongside a People Leader who is there to support and uplift - not criticize and over-look.

Speak Up Culture

Let's face it - suffering in silence should no longer be the norm. At Skin Laundry your voice is not only heard, but VITAL to the health of the organization. You have a safe space to speak up, give feedback, and share your needs.

We don't hire jerks

It's as simple as that. We are a group of humble, kind, and self-aware individuals - there is no room for bullying, gossip, racism, or any other kind of discrimination or intolerance here. 


We love hearing from anyone who is enthusiastic about transforming the skin care &amp; beauty industry. Not sure you meet all the qualifications? Research shows that women and members of other under-represented groups tend to not apply to jobs when they think they may not meet every qualification, when, in fact, they often do! We are committed to creating a diverse and inclusive environment and strongly encourage you to apply.

This job description is not designed to cover or contain a comprehensive listing of all activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time, with or without notice.<div> 
Equal Opportunity Employer:

At Skin Laundry, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates without regard to race, color, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military and veteran status, and any other characteristic protected by applicable law. Skin Laundry believes that diversity and inclusion among our teammates is critical to our success as a global company, and we seek to recruit, develop and retain the most talented people from a diverse candidate pool.

Accommodation Assistance:
Skin Laundry is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. To request reasonable accommodation, contact PeopleTeam@SkinLaundry.com
Employment Agencies:

Skin Laundry will not accept unsolicited resumes from any source other than directly from a candidate. Any unsolicited resumes sent to Skin Laundry, including unsolicited resumes sent to a Skin Laundry mailing address, fax machine or email address, directly to Skin Laundry employees, or to Skin Laundry's resume database will be considered Skin Laundry property. Skin Laundry will NOT pay a fee for any placement resulting from the receipt of an unsolicited resume. Skin Laundry will consider any candidate for whom an Agency has submitted an unsolicited resume to have been referred by the Agency free of any charges or fees.</div></div>

Aesthetician PT

<div>
 
 Aesthetician
 
 
 
 
 Location
 
 
 :
 
 Houston, TX - Uptown Park
 
 
 
 Job Type
 
 
 :
 
 Part-Time
 
 
 
 Compensation:
 
 This role is a fully based commission role, with a
 
 $30
 
 per hour guarantee rate.
 
 
 
 Schedule/Availability:
 
 
 
 <ul>
 <li>
 Must be available and able to work weekends (sat AND sun) regularly.
 </li>
 <li>
 Must have a minimum of 3 days available to work per week. One of those days must be a Friday or Monday, with both highly preferred.
 </li>
 <li>
 Must be available to work during Clinic Operating Hours (as posted on website *subject to change). You will be scheduled 11 hours, working 10 hours after breaks.
 </li>
 <li>
 Must be able to work a minimum of 1 day per week but will regularly work 1-2 days per week and must have the ability to work up to 3 days per week.
 </li>
 <li>
 You must be able to commit to a schedule made 60 days in advance.
 
 
 </li>
 </ul>
 
 Ability to commute/cover other clinics:
 
 Reliably commute to home clinic location &amp; periodically travel to other clinics to provide coverage as needed.
 
 
 
 Job Summary
 
 
 
 The Aesthetician is responsible for delivering safe and effective treatments to clients while providing an exceptional customer experience. This role includes performing laser-based or aesthetic procedures, educating clients on skincare and post-treatment care, and maintaining compliance with medical and organizational standards. The NP collaborates with the clinic team to ensure a welcoming and professional environment while upholding the highest standards of safety and care. Success in this role requires clinical expertise, a passion for client care, and the ability to support the clinic in achieving its overall performance goals.
 
 
 
 Reports To:
 
 Clinic Manager
 
 
 
 Requirements:
 
 
 
 
 License and Certifications:
 
 
 
 <ul>
 <li>
 Licensure: Active and unrestricted Aesthetician license in the state of employment.
 </li>
 <li>
 Laser Certification (as required by state regulations).
 
 
 </li>
 </ul>
 
 Physical:
 
 
 
 <ul>
 <li>
 This role requires long periods of sitting &amp; standing. Individuals are required to lift and move inventory and other clinic assets.
 
 
 </li>
 </ul>
 
 Preferred Experience:
 
 
 
 <ul>
 <li>
 Experience with appointment scheduling platforms such as Zenoti or comparable tools.
 </li>
 <li>
 Experience in aesthetics, dermatology, customer service, or sales.
 </li>
 <li>
 Continuing education in aesthetics or skincare preferred.
 </li>
 <li>
 Prior experience in a clinical or aesthetic setting is preferred but not required.
 </li>
 <li>
 Knowledge of skin types, treatment indications, and pre/post-care requirements.
 </li>
 <li>
 Advanced interpersonal skills to create a positive and comfortable client experience while delivering treatments.
 </li>
 <li>
 Strong verbal and written communication skills to educate clients.
 </li>
 <li>
 Ability to effectively problem solve in order to assess client needs and address concerns promptly and professionally.
 </li>
 <li>
 Strong team collaboration to work seamlessly with clinic staff to achieve shared goals.
 </li>
 <li>
 Clinically competent, professional, compassionate, and able to provide safe and therapeutic services.
 </li>
 <li>
 Attention to detail in following medical protocols and prioritize client safety.
 </li>
 <li>
 Strong listening and conversational skills.
 
 
 </li>
 </ul>
 
 Responsibilities Include:
 
 
 
 
 Treatment Delivery
 
 
 
 <ul>
 <li>
 Perform non-invasive treatments, including laser therapies, under the direction of medical protocols and company standards (all treatment types, and timeframes required).
 </li>
 <li>
 Assess client eligibility for treatments by reviewing medical history, obtaining informed consent, and addressing client questions or concerns.
 </li>
 <li>
 Administer treatments with precision and care, ensuring client comfort and satisfaction throughout the procedure.
 </li>
 <li>
 Maintain detailed and accurate client treatment records in compliance with legal and organizational requirements.
 
 
 </li>
 </ul>
 
 Client Education and Experience
 
 
 
 <ul>
 <li>
 Educate clients on the benefits, risks, and expected outcomes of treatments, as well as post-treatment care instructions.
 </li>
 <li>
 Build trust and rapport with clients, ensuring they feel confident and well-informed about their care plan.
 </li>
 <li>
 Deliver exceptional customer service, creating a positive and professional client experience.
 </li>
 <li>
 Address client concerns promptly and professionally, escalating issues to medical or clinic leadership
 
 
 </li>
 </ul>
 
 Team Collaboration
 
 
 
 <ul>
 <li>
 Partner with the clinic team to maintain a clean, organized, and efficient treatment environment.
 </li>
 <li>
 Communicate effectively with clinic staff to ensure seamless client care and clinic operations.
 </li>
 <li>
 Support clinic goals by promoting additional services, skincare products, or treatment packages to clients.
 
 
 </li>
 </ul>
 
 Safety and Compliance
 
 
 
 <ul>
 <li>
 Follow all safety protocols and infection control standards, ensuring compliance with company policies and regulatory guidelines.
 </li>
 <li>
 Regularly inspect and maintain equipment, documenting and reporting any issues to clinic leadership.
 </li>
 <li>
 Stay updated on industry best practices, new procedures, and safety standards through continuing education.
 
 
 </li>
 </ul>
 
 Occasional Tasks
 
 
 
 <ul>
 <li>
 Participate in training sessions or continuing education to learn new treatments or technologies.
 </li>
 <li>
 Assist with special events or promotional activities to support client acquisition and retention.
 </li>
 <li>
 Provide mentorship or guidance to new nurses or clinic staff as needed.
 
 
 </li>
 </ul>
 
 Support for the Team
 
 
 
 <ul>
 <li>
 Assist with administrative tasks, such as inventory checks or restocking treatment supplies.
 </li>
 <li>
 Support other team members during peak times or unexpected staffing shortages.
 
 
 </li>
 </ul>
 
 Contributing to Broader Goals
 
 
 
 <ul>
 <li>
 Collaborate with clinic leadership to provide feedback on treatment protocols or client needs.
 </li>
 <li>
 Participate in quality assurance initiatives to ensure the highest level of care and service.
 
 
 </li>
 </ul>
 
 Travel as an Opportunity
 
 
 
 Travel is not a requirement for this role but may occasionally involve providing support to neighboring stores during peak times or special events.
 
 
 
 Flexibility as a Strength
 
 
 
 This role requires flexibility in working hours, including evenings, weekends, and holidays, to meet the demands of high-volume clinic environments. This provides opportunities to lead during peak times, oversee key events, and support new initiatives.
 
 
 
 In-Person Connections
 
 
 
 The Aesthetician role is an on-site role, requiring a strong presence during assigned shifts to lead operations, engage with clients, and support team success.
 
 
 
 Employee Benefits &amp; Perks
 
 
 :
 
 
 
 <ul>
 <li>
 Skin Laundry Employee Treatment &amp; Product Discount Program
 
 
 </li>
 </ul>
 
 5 ways we give back to YOU
 
 
 
 
 
 We are committed to your growth
 
 
 
 
 You are our priority. Skin Laundry has a team of individuals who are responsible for building out a roadmap that makes your success and development guaranteed - as long as you are willing to put in the work.
 
 
 
 
 Work/Life Balance
 
 
 
 
 We believe that all our team members should be cared for as a HUMAN first and foremost. We have an extensive Holiday Policy and are working relentlessly to release new initiatives that support your mental health in and out of work.
 
 
 
 
 You will be led, not managed
 
 
 
 
 The days of being managed are over. We believe that success comes from working alongside a People Leader who is there to support and uplift - not criticize and over-look.
 
 
 
 
 Speak Up Culture
 
 
 
 
 Let&rsquo;s face it - suffering in silence should no longer be the norm. At Skin Laundry your voice is not only heard, but VITAL to the health of the organization. You have a safe space to speak up, give feedback, and share your needs.
 
 
 
 
 We don&rsquo;t hire jerks
 
 
 
 
 It&rsquo;s as simple as that. We are a group of humble, kind, and self-aware individuals - there is no room for bullying, gossip, racism, or any other kind of discrimination or intolerance here.
 
 
 
 We love hearing from anyone who is enthusiastic about transforming the skin care &amp; beauty industry. Not sure you meet all the qualifications? Research shows that women and members of other under-represented groups tend to not apply to jobs when they think they may not meet every qualification, when, in fact, they often do! We
 
 
 
 are
 
 
 
 committed to creating a diverse and inclusive environment and strongly encourage you to apply.
 
 
 
 
 This job description is not designed to cover or contain a comprehensive listing of all activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time, with or without notice.
 
 
 
 
 Equal Opportunity Employer
 
 :
 
 
 At Skin Laundry, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates without regard to race, color, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military and veteran status, and any other characteristic protected by applicable law. Skin Laundry believes that diversity and inclusion among our teammates is critical to our success as a global company, and we seek to recruit, develop and retain the most talented people from a diverse candidate pool.
 
 
 
 Accommodation Assistance:
 
 
 
 Skin Laundry is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. To request reasonable accommodation, contact PeopleTeam@SkinLaundry.com
 
 
 
 Employment Agencies:
 
 
 
 Skin Laundry will not accept unsolicited resumes from any source other than directly from a candidate. Any unsolicited resumes sent to Skin Laundry, including unsolicited resumes sent to a Skin Laundry mailing address, fax machine or email address, directly to Skin Laundry employees, or to Skin Laundry&rsquo;s resume database will be considered Skin Laundry property. Skin Laundry will NOT pay a fee for any placement resulting from the receipt of an unsolicited resume. Skin Laundry will consider any candidate for whom an Agency has submitted an unsolicited resume to have been referred by the Agency free of any charges or fees.
</div>

<div>Houston, United States of America | Full time | Home-based | R1537654</div>
 <div><div>Bi-lingual Pharmacy Support Call Center Representative 
Contract Remote Role &ndash; Location (Open to Remote US)</div><div>
As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product&rsquo;s value to payers, physicians, and patients. A significant part of our business is providing patient support programs on the behalf of our customers. With the right experience, you can help provide support to patients in need of available therapies.</div><div>
IQVIA has the world&rsquo;s largest Commercial Sales &amp; Medical Solutions (CSMS) organization dedicated to the launch and marketing of pharmaceutical and medical products. With a focus on providing talent for patient support, field/inside sales, medical device support, clinical support, and medical affairs our CSMS division has 10,000+ field professionals in more than 30 countries addressing physician and patient needs.</div><div>
We are excited to announce that currently we are looking for a 100% remote (work from home&mdash;WFH) contract Pharmacy Support Call Center Representative to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The Pharmacy Support Call Center Representative is primarily responsible for fielding requests such as: card activation, program eligibility, explanation of program benefit and explanation/troubleshooting of submission rejection. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.</div><div>
Role Purpose:</div><ul><li>
Primary Call Center contact for patients, pharmacies and medical professionals utilizing an Opus Health program. Call Center Representatives are responsible for fielding requests such as: card activation, program eligibility, explanation of program benefit and explanation/troubleshooting of submission rejection.</li></ul><div>
Job Responsibilities:</div><ul><li>
Provide initial support for customer requests via telephone, email, fax, or other available means of contact to the Support Center</li><li>
Quickly assess the user's issue and provides first level support for problem resolution</li><li>
Document information specific to the resolution and escalate unresolved issues expeditiously to the appropriate area</li><li>
Recognize operational challenges and suggest recommendations to management, as necessary</li><li>
Ability to work 40 hours per week under moderate supervision</li><li>
Multiple shifts available:</li></ul><h3 class="jobSectionHeader">
8:00 am - 5:00 pm EST
</h3><h3 class="jobSectionHeader">9:00 am &ndash; 6:00 pm EST</h3><h3 class="jobSectionHeader">
10:00am &ndash; 7:00pm EST</h3><h3 class="jobSectionHeader">
11:00 am &ndash; 8:00pm EST</h3><div>
Minimum Education &amp; Experience:</div><ul><li>
High School Diploma or equivalent</li><li>
Pharmacy Technician experience required</li><li>
HIPAA certified</li><li>
Call center experience required (3+ years preferred)</li><li>
Experience in medical claim processing is a plus</li><li>
Bi-lingual (English/Spanish)</li></ul><div>
The pay range for this role is $18.00 per hour. To be eligible for this position, you must reside in the same country where the job is located.</div><div>
IQVIA is an Equal Opportunity Employer. We cultivate a diverse corporate culture across the 100+ countries where we operate, celebrating and rewarding teamwork and inclusiveness. By embracing our differences, we create innovative solutions that are good for IQVIA, our clients, and the advancement of healthcare everywhere. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.</div><div>
#LI-CES</div><div>
#LI-Remote</div><div>
#LI-DNP</div><div>
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at https://jobs.iqvia.com</div><div>
IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe</div><div>
IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.</div>
The potential base pay range for this role is $18.00 per hour. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.</div>

Bi-lingual Pharmacy Tech Support/Call Center Rep (Work from Home)

PFS Group

<div>Job Purpose:
The Insurance Representative at PFS Group under the supervision of the Insurance Supervisor, the Insurance Representative manages insurance claims to ensure timely and accurate reimbursement. The role involves researching unpaid balances, correcting billing issues, submitting appeals, and communicating with insurers, patients, and internal teams to resolve discrepancies. Strong knowledge of insurance guidelines, billing systems, and effective accounts receivable management is essential, with responsibility for managing assigned inventories based on client needs. 
 
Key Responsibilities:
<ul><li>Initiates contact with insurance payers to collect contracted rates on outstanding claims</li><li>
Reviews, monitors and effectively reduces aged inventory</li><li>
Successfully identifies root causes for denials or non-payment, prioritizing collection metrics in all work efforts</li><li>
Ensures timely filing deadlines are achieved according to payer guidelines</li><li>
Monitors accounts for updates on claims processing, taking care to resolve balances with single interventions whenever possible</li><li>
Request appropriate claim corrections and rebill as needed</li><li>
Informs supervisor of trends noticed when working insurance inventory
</li><li>Interpret payment variances and payer guidelines to monitor for underpayment opportunities
</li><li>Contacts guarantors as needed to resolve coverage discrepancies</li><li>
Corrects adjustments as needed to ensure balances are accurately documented</li></ul>
Education and Experience:<ul><li>
High school diploma or equivalent is required</li><li>
At lease one year experience in revenue cycle, with emphasis on Insurance Follow-Up, Denials, Billing, or Cash Posting</li><li>
Experience with EPIC HB or PB Resolute</li></ul> 
Required Skills and Abilities:<ul><li>
Strong understanding of insurance policies, coverage, claims processes, and reimbursement, with the ability to research payer billing policies and medical bulletins to accurately troubleshoot denials and unpaid balances</li><li>
Excellent communication skills, both verbal and written, with the ability to explain complex information clearly</li><li>
Proficient in using insurance-related software and Microsoft Office Suite, including Word, Excel, and Outlook</li><li>
Strong analytical and problem-solving skills, with attention to detail</li><li>
Ability to work independently and manage time effectively in a fast-paced environment</li></ul>
PFS Group
Nationwide Patient Account Management Firm.
Based in Houston, Texas, we currently work with 32+ clients who operate more than 100 hospital facilities from small, rural community medical centers to metro population center health systems. Leaders in their respective markets and nationwide, our clients rely on our services to support their accounts receivable departments.
PFS Group offers a friendly, caring work environment, with competitive benefits and compensation, (medical, dental, vision, short and long-term disability, life insurance, hospital indemnity, critical illness, accident insurance and a matching 401(k) and Zayzoon!
If you are looking for a position in a dynamic, fast-paced organization with career growth opportunities, come grow with us! www.pfsgroup.org</div>

Insurance Rep

Duracare Home Health Services

Job Summary We are seeking a dedicated and compassionate Home Health Case Manager to join our dynamic healthcare team. In this vital role, you will coordinate and oversee patient care plans within the home health setting, ensuring seamless delivery of high-quality, patient-centered services. Your expertise will help facilitate smooth transitions from hospital or outpatient settings to home care, promoting recovery, safety, and well-being. This position offers an exciting opportunity to make a meaningful difference in patients&rsquo; lives by providing comprehensive case management that emphasizes clinical excellence and compassionate support.Duties<ul><li>Manage documentation of medical records, ensuring compliance with HIPAA regulations and maintaining accurate records of patient interactions and treatment plans.</li><li>Facilitate communication between patients, families, healthcare providers, and managed care organizations to optimize health outcomes.</li><li>Oversee utilization management processes by evaluating diagnostic evaluations and ensuring appropriate resource utilization for each case.</li><li>Coordinated admissions, recertifications, and discharges</li><li>Obtained prior authorizations from payers (e.g., Blue Cross Blue Shield, Medicare, Medicaid)</li><li>Coordinated clinician schedules and patient visit frequency</li></ul>Experience<ul><li>medical office experience</li><li>insurance authorizations</li><li>bilingual (spanish) A MUST.</li></ul>Pay: $17.00 per hourWork Location: In person

home health case manager

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home health case manager