group insurance specialist

AR Insurance Specialist - Mountain Standard Time

DC Department of Human Resources

<div>
 
 (This position may be filled at any of the following grade levels, CS-09, CS-11, or CS-12, and has promotion potential within the career ladder to the next grade level.)
 
 
 
 
 SALARY RANGE PER GRADE LEVEL
 
 
 
 Grade CS-9 - $62,158 - $80,032
 
 
 Grade CS-11 - $74,893 - $96,547
 
 
 Grade CS-12 - $92,656 - $118,558
 
 
 If you like to stay busy and immersed in cultural activities, then Washington, DC is the place to be! Museums, restaurants, great climate, green space and job opportunities are among the many positives of living in the Nation&rsquo;s Capital. Not to mention the residents of the District of Columbia are highly educated and the region has some of the best schools in the country. Each day the District of Columbia continues to be ranked in the top 10 of thriving city indicators where you can live, work and play.
 
 
 
 INTRODUCTION
 
 
 
 This position is located in the Disability Determination Division, Rehabilitation Services Administration, Department on Disability Services. The Disability Determination Division determines the absence or presence of a disability and adjudicates claims and their appeals for disability benefits under the Social Security Act. All program costs are fully reimbursed from the Social Security Administration.
 
 
 
 MAJOR DUTIES
 
 
 
 The incumbent will review and analyze Initial claims for evidence of illness, injury, disease, and/or other medical conditions and vocational factors, which prevent an individual from working or gaining employment. Conducts interviews to obtain, clarify and verify information about Initial eligibility for benefits. Adjudicates claims for benefits using conventional procedures that easily apply to most situations. Determines if applicants for or recipients of disability insurance are engaging in substantial gainful employment. Prepares an analysis explaining the facts of the case and the basis for the decision and provides written notice to the claimant and the Social Security Administration.
 
 
 <ul>
 <li>
 Maintains a caseload of initial claims for Social Security Disability and Supplemental Security Income, developing appropriate information and evidence. Analyzes facts, evidence, and allegations to determine accuracy and applicability.
 </li>
 <li>
 Completes case reviews and writes a comprehensive analysis on initial disability cases, at different stages of development, in order to assure compliance with the Social Security laws and regulations and legal statutes utilizing the appropriate internal office procedures.
 </li>
 <li>
 Interviews or corresponds with claimants, family members, legal representatives, employers, community resources and others as needed, to obtain additional information or collateral evidence concerning an individual's functional abilities.
 </li>
 <li>
 Conducts interviews with claimants, family, case workers, medical providers, and others to obtain, clarify, and verify information for Initial claims.
 </li>
 <li>
 Interprets the various medical reports and evaluates the age and authenticity of evidence submitted as proof of eligibility in compliance with Social Security rules and regulations (POMs).
 </li>
 <li>
 Determines the need for additional medical tests, evaluations, or consultative examinations in the fields of medicine, psychology, psychiatry, or other specialties.
 </li>
 <li>
 Prepares a written residual functional capacity assessment based on the severity of the medical, psychological, and all applicable potential other conditions and how the nature of the impairment impacts the function and ability to work at the level of substantial gainful activity.
 </li>
 <li>
 Consults with internal and external professionals or contract providers, including physicians, psychologists, counselors, speech and language pathologists, social workers, and vocational experts to address issues and provide specialized guidance.
 </li>
 <li>
 Reviews vocational factors in correlation with the established medical assessments and provides an explanation of ability to return to past work, transfer to other work, or pardoned from any available work in the national economy due to medical factors.
 </li>
 <li>
 Prepares a detailed written analysis explaining the facts of the case and the basis for the decision and provides written notice to the claimant and the Social Security Administration.
 </li>
 <li>
 Protects and safeguards confidential and sensitive personal, medical, and vocational information in accordance with federal and state mandates.
 </li>
 <li>
 Performs other duties as assigned.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 Applicant must have one (1) year of Specialized Experience at the next lower grade level. Three years of related work experience that equipped the applicant with the particular knowledge, skills, and abilities to successfully perform the duties of the position and is related to adjudicating and authorizing entitlement or disallowance actions at all levels of difficulty and complexity under programs administered by SSA.
 
 
 You must meet all qualifications and eligibility requirements by the closing date of this announcement.
 
 
 
 Applicants must have met the qualifications requirements for this position by the closing date to be eligible for this position.
 
 
 
 
 Education, Licenses, Certifications, And Other Requirements
 
 
 
 2 years of progressively higher-level graduate education leading to a master&rsquo;s degree or master&rsquo;s equivalent graduate degree. An equivalent combination of education and experience will be considered.
 
 
 
 Work Experience/Knowledge
 
 
 
 Knowledge of policies, procedures, and provisions of the Social Security Act concerning eligibility for disability benefits, Social Security rulings, and pertinent court rulings.
 
 
 Knowledge of other Federal and State benefits, tax, citizenship, veterans, and welfare programs and as appropriate, international legal agreements, other public, private, and nonprofit retirement programs and other programs that interrelate with social insurance programs.
 
 
 Knowledge of Federal and State laws regarding confidentiality of personal information and procedures for obtaining and disclosing information and validity of marriage, divorce, descent, and distribution of property as they affect eligibility for social insurance benefits.
 
 
 Knowledge of the agency's integrated automated case processing systems and skill in using the systems' input and output, methodology, forms, and data.
 
 
 Skill in obtaining and evaluating information concerning an individual's functional abilities, employment, education, and other factors.
 
 
 Ability to research precedent decisions and other reference materials
 
 
 
 Collective Bargaining Unit
 
 
 
 This position is in the collective bargaining unit represented by the local union AFSCME 2401.
 
 
 
 Additional Information
 
 
 
 Once applications are submitted, applicants will not be able to change their responses to the online questions.
 
 
 The position for which the individual is applying has been identified and designated as requiring enhanced suitability screening.
 
 
 If tentatively selected for the position, a criminal background check, traffic record check, consumer credit check, and mandatory drug and alcohol test will be conducted (
 
 as appropriate
 
 ); and
 
 
 The appointee to the position may be offered employment contingent upon receipt of a satisfactory enhanced suitability screening.
 
 
 
 Work Schedule
 
 
 
 This position requires 4 days a week in the office.
 
 
 
 How You Will Be Evaluated
 
 
 
 You will be evaluated for this job based on how well you meet the qualifications above. Your application includes your resume, responses to the online questions, and required supporting documents. Please be sure that your resume includes detailed information to support your qualifications for this position; failure to provide sufficient evidence in your resume will result in a "not qualified" determination.
 
 
 
 EEO Statement
 
 
 
 The District of Columbia Government is an Equal Opportunity Employer. All qualified candidates will receive consideration without regard to race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, family responsibilities, matriculation, physical handicap, or political affiliation.
</div>

Social Insurance Specialist

FedEx

<div>Job Duties 
Assists in the production, coordination and communication of monthly operational/fiscal year/long range system form schedules and load plans. Analyze change requests to determine operational feasibility and cost/benefits. Gather and interpret reports and maintain information regarding line haul activity. Performs other duties as assigned. 
Minimum Education
Bachelor's degree/equivalent.
Minimum Experience
Related experience scheduling, planning, analysis or FedEx package movement, trucking, flight operation preferred.
Knowledge, Skills, and Abilities
Good analytical and communications skills. 
Preferred Qualifications:
Pay Transparency:
Pay: $4,107.80/mo- $10,744.16/mo
Additional Details: This position must be domiciled in Memphis, TN. 
For details on our comprehensive benefits, click here. 
Federal Express Corporation is an Equal Opportunity Employer including, Vets/Disability.
Reasonable accommodations are available for qualified individuals with disabilities throughout the application process. Applicants who require reasonable accommodations in the application or hiring process should contact recruitmentsupport@fedex.com.
Applicants have rights under Federal Employment Laws:<ul><li>
Know Your Rights</li><li>
Pay Transparency</li><li>
Family and Medical Leave Act (FMLA)</li><li>
Employee Polygraph Protection Act</li></ul>
E-Verify Program Participant: Federal Express Corporation participates in the Department of Homeland Security U.S. Citizenship and Immigration Services&rsquo; E-Verify program (For U.S. applicants and employees only). Please click below to learn more about the E-Verify program:<ul><li>
E-Verify Notice (bilingual)</li><li>
Right to Work Notice (English) / (Spanish)</li></ul></div>

Assoc System Form Specialist - Global Linehaul Specialist

Centurum

<div><h4 class="jobSectionHeader">Job Summary</h4>
The Configuration Management Specialist supports the evolution of the Operations Control Center (OCC) from traditional administrative and security access-control functions to a digitally enabled, data-driven operational environment. This role is responsible for configuration management, operational coordination, and real-time decision support within a modernized cloud-enabled ecosystem. 
 
DUTIES AND RESPONSIBILITIES
<ul><li>Provide high-level customer service as a central OCC interface, supporting users with access requests, asset coordination, scheduling, and operational inquiries in a technologically advanced environment.</li><li>
Manage and maintain configuration management (CM) of laboratory products, services, hardware, software, documentation, inventories, and technical baselines throughout the system life cycle.</li><li>
Support Configuration Change Requests (CCRs), Engineering Changes (ECs), and Field Changes (FCs), including documentation, tracking, impact analysis, and coordination with the Configuration Control Board (CCB).</li><li>
Interpret and monitor digital dashboards, automated alerts, and system health indicators to support real-time operational awareness and decision-making.</li><li>
Operate and navigate interconnected applications and platforms (e.g., BMC toolsets, SaaS-based systems, cloud-hosted environments) used for scheduling, maintenance coordination, access verification, and incident response.</li><li>
Support requirements management (RM), quality management system (QMS) processes, and continuous process improvement initiatives aligned with testbed operations.</li><li>
Assist in maintaining material management processes, including General Equipment (GE), OM&amp;S, and classified/unclassified inventory tracking and audits.</li><li>
Coordinate technical documentation, media management, and safeguarding of classified material in accordance with DoD and NIWC Pacific policies.</li><li>
Participate in Technical Interchange Meetings (TIMs) and operational coordination meetings to support integration, scheduling, and execution of testbed activities.</li></ul> 

REQUIRED SKILLS/YEARS OF EXPERIENCE
<ul><li>3+ years of professional experience in configuration management</li><li>
Knowledge of scheduling tools, including MS Project or Primavera</li></ul> 

Education: High School Diploma or GED 
Travel Required: 0% 
Work Location: San Diego, CA (Naval Base Point Loma) 
This position is required to have and maintain a Secret US DoD security clearance. 
 
PREFERRED SKILLS<ul><li>
Associates degree</li><li>
Three (3) or more years of professional experience in configuration management, operations control, or technical coordination</li><li>
Familiarity with Quality Management Systems (QMS), Configuration Management (CM), CCB processes, and requirements management (RM)</li><li>
Experience working with IT service management tools (e.g., BMC or similar platforms), cloud-based or SaaS solutions</li><li>
Exposure to testbed operations, C5ISR, networked systems, or lab environments</li><li>
Ability to work in fast-paced, operational settings requiring judgment, prioritization, and coordination across multiple teams</li></ul> 

REMARKS<ul><li>
Must be able to communicate effectively in English, both verbally and in writing</li><li>
Must be able to interface effectively with all levels of technical and management personnel</li><li>
Position supports transforming operational environment emphasizing digitization, automation, and data-driven decision-making</li></ul> 
Compensation: $33-$36.65 an hour. 
Compensation for positions at Centurum vary depending on a wide range of factors including, but not limited to, location, responsibilities, skill set, and level of experience. 
Labor Category is Specialist, Configuration Management I 
 
EOE M/F/Disability/Veteran 
***When responding to this posting please reference job # KN26-03 Configuration Management Specialist**<div>

Benefits
Full-time employees are eligible for the following benefits enrollment from their date of hire:
<ul><li>Health Insurance - Centurum provides insurance for employee and dependent in a comprehensive package. Coverage for vision care is included. This option is available on a cost-sharing basis.</li>
<li>Dental Insurance - Available in conjunction with Health Insurance for an additional cost. Provides oral maintenance care for employee and dependent.</li>
<li>Basic Life Insurance - Company provided benefit for all full-time employees.</li>
<li>Supplemental Life Insurance - Optional life insurance coverage to employees at group rates.</li>
<li>Dependant Life Insurance - Optional coverage for dependents at a group rate.</li>
<li>Long Term Disability Insurance - Optional coverage available to employees at group rates.</li>
<li>Vacation and Sick Leave - Leave accrual is determined by length of service.</li>
<li>Holidays - The company observes ten paid holidays each year.</li>
<li>Retirement 401(k) Plan - Centurum&rsquo;s corporate benefits package includes 401K with a company bi-weekly match and a year-end profit sharing company match for all eligible employees. Investments can be made into selected funds under this plan.</li>
</ul>
Centurum is an Equal Opportunity Employer, providing employment opportunities for all persons without discrimination on the basis of race, color, religion, sex, sexual orientation, national origin, age, disability, marital status, citizenship or any other characteristic protected by U.S. law. Centurum makes reasonable accommodations for persons with disabilities.
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Configuration Management Specialist I (CTB)

Presbyterian Healthcare Services

<div>Location Address:
9521 San Mateo NE Albuquerque, NM 87113-2237

Compensation Pay Range:
Minimum Offer $15.60 Maximum Offer $22.12 Now Hiring: Patient Access Account Specialist I-ABQ
Summary:
Under the direction of the Patient Access Supervisor, the Patient Access Account Specialist I provides basic functions to financial clear patient accounts for government and commercial accounts prior to the date of service. Performs basic financial clearance functions, including insurance verification, authorization, collection and documentation of patient demographics, benefit analysis, and pre-service collections. The Patient Access Account Specialist I will ensure follow up on authorizations for scheduled and Urgent/Emergent procedures and admissions until date of service or discharge for admissions. The Patient Access Account Specialist I must possess a basic knowledge of Medicare (CMS) guidelines, as well as other Compliance Regulatory guidelines applicable to Patient Access to include HIPAA, EMTALA, and CMS guidelines of MSPQ. The Patient Access Account Specialist (PAAS I) monitors work queues for financial clearance and missing authorizations ensuring a payment source is identified and secured and there is a clean claim for billing. The Patient Access Account Specialist I acts as resource to all employees within Patient Access. The Patient Access Account Specialist I is responsible for providing the highest level of customer service to patients, ancillary departments and payers when financially clearing accounts. The PAAS I will work with ancillary departments to ensure the procedures scheduled and authorized meet payer requirements. The Patient Access Account Specialist I provides coverage to other areas and hospitals as needed to minimize overtime and guarantee the patients receive services as needed without registration delays. Type of Opportunity: Full time Job Exempt: No Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Days (United States of America)

Responsibilities:
Customer Service and Caring Practices: *Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools. *Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times and de-escalation processes. *Ability to manage conflict and appropriately request the help of a supervisor when needed. *Implement PROMISE and CARES behaviors in every encounter. *Educates patients for whom they speak regarding insurance benefits and liabilities. *Ensures accounts are financially cleared prior to date of service to alleviate patient concerns over hospital financial matters Encounter Components: *Performs the patient registration process. Manage the accurate collection of patient data which includes but is not limited to; *Obtain/confirm and enter demographic and other financial and clinical information necessary for final clearance of scheduled accounts. *Review Urgent/Emergent admission accounts for notification, financial clearance and authorization pre-discharge. *Obtain missing insurance information, to include policy number, group number, date of birth, and insurance phone number if not already identified in account. *Verify insurance for eligibility and benefits using online electronic verification system or by contacting payer directly. *Review and process work queues related to Patient Access pre-visit or urgent/emergent admissions, per department guidelines. *Review of accounts falling within the work queues to ensure the insurance information contains accurate policy ID#s, Group Name and Numbers, Subscriber information, Authorization numbers, as well as correct payer and Coordination of benefits prior to date of service. *Accurately document actions taken in the system of record to drive effective follow-up and ensure an accurate audit trail. *Maintain ongoing knowledge of authorization requirements and payer guidelines. Maintain a proficient knowledge of Medicare (CMS) guidelines as it relates to admissions and outpatient services. Ensuring compliance with admissions forms, benefit entitlement verification, and billing requirements *Ensure accurate completion of MSPQ prior to date of service. *Daily focus on attaining productivity standards; recommend new approaches for enhancing performance and productivity when appropriate. *Monitor and track Data Quality program to ensure errors are corrected prior to final bill and correct accounts as necessary. *Maintain appropriate records, files, and timely and accurate documentation in the system of record. *Work with ancillary departments to ensure coding, diagnosis and facility are authorization are in alignment. *Work with payers to ensure authorization is in place; initiating the auth when appropriate. *Coordinate efforts with Financial Advocates to secure payer source current and future visits. *Monitor work queues to identify late add-on accounts and complete financial clearance procedures prior to services to avoid unauthorized procedures from being performed. *Work with physician offices to resolve discrepancies in authorizations and scheduled procedures. Financial Accountabilities: *Collects identified patient financial obligation amounts including residual balance if applicable. Collect liability from patient prior to visit or make arrangements for payment at time of service. *Ensure a payer source has been identified prior to services being rendered. *Ensure authorization for correct procedure (CPT), facility, and date of service is obtained. Patient Relations *Contact patients pre-visit to complete any information missing from the account to ensure accuracy prior to visit. *Transparency with patients through communication of patient liabilities and authorization issue in a timely manner, allowing patients ability to make informed decisions. *Educate patients and answer questions from patients on benefits, liabilities and financial options. *Provide patient with way-finding for appointment at time of pre-registration. *Perform AIDET when speaking to patient to alleviate anxiety and confusion. Quality Improvement: *Perform assigned patient care responsibilities, which may include but not limited to: *Cooperate fully in all risk management activities and investigations. *Report promptly any suspected or potential violations to laws, regulations, procedures, policies, and practices, and cooperate in related investigation. *Conduct all transactions in compliance with all company policies, procedures, standards, and practices. *Demonstrate knowledge of all applicable compliance and legal requirements of the job based on the scope of practice of the position. C.A.R.E.S Behaviors: *Demonstrates CARES behaviors of Collaborate, be Accountable, Respect, Engage and Serve to all whom you encounter. *Other duties as assigned
Qualifications:
*High school diploma, continued education preferred *External and Internal Non-Patient Access Candidates: Pass Patient Academy with passing score of 85% or higher *Previous completion and passing of Patient Access Advocate II and III Advancement test. *A minimum of 2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background. *Strong knowledge and understanding of insurance and financial processing of accounts. *Proficient in EPIC ADT system *Specialty Certifications: CHAA, CHAM or other industry equivalent certification preferred *Pass annual competency exam for all areas of responsibility. *Requires general knowledge of the customer encounter process which may include registration, contract requirements, and coordination of benefits. *Knowledge in Microsoft Office Products. *Demonstrated strong keyboarding skills, ensuring efficient data entry and documentation. *Pass EPIC proficiency test required with a 85% score at completion of the Epic Training class. UPDATED 7/29/25
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. 
Wellness 
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more. 
Why work at Presbyterian? 
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. 
About Presbyterian Healthcare Services 
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.<h1 class="jobSectionHeader">
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services</h1></div>

Patient Access Account Specialist I-ABQ

Solvere Technical Group

<div>Solvere Technical Group is looking for a Cognitive Performance Specialist (CPS) to join the team.
Experience:
<ul><li>2+ years providing cognitive performance services.</li>
<li>Experience in collegiate (or higher), professional, or tactical athletics; aerospace industry, test pilot/astronaut, or similar man-machine high-performance environment.</li>
</ul>
Education:
<ul><li>Master&rsquo;s degree in psychology, counseling, or human-related field.</li>
<li>Performance, Kinesiology, Exercise Science, or Sport Sciences with a specialization in Sport Psychology or similar from an accredited institution/university.</li>
</ul>
Clearance:
<ul><li>Active Secret</li>
</ul>
Required Certifications:
<ul><li>Current certification in basic cardiopulmonary resuscitation (CPR), including Automated External Defibrillator (AED) training.</li>
<li>External Defibrillator (AED) training.</li>
</ul>
BENEFITS
Solvere offers a comprehensive and generous benefits package. The Solvere benefits package includes medical, dental, and vision insurance for the employee and/or families. Solvere also includes basic life insurance plus short- and long-term disability for the employee. Employees may elect to enroll in our company&rsquo;s 401k plan. Employees will also accrue paid time off and holidays. Additional voluntary options include supplemental insurance plans.
About the Company Visit: www.solveretechnical.com
Solvere Technical Group is committed to non-discrimination and equal employment opportunity. All qualified applicants will receive consideration for employment without discrimination based on disability, protected veteran status or any other characteristics protected by law.</div>

Cognitive Performance Specialist (CPS) Level 1

Addison Group

Job Overview We are seeking a dynamic and detail-oriented Medical Billing Specialist to join our healthcare team. In this vital role, you will be responsible for managing the entire billing process, ensuring accurate coding, timely submission of claims, and effective follow-up on outstanding accounts. Your expertise will help optimize revenue cycle management while maintaining compliance with industry standards. This position offers an exciting opportunity to contribute to efficient healthcare delivery through precise medical billing practices.Responsibilities<ul><li>Prepare and submit insurance claims using appropriate coding systems such as CPT (Current Procedural Terminology), ICD-9, and ICD-10 codes.</li><li>Review medical records and documentation to ensure accuracy and completeness for billing purposes.</li><li>Verify patient insurance coverage and eligibility before submitting claims.</li><li>Follow up on unpaid or rejected claims through effective medical collection strategies.</li><li>Maintain detailed records of billing activities within Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems.</li><li>Collaborate with healthcare providers to clarify diagnoses or procedures requiring accurate DRG (Diagnosis-Related Group) coding.</li><li>Ensure compliance with healthcare regulations and industry standards related to medical coding and billing.</li></ul>Requirements<ul><li>Proven experience in medical office settings or healthcare billing environments.</li><li>Strong knowledge of medical terminology, medical records management, and billing procedures.</li><li>Familiarity with DRG, CPT coding, ICD-9, ICD-10, and ICD coding systems.</li><li>Experience working with EMR/EHR systems for documentation and billing purposes.</li><li>Excellent attention to detail and organizational skills to manage multiple claims efficiently.</li><li>Ability to interpret complex medical documentation and translate it into accurate billing codes.</li><li>Effective communication skills to coordinate with providers, insurance companies, and patients. Join our team as a Medical Billing Specialist and play a crucial role in ensuring smooth financial operations while supporting quality patient care!</li></ul>Pay: $34.39 - $59.37 per hourBenefits:<ul><li>Dental insurance</li><li>Health insurance</li><li>Retirement plan</li></ul>Work Location: In person

Medical Billing Specialist

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