Corden Pharma Colorado
Boulder, Colorado
Job Description Job Description CordenPharma is a leading full-service Contract Development and Manufacturing Organization (CDMO) specializing in active pharmaceutical ingredients (APIs), excipients, drug products (DPs), and packaging. With around 3,000 employees worldwide, we help pharmaceutical and biotech companies manufacture medicines with the ultimate goal of improving people's lives. Our network, spanning Europe and the U.S., provides flexible and specialized solutions across six technology platforms: Peptides, Lipids & Carbohydrates, Injectables, Highly Potent & Oncology, Small Molecules, and Oligonucleotides. We strive for excellence in supporting this network and are committed to delivering the highest quality products for patient well-being. Our People Vision We strive for excellence. We share our passion. Together, we make a difference in patients' lives. SUMMARY The Manager of Automation & MES (OT) leads Engineers, Technical Specialists, SMEs, and contractors responsible for OT controls of manufacturing equipment, support equipment, integration of systems, and site-wide continuous improvement initiatives. This role includes the conceptualization, design, implementation, and documentation of OT projects and lifecycle management in compliance with regulatory requirements. The Manager represents the department during regulatory meetings and audits and oversees hiring, training, career development, performance appraisals, and team motivation. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Other duties may be assigned. Develop and execute a plant-wide OT strategy and roadmap aligned with long-term business objectives and operational excellence targets Evaluate, select, and deploy advanced automation technologies (robotics, MES, DeltaV, PAT, historian solutions, reporting, etc.) to improve efficiency, quality, safety, and agility Drive adoption of new and existing systems through effective communication, training, and stakeholder engagement Manage multi-year expense budgets, timelines, and a cross-functional team of engineers, program managers, and solution architects Assist Technical Operations management in CAPEX planning to deploy OT solutions site-wide within capital projects Define KPIs, dashboards, and governance frameworks to track program impact Collaborate with site leadership and department staff to achieve project goals Oversee and support user training for Corden Pharma OT Systems Ensure daily performance support for Corden Pharma Automation Systems including preventative maintenance and technical support/troubleshooting to minimize impact to production schedules Manage technical problem resolution for Corden Pharma OT networks and other process control infrastructures Manage validation of new OT applications, including computer system validation (CSV), and maintain systems in a validated state Coordinate and execute continuous improvement projects to implement new equipment, technologies, processes, or materials Manage employees and contractors, coordinate with vendors for project execution Review and draft equipment drawings, electrical diagrams, system manuals, engineering protocols, and quality system documentation Ensure all automation systems comply with regulatory requirements (FDA, cGMP, etc.) As a system subject matter expert (SME), be accountable and responsible to provide the necessary support during internal and external regulatory and client audits Maintain documentation including functional specification, validation protocols, and change controls Provide expertise and improvements to address nonconformance, implement corrective & preventative actions, and execute Commissioning & Qualification activities LEADERSHIP & BUDGET RESPONSIBILITIES Provides direct leadership to department employees and works with other site leaders to manage all assets in an efficient and compliant manner. Conducts all managerial responsibilities in accordance with the organization's policies, regulatory compliance, and applicable laws. Supervisory responsibilities include daily leadership of team, training, and development; interviewing and hiring; managing time and attendance records; performance appraisals; rewarding and disciplining employees; and resolving daily problems and conflicts. SAFETY & ENVIRONMENTAL RESPONSIBILITIES Every individual is personally responsible for the safety and environmental aspects of his or her activities in the workplace. Each employee is expected to perform their job duties in a safe manner utilizing all their knowledge, training, ability, and experience. QUALITY RESPONSIBILITIES Corden Pharma Colorado (CPC) is a manufacturer of a variety of pharmaceutical products. In following Current Good Manufacturing Practices (cGMP), Corden Pharma Colorado manufactures in accordance with the US Food and Drug Administration (FDA), International Council for Harmonisation Q7 (ICH), and other global regulations as applicable. This is critical as it is our mission to not place patients at risk due to inadequate safety, quality, or efficacy. CPC's Quality Management System, which incorporates cGMP, is designed to deliver this quality objective. Attainment is produced through the requisite participation and commitment of all staff across departments and at all levels within the company. cGMP is the part of Quality Management System ensuring products are consistently produced to accurate quality standards. Adherence to clearly defined procedures, in compliance with the principles of cGMP, is required when performing operations across Corden Pharma Colorado. QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily while proficiently demonstrating the Core Competencies listed below. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions described. The following requirements are representative of the knowledge, skill, and/or ability required for this role. The individual must demonstrate a business working knowledge of the following: DCS, PLC deployment (i.e., DeltaV, Allen Bradley, and Siemens) HMI development and programming MES deployment, integration and implementation Common OT communication protocols Ability to interpret electrical and piping & instrumentation diagrams (P&IDs) Strong working knowledge of electrical and controls principles, methods and standards CAPEX scope, schedule, and budget business processes Management and collaboration with Contract resources EDUCATION and/or EXPERIENCE B.S. or M.S. in Engineering Field or equivalent OT experience in Pharmaceutical, Chemical, or Medical Device industries. Eight years of experience in process automation and control systems within regulated pharmaceutical or life sciences environments. LANGUAGE SKILLS Ability to read and understand common information technology technical literature. Ability to effectively communicate verbally and in writing with peers, customers, and management. MATHEMATICAL SKILLS Ability to comprehend and apply principles of advanced calculus, modern algebra, and advanced statistical theory. Ability to understand basic accounting and financial principles (ROI & IRR analysis, cashflow, committed vs. actual costs, etc.) as they apply to Automation Engineering. REASONING ABILITY Ability to apply problem-solving and best judgement to assigned tasks. CERTIFICATES, LICENSES, REGISTRATIONS None. PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to stand; walk; work with hands; stoop, kneel, crouch, or crawl; and talk or hear. The employee is occasionally required to sit, reach above shoulder height, and climb or balance. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee may be exposed to fumes or airborne particles and low levels of toxic or caustic chemicals. The employee may be exposed to moving mechanical parts, outside weather conditions, and risk of electric shock. The noise level in the work environment is usually moderate. CORE COMPETENCIES These are the specific areas of knowledge, skill and ability that are important for successful job performance. They must be job related and consistent with business necessity. Proven leadership skills with the ability to influence and drive significant change Proven ability in applying scientific problem-solving methods Experience managing culture change and deployment of Enterprise transforming solutions Proficiency with the Microsoft Office Suite, Visual Basic, and SQL scripting Strong knowledge of computer systems (software and hardware) Basic Active Directory administration experience . click apply for full job details
Job Description Job Description CordenPharma is a leading full-service Contract Development and Manufacturing Organization (CDMO) specializing in active pharmaceutical ingredients (APIs), excipients, drug products (DPs), and packaging. With around 3,000 employees worldwide, we help pharmaceutical and biotech companies manufacture medicines with the ultimate goal of improving people's lives. Our network, spanning Europe and the U.S., provides flexible and specialized solutions across six technology platforms: Peptides, Lipids & Carbohydrates, Injectables, Highly Potent & Oncology, Small Molecules, and Oligonucleotides. We strive for excellence in supporting this network and are committed to delivering the highest quality products for patient well-being. Our People Vision We strive for excellence. We share our passion. Together, we make a difference in patients' lives. SUMMARY The Manager of Automation & MES (OT) leads Engineers, Technical Specialists, SMEs, and contractors responsible for OT controls of manufacturing equipment, support equipment, integration of systems, and site-wide continuous improvement initiatives. This role includes the conceptualization, design, implementation, and documentation of OT projects and lifecycle management in compliance with regulatory requirements. The Manager represents the department during regulatory meetings and audits and oversees hiring, training, career development, performance appraisals, and team motivation. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Other duties may be assigned. Develop and execute a plant-wide OT strategy and roadmap aligned with long-term business objectives and operational excellence targets Evaluate, select, and deploy advanced automation technologies (robotics, MES, DeltaV, PAT, historian solutions, reporting, etc.) to improve efficiency, quality, safety, and agility Drive adoption of new and existing systems through effective communication, training, and stakeholder engagement Manage multi-year expense budgets, timelines, and a cross-functional team of engineers, program managers, and solution architects Assist Technical Operations management in CAPEX planning to deploy OT solutions site-wide within capital projects Define KPIs, dashboards, and governance frameworks to track program impact Collaborate with site leadership and department staff to achieve project goals Oversee and support user training for Corden Pharma OT Systems Ensure daily performance support for Corden Pharma Automation Systems including preventative maintenance and technical support/troubleshooting to minimize impact to production schedules Manage technical problem resolution for Corden Pharma OT networks and other process control infrastructures Manage validation of new OT applications, including computer system validation (CSV), and maintain systems in a validated state Coordinate and execute continuous improvement projects to implement new equipment, technologies, processes, or materials Manage employees and contractors, coordinate with vendors for project execution Review and draft equipment drawings, electrical diagrams, system manuals, engineering protocols, and quality system documentation Ensure all automation systems comply with regulatory requirements (FDA, cGMP, etc.) As a system subject matter expert (SME), be accountable and responsible to provide the necessary support during internal and external regulatory and client audits Maintain documentation including functional specification, validation protocols, and change controls Provide expertise and improvements to address nonconformance, implement corrective & preventative actions, and execute Commissioning & Qualification activities LEADERSHIP & BUDGET RESPONSIBILITIES Provides direct leadership to department employees and works with other site leaders to manage all assets in an efficient and compliant manner. Conducts all managerial responsibilities in accordance with the organization's policies, regulatory compliance, and applicable laws. Supervisory responsibilities include daily leadership of team, training, and development; interviewing and hiring; managing time and attendance records; performance appraisals; rewarding and disciplining employees; and resolving daily problems and conflicts. SAFETY & ENVIRONMENTAL RESPONSIBILITIES Every individual is personally responsible for the safety and environmental aspects of his or her activities in the workplace. Each employee is expected to perform their job duties in a safe manner utilizing all their knowledge, training, ability, and experience. QUALITY RESPONSIBILITIES Corden Pharma Colorado (CPC) is a manufacturer of a variety of pharmaceutical products. In following Current Good Manufacturing Practices (cGMP), Corden Pharma Colorado manufactures in accordance with the US Food and Drug Administration (FDA), International Council for Harmonisation Q7 (ICH), and other global regulations as applicable. This is critical as it is our mission to not place patients at risk due to inadequate safety, quality, or efficacy. CPC's Quality Management System, which incorporates cGMP, is designed to deliver this quality objective. Attainment is produced through the requisite participation and commitment of all staff across departments and at all levels within the company. cGMP is the part of Quality Management System ensuring products are consistently produced to accurate quality standards. Adherence to clearly defined procedures, in compliance with the principles of cGMP, is required when performing operations across Corden Pharma Colorado. QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily while proficiently demonstrating the Core Competencies listed below. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions described. The following requirements are representative of the knowledge, skill, and/or ability required for this role. The individual must demonstrate a business working knowledge of the following: DCS, PLC deployment (i.e., DeltaV, Allen Bradley, and Siemens) HMI development and programming MES deployment, integration and implementation Common OT communication protocols Ability to interpret electrical and piping & instrumentation diagrams (P&IDs) Strong working knowledge of electrical and controls principles, methods and standards CAPEX scope, schedule, and budget business processes Management and collaboration with Contract resources EDUCATION and/or EXPERIENCE B.S. or M.S. in Engineering Field or equivalent OT experience in Pharmaceutical, Chemical, or Medical Device industries. Eight years of experience in process automation and control systems within regulated pharmaceutical or life sciences environments. LANGUAGE SKILLS Ability to read and understand common information technology technical literature. Ability to effectively communicate verbally and in writing with peers, customers, and management. MATHEMATICAL SKILLS Ability to comprehend and apply principles of advanced calculus, modern algebra, and advanced statistical theory. Ability to understand basic accounting and financial principles (ROI & IRR analysis, cashflow, committed vs. actual costs, etc.) as they apply to Automation Engineering. REASONING ABILITY Ability to apply problem-solving and best judgement to assigned tasks. CERTIFICATES, LICENSES, REGISTRATIONS None. PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to stand; walk; work with hands; stoop, kneel, crouch, or crawl; and talk or hear. The employee is occasionally required to sit, reach above shoulder height, and climb or balance. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee may be exposed to fumes or airborne particles and low levels of toxic or caustic chemicals. The employee may be exposed to moving mechanical parts, outside weather conditions, and risk of electric shock. The noise level in the work environment is usually moderate. CORE COMPETENCIES These are the specific areas of knowledge, skill and ability that are important for successful job performance. They must be job related and consistent with business necessity. Proven leadership skills with the ability to influence and drive significant change Proven ability in applying scientific problem-solving methods Experience managing culture change and deployment of Enterprise transforming solutions Proficiency with the Microsoft Office Suite, Visual Basic, and SQL scripting Strong knowledge of computer systems (software and hardware) Basic Active Directory administration experience . click apply for full job details
Amplifii LLC
Denver, Colorado
Job Description Job Description Description: At AMPLIFII, we support Federally Qualified Health Centers who provide comprehensive services-including primary care, dental, pharmacy, behavioral health, health education, and outreach. General Purpose: This position is critical to the success of the revenue cycle. Bill and collect payments for services rendered from a variety of payor sources. The Revenue Cycle Specialist is responsible for timely and accurate coding, billing, claim denials, and payment posting. Essential Duties and Responsibilities: Resolve issues with incomplete and/or inaccurate patient registration Verify charges were entered correctly and update as needed. Work aged receivables utilizing A/R reports/functionality in revenue cycle management (RCM) module Review and assess adjudicated claims for timely and proper payment of outstanding balances Research, correct and resubmit or reprocess unpaid claims as necessary Verify validity of account balance by researching, reviewing, and ensuring accuracy or payment and adjustment posting Review and interpret explanation of benefits (EOB) for denials and reimbursement underpayments Research and resolve denials and underpayments with insurance carriers Submit third party payor appeals and reconsideration requests in a timely manner Meet department and/or organization productivity goals/benchmarks Post third party payors(s), government, grant funded and patient payments Respond to patient inquiries regarding billings Assist other staff as needed to keep department workload current Maintain communication with all interested parties regarding patient account issues Perform other duties as assigned Requirements: Education and Experience: Required: High school diploma or GED. CPC Certification preferred Skills and Expertise: Ability to interact positively and build rapport with patients, coworkers and/or external contacts Ability to work independently and organize work in a manner that ensures accuracy and efficiency Knowledge of medical electronic billing procedures and coding Ability to demonstrate the capability to effectively and sensitively respond to the needs and concerns of the patients. Customer service skills, including the ability to diffuse upset patients Basic math skills required; Basic excel spreadsheet skills and a basic understanding of accounting helpful Skill in using a variety of computer software including but not limited to the internet and MS Office products Ability to handle sensitive information ethically and responsibly Ability to protect the confidentiality of patients, employee and business information Bilingual Spanish is preferred Must be experienced in working in a fast-paced environment and be able to multi-task and prioritize Required Tools of the Job: Epic EHR Revenue Cycle applications specific to Ambulatory clinic medical billing Additional applications include Centricity EHR (legacy), Faxcom, Citrix Xenapps, Citrix Director Microsoft suite and various audio/video platforms Internal and external IT ticketing systems Working Environment and Physical Activities: Office environment within a clinical setting. Enters data into computer programs via computer, mouse, and keyboard. Moves about the office environment and occasionally to other locations. Moves/transports objects up to 25 lbs. occasionally. Communicate information to others. Discerns/analyzes information from others to assist in decision making. To ensure a successful integration into our team, we implement a 90-day probationary period for all new employees. This timeframe is designed to evaluate performance and assess cultural alignment within our organization. It offers both the employee and the employer the opportunity to determine if the role is a mutual fit, promoting long-term success and satisfaction in your career with us. Join our dedicated team and contribute to our mission of providing quality health care to our community! Work Schedule: Monday-Friday, 8:30am - 5:00pm This hybrid role requires candidates to be located in Colorado or in the process of relocating. AMPLIFII offers a competitive hourly range of $22.00-$26.00, depending on experience. The salary range reflects AMPLIFII's good faith estimate of potential compensation at the time of posting. The final offer for the selected candidate will be determined based on several factors, including experience, education, budget, internal equity, specialty and training. Why AMPLIFII Medical, dental and vision coverage Paid time off and paid holidays Health Savings account (HSA) and Flexible Spending accounts, including dependent care options. 401(K) with matching for eligible employees Work-Life balance-No nights, no weekend and no major holidays Employee Assistance Program (EAP) Employee discount programs on top local attractions Competitive wages AMPLIFII conducts background checks, including criminal history, education, license and certification. AMPLIFII is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to any characteristic protected by law. AMPLIFII complies with the Americans with Disabilities Act, providing reasonable accommodations as needed. Health and Safety commitment: To ensure the safety of our patients, staff, and communities, all new hires at AMPLIFII must receive an annual flu shot or provide an exemption, as well as undergo tuberculosis screening and testing. Application submission closing date: Applicants will be considered until the position is filled.
Job Description Job Description Description: At AMPLIFII, we support Federally Qualified Health Centers who provide comprehensive services-including primary care, dental, pharmacy, behavioral health, health education, and outreach. General Purpose: This position is critical to the success of the revenue cycle. Bill and collect payments for services rendered from a variety of payor sources. The Revenue Cycle Specialist is responsible for timely and accurate coding, billing, claim denials, and payment posting. Essential Duties and Responsibilities: Resolve issues with incomplete and/or inaccurate patient registration Verify charges were entered correctly and update as needed. Work aged receivables utilizing A/R reports/functionality in revenue cycle management (RCM) module Review and assess adjudicated claims for timely and proper payment of outstanding balances Research, correct and resubmit or reprocess unpaid claims as necessary Verify validity of account balance by researching, reviewing, and ensuring accuracy or payment and adjustment posting Review and interpret explanation of benefits (EOB) for denials and reimbursement underpayments Research and resolve denials and underpayments with insurance carriers Submit third party payor appeals and reconsideration requests in a timely manner Meet department and/or organization productivity goals/benchmarks Post third party payors(s), government, grant funded and patient payments Respond to patient inquiries regarding billings Assist other staff as needed to keep department workload current Maintain communication with all interested parties regarding patient account issues Perform other duties as assigned Requirements: Education and Experience: Required: High school diploma or GED. CPC Certification preferred Skills and Expertise: Ability to interact positively and build rapport with patients, coworkers and/or external contacts Ability to work independently and organize work in a manner that ensures accuracy and efficiency Knowledge of medical electronic billing procedures and coding Ability to demonstrate the capability to effectively and sensitively respond to the needs and concerns of the patients. Customer service skills, including the ability to diffuse upset patients Basic math skills required; Basic excel spreadsheet skills and a basic understanding of accounting helpful Skill in using a variety of computer software including but not limited to the internet and MS Office products Ability to handle sensitive information ethically and responsibly Ability to protect the confidentiality of patients, employee and business information Bilingual Spanish is preferred Must be experienced in working in a fast-paced environment and be able to multi-task and prioritize Required Tools of the Job: Epic EHR Revenue Cycle applications specific to Ambulatory clinic medical billing Additional applications include Centricity EHR (legacy), Faxcom, Citrix Xenapps, Citrix Director Microsoft suite and various audio/video platforms Internal and external IT ticketing systems Working Environment and Physical Activities: Office environment within a clinical setting. Enters data into computer programs via computer, mouse, and keyboard. Moves about the office environment and occasionally to other locations. Moves/transports objects up to 25 lbs. occasionally. Communicate information to others. Discerns/analyzes information from others to assist in decision making. To ensure a successful integration into our team, we implement a 90-day probationary period for all new employees. This timeframe is designed to evaluate performance and assess cultural alignment within our organization. It offers both the employee and the employer the opportunity to determine if the role is a mutual fit, promoting long-term success and satisfaction in your career with us. Join our dedicated team and contribute to our mission of providing quality health care to our community! Work Schedule: Monday-Friday, 8:30am - 5:00pm This hybrid role requires candidates to be located in Colorado or in the process of relocating. AMPLIFII offers a competitive hourly range of $22.00-$26.00, depending on experience. The salary range reflects AMPLIFII's good faith estimate of potential compensation at the time of posting. The final offer for the selected candidate will be determined based on several factors, including experience, education, budget, internal equity, specialty and training. Why AMPLIFII Medical, dental and vision coverage Paid time off and paid holidays Health Savings account (HSA) and Flexible Spending accounts, including dependent care options. 401(K) with matching for eligible employees Work-Life balance-No nights, no weekend and no major holidays Employee Assistance Program (EAP) Employee discount programs on top local attractions Competitive wages AMPLIFII conducts background checks, including criminal history, education, license and certification. AMPLIFII is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to any characteristic protected by law. AMPLIFII complies with the Americans with Disabilities Act, providing reasonable accommodations as needed. Health and Safety commitment: To ensure the safety of our patients, staff, and communities, all new hires at AMPLIFII must receive an annual flu shot or provide an exemption, as well as undergo tuberculosis screening and testing. Application submission closing date: Applicants will be considered until the position is filled.
Omaha Tribe of Nebraska
Macy, Nebraska
Job Description Job Description SUMMARY: The Revenue Cycle Specialist is responsible for researching, correcting, resubmitting, and resolving medical claims that have been rejected, denied, underpaid, or otherwise not processed correctly by insurance payers. This position focuses on identifying the causes of claim issues, coordinating necessary corrections with internal departments and external payers, and following claims through to resolution. The Medical Billing Specialist works closely with the Billing Technician, Business Office Manager, providers, coding staff, clinical departments, and insurance representatives to resolve billing issues, reduce preventable denials, and support appropriate reimbursement for services provided by the Health Center. ESSENTIAL DUTIES AND RESPONSIBILITIES will include the following: Electronic Clearinghouse Rejections Monitor the designated electronic clearinghouse for rejected claims, submission errors, and other claim transmission issues. Review and address electronic clearinghouse rejections promptly upon receipt. Research rejection reasons and determine the appropriate corrective action. Correct and resubmit claims when issues can be resolved within the scope of the position. Coordinate with the Billing Technician, registration, coding staff, providers, or other departments when additional information or corrections are required. Document rejection reasons, actions taken, outstanding issues, and follow-up plans. Monitor unresolved rejections until corrected and resubmitted or otherwise appropriately resolved. Ensure no rejection remains unaddressed or without documented follow-up. Denied Claims and Corrected Claim Submission Review remittance advice, explanations of benefits (EOBs), denial reports, and claim status information to identify denied or incorrectly processed claims. Research denial codes, payer explanations, claim history, billing requirements, and supporting documentation to determine the reason for denial. Correct claim information and coordinate necessary documentation or coding clarification. Prepare and submit corrected claims, resubmissions, reconsiderations, and appeals as appropriate. Verify that corrections address the original rejection or denial reason before resubmission. Track corrected claims to confirm receipt and monitor payer processing. Maintain documentation of denial reasons, corrective actions, resubmission dates, payer responses, and outcomes. Escalate claims requiring management review, clinical clarification, or additional intervention. Denial Research and Resolution Investigate recurring and complex denials to identify root causes and prevent repeated billing errors. Research payer policies, eligibility issues, authorization requirements, filing limits, coding requirements, and documentation requirements relevant to denied claims. Contact insurance representatives and use payer portals to clarify denial reasons, claim status, payment decisions, and required corrective actions. Coordinate with providers, coding staff, and clinical departments to obtain missing or corrected information. Prepare and submit appeals or reconsideration requests within applicable payer deadlines when appropriate. Monitor appealed claims until a determination is received. Identify recurring denial trends and report significant issues to the Business Office Manager. Unpaid and Incorrectly Processed Claims Research unpaid, pending, underpaid, and incorrectly processed claims to determine the cause and appropriate resolution. Follow up with payers regarding claims that remain unpaid or have not been processed correctly. Review discrepancies between billed amounts, payer adjudication, remittance advice, and expected reimbursement. Determine whether claim correction, resubmission, additional documentation, reconsideration, or appeal is appropriate. Monitor claims approaching timely filing limits, appeal deadlines, and other payer-specific timeframes. Maintain a tracking system documenting claim status, actions taken, outstanding issues, and follow-up dates. Escalate unresolved claims with significant financial impact or barriers to resolution to the Business Office Manager. Continue follow-up until the claim is resolved, appropriately escalated, or closed with documented justification. Prior Authorization-Related Claim Issues Research claim denials related to missing, incomplete, expired, or mismatched prior authorizations. Coordinate with appropriate clinical or administrative staff to obtain authorization information or supporting documentation. Communicate authorization-related claim issues to the responsible department. Monitor corrected claims related to authorization issues to determine whether the payer has processed them. Document actions taken and escalate unresolved issues as appropriate. This responsibility focuses on authorization issues affecting claim payment. Routine prior authorization requests remain with designated staff unless otherwise assigned. Documentation and Process Improvement Maintain accurate records of rejections, denials, corrected claims, appeals, payer communications, and resolution efforts. Ensure unresolved items have documented actions, next steps, and follow-up dates. Coordinate with the Billing Technician and other departments to address recurring claim issues. Identify opportunities to reduce preventable rejections and denials and improve claim resolution. Assist with billing reviews, payer audits, and quality improvement activities as assigned. Maintain knowledge of payer policies, claim correction procedures, appeal requirements, and applicable billing guidelines. Confidentiality and Compliance Protect patient confidentiality and the security of health records and other confidential information. Comply with applicable privacy and security laws, including HIPAA and the Privacy Act of 1974 when applicable, and Health Center policies. Follow applicable payer requirements and established Health Center procedures. Perform other related duties within the scope of the position as assigned by the Business Office Manager. QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform the essential duties satisfactorily. The requirements listed below represent the knowledge, skills, and abilities needed for the position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties. EDUCATION AND EXPERIENCE: Associate of Arts (AA) degree or at least two (2) years of relevant work experience in medical billing, healthcare administration, insurance claims processing, accounts receivable, or a related field. Ability to research billing issues, identify errors, follow established procedures, and complete corrective actions accurately and promptly. Strong attention to detail and ability to organize work, meet deadlines, maintain accurate documentation, and communicate effectively with internal departments and insurance payers. Ability to learn and apply insurance payer requirements, claim correction procedures, and denial resolution processes. Experience reviewing electronic clearinghouse rejections, insurance denials, and payment discrepancies. Experience correcting and resubmitting claims, researching unpaid claims, or assisting with appeals and reconsiderations. Familiarity with electronic clearinghouses, payer portals, electronic health records, or practice management systems. Knowledge of Medicare, Medicaid, commercial insurance, managed care plans, and payer billing requirements. Familiarity with ICD-10-CM, CPT, and HCPCS coding concepts. Medical billing certification, such as Certified Professional Biller (CPB), or medical coding certification, such as Certified Professional Coder (CPC). Experience working in a Tribal Health, Indian Health Service (IHS), community health center, or similar healthcare setting. CERTIFICATES, LICENSES, AND/OR REGISTRATIONS: Medical billing or coding certification is preferred but not required. KNOWLEDGE, SKILLS, AND ABILITIES: Ability to research and resolve claim rejections, denials, and billing discrepancies. Ability to learn payer-specific correction, resubmission, reconsideration, and appeal requirements. Strong organizational, analytical, and problem-solving skills. Effective written and verbal communication skills. Ability to recognize recurring billing issues and communicate potential solutions. Ability to maintain accurate records and protect confidential patient information. Proficiency with standard computer applications, including Microsoft Word and Excel, and the ability to learn designated billing systems and electronic clearinghouse tools. Ability to work independently, manage competing priorities, meet deadlines, and seek assistance when necessary. Ability to coordinate professionally with internal departments and external insurance representatives. PLEASE NOTE: P.L. 93-638, Indian Preference and Tribal Employment Rights Ordinance, (TERO), will be practiced, however all qualified applicants will be considered. IF YOU ARE INTERESTED . click apply for full job details
Job Description Job Description SUMMARY: The Revenue Cycle Specialist is responsible for researching, correcting, resubmitting, and resolving medical claims that have been rejected, denied, underpaid, or otherwise not processed correctly by insurance payers. This position focuses on identifying the causes of claim issues, coordinating necessary corrections with internal departments and external payers, and following claims through to resolution. The Medical Billing Specialist works closely with the Billing Technician, Business Office Manager, providers, coding staff, clinical departments, and insurance representatives to resolve billing issues, reduce preventable denials, and support appropriate reimbursement for services provided by the Health Center. ESSENTIAL DUTIES AND RESPONSIBILITIES will include the following: Electronic Clearinghouse Rejections Monitor the designated electronic clearinghouse for rejected claims, submission errors, and other claim transmission issues. Review and address electronic clearinghouse rejections promptly upon receipt. Research rejection reasons and determine the appropriate corrective action. Correct and resubmit claims when issues can be resolved within the scope of the position. Coordinate with the Billing Technician, registration, coding staff, providers, or other departments when additional information or corrections are required. Document rejection reasons, actions taken, outstanding issues, and follow-up plans. Monitor unresolved rejections until corrected and resubmitted or otherwise appropriately resolved. Ensure no rejection remains unaddressed or without documented follow-up. Denied Claims and Corrected Claim Submission Review remittance advice, explanations of benefits (EOBs), denial reports, and claim status information to identify denied or incorrectly processed claims. Research denial codes, payer explanations, claim history, billing requirements, and supporting documentation to determine the reason for denial. Correct claim information and coordinate necessary documentation or coding clarification. Prepare and submit corrected claims, resubmissions, reconsiderations, and appeals as appropriate. Verify that corrections address the original rejection or denial reason before resubmission. Track corrected claims to confirm receipt and monitor payer processing. Maintain documentation of denial reasons, corrective actions, resubmission dates, payer responses, and outcomes. Escalate claims requiring management review, clinical clarification, or additional intervention. Denial Research and Resolution Investigate recurring and complex denials to identify root causes and prevent repeated billing errors. Research payer policies, eligibility issues, authorization requirements, filing limits, coding requirements, and documentation requirements relevant to denied claims. Contact insurance representatives and use payer portals to clarify denial reasons, claim status, payment decisions, and required corrective actions. Coordinate with providers, coding staff, and clinical departments to obtain missing or corrected information. Prepare and submit appeals or reconsideration requests within applicable payer deadlines when appropriate. Monitor appealed claims until a determination is received. Identify recurring denial trends and report significant issues to the Business Office Manager. Unpaid and Incorrectly Processed Claims Research unpaid, pending, underpaid, and incorrectly processed claims to determine the cause and appropriate resolution. Follow up with payers regarding claims that remain unpaid or have not been processed correctly. Review discrepancies between billed amounts, payer adjudication, remittance advice, and expected reimbursement. Determine whether claim correction, resubmission, additional documentation, reconsideration, or appeal is appropriate. Monitor claims approaching timely filing limits, appeal deadlines, and other payer-specific timeframes. Maintain a tracking system documenting claim status, actions taken, outstanding issues, and follow-up dates. Escalate unresolved claims with significant financial impact or barriers to resolution to the Business Office Manager. Continue follow-up until the claim is resolved, appropriately escalated, or closed with documented justification. Prior Authorization-Related Claim Issues Research claim denials related to missing, incomplete, expired, or mismatched prior authorizations. Coordinate with appropriate clinical or administrative staff to obtain authorization information or supporting documentation. Communicate authorization-related claim issues to the responsible department. Monitor corrected claims related to authorization issues to determine whether the payer has processed them. Document actions taken and escalate unresolved issues as appropriate. This responsibility focuses on authorization issues affecting claim payment. Routine prior authorization requests remain with designated staff unless otherwise assigned. Documentation and Process Improvement Maintain accurate records of rejections, denials, corrected claims, appeals, payer communications, and resolution efforts. Ensure unresolved items have documented actions, next steps, and follow-up dates. Coordinate with the Billing Technician and other departments to address recurring claim issues. Identify opportunities to reduce preventable rejections and denials and improve claim resolution. Assist with billing reviews, payer audits, and quality improvement activities as assigned. Maintain knowledge of payer policies, claim correction procedures, appeal requirements, and applicable billing guidelines. Confidentiality and Compliance Protect patient confidentiality and the security of health records and other confidential information. Comply with applicable privacy and security laws, including HIPAA and the Privacy Act of 1974 when applicable, and Health Center policies. Follow applicable payer requirements and established Health Center procedures. Perform other related duties within the scope of the position as assigned by the Business Office Manager. QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform the essential duties satisfactorily. The requirements listed below represent the knowledge, skills, and abilities needed for the position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties. EDUCATION AND EXPERIENCE: Associate of Arts (AA) degree or at least two (2) years of relevant work experience in medical billing, healthcare administration, insurance claims processing, accounts receivable, or a related field. Ability to research billing issues, identify errors, follow established procedures, and complete corrective actions accurately and promptly. Strong attention to detail and ability to organize work, meet deadlines, maintain accurate documentation, and communicate effectively with internal departments and insurance payers. Ability to learn and apply insurance payer requirements, claim correction procedures, and denial resolution processes. Experience reviewing electronic clearinghouse rejections, insurance denials, and payment discrepancies. Experience correcting and resubmitting claims, researching unpaid claims, or assisting with appeals and reconsiderations. Familiarity with electronic clearinghouses, payer portals, electronic health records, or practice management systems. Knowledge of Medicare, Medicaid, commercial insurance, managed care plans, and payer billing requirements. Familiarity with ICD-10-CM, CPT, and HCPCS coding concepts. Medical billing certification, such as Certified Professional Biller (CPB), or medical coding certification, such as Certified Professional Coder (CPC). Experience working in a Tribal Health, Indian Health Service (IHS), community health center, or similar healthcare setting. CERTIFICATES, LICENSES, AND/OR REGISTRATIONS: Medical billing or coding certification is preferred but not required. KNOWLEDGE, SKILLS, AND ABILITIES: Ability to research and resolve claim rejections, denials, and billing discrepancies. Ability to learn payer-specific correction, resubmission, reconsideration, and appeal requirements. Strong organizational, analytical, and problem-solving skills. Effective written and verbal communication skills. Ability to recognize recurring billing issues and communicate potential solutions. Ability to maintain accurate records and protect confidential patient information. Proficiency with standard computer applications, including Microsoft Word and Excel, and the ability to learn designated billing systems and electronic clearinghouse tools. Ability to work independently, manage competing priorities, meet deadlines, and seek assistance when necessary. Ability to coordinate professionally with internal departments and external insurance representatives. PLEASE NOTE: P.L. 93-638, Indian Preference and Tribal Employment Rights Ordinance, (TERO), will be practiced, however all qualified applicants will be considered. IF YOU ARE INTERESTED . click apply for full job details
Sonic Automotive
Calabasas, California
Job Description Job Description Company Description At Mercedes Benz of Calabasas, a Sonic Automotive family dealership, you'll find the opportunities, resources, and support you need to grow and develop professionally. Our 100+ dealerships are concerned with more than moving inventory; they're committed to your success and invested in your future. So read on, and consider a rewarding career with Sonic Automotive, Inc. Hourly pay: $18.00 (The Mercedes-Benz Digital Experience Specialist Position has a Pay Scale consisting of the following elements and ranges. Wages include Base Hourly Compensation of $18.00) Our associates are happy to work here because: We boast the lowest turnover in the industry. We provide award winning training (Training Magazine Top 125, and Brandon Hall Awards). We are committed to developing and promoting within the company. Our benefits are extremely competitive with Medical, dental, vision, HSA, 401k and PTO. We encourage peer to peer teamwork and recognition. Special benefits to purchasing and leasing a car. Personal Automotive Concierge Service. If you want to find out more about the types of jobs we have here, we've highlighted a few. We're proud of what we're doing here. Come and join us! Job Description The Mercedes-Benz Digital Experience Specialist is responsible for assisting dealership customers with the setup, activation, and ongoing use of the Mercedes-Benz me Connect app and connected vehicle services. This position serves as the dealership's primary resource for helping customers understand and maximize their vehicle's digital and connected features. The representative will work closely with the Sales and Service departments to ensure customers have seamless digital experience from vehicle delivery through ownership. Responsibilities include guiding customers through app installation and account registration, pairing vehicles with their Mercedes-Benz account, explaining available connected services, troubleshooting common issues, and providing exceptional customer support. Responsibilities: Assist customers with downloading, registering, and setting up the Mercedes-Benz me Connect app. Guide customers through vehicle pairing, account activation, and connected-service enrollment. Educate customers on Mercedes-Benz digital features, remote vehicle functions, vehicle status, navigation, and other applicable connected services. Troubleshoot common app, account, connectivity, and activation issues and escalate technical concerns when necessary. Partner with Sales Consultants to ensure every new and pre-owned Mercedes-Benz customer receives a complete me Connect introduction during vehicle delivery. Maintain accurate customer and activation information while following dealership and Mercedes-Benz privacy and security procedures. Stay current on Mercedes-Benz connected technology, software updates, app functionality, and new digital products or services. Provide a high level of customer service while creating positive and technology-focused dealership experience. Qualifications Previous experience in customer service, automotive, dealership, technology, or product-support role preferred. Strong understanding and comfort with smartphones, mobile applications, Bluetooth connectivity, and digital technology. Excellent communication skills with the ability to explain technical information clearly to customers with varying levels of technology experience. Strong problem-solving and troubleshooting skills with a patient, solutions-oriented approach. Ability to work effectively with Sales, Service, and management teams in a fast-paced dealership environment. Highly organized, detail-oriented, and capable of managing multiple customer interactions while maintaining accurate records. Professional appearance and demeanor with a strong commitment to delivering an exceptional Mercedes-Benz customer experience. Additional Requirements: Valid driver's license with an acceptable driving record. Must be legally authorized to work in the United States. Ability to successfully complete pre-employment requirements, including background check, motor vehicle record (MVR) review, and drug screening. Additional Information Schedule: Full Time Monday through Saturday availability Sundays off What We Offer: Comprehensive benefits package, including medical, dental, and vision coverage Company-paid life insurance 401(k) retirement plan with company match (Traditional and Roth options) Generous paid time off and paid parental leave Ongoing training and professional development to support career growth A collaborative, performance-driven work environment Learn more: Sonic Automotive is a Fortune 500 leader and one of the largest automotive retailers in the U.S., powering a nationwide network of top-brand dealerships. We're transforming the car-buying experience with a fast-paced, people-first culture, innovative technology, and a relentless drive to win-for our guests and our teammates. All your information will be kept confidential according to EEO guidelines.
Job Description Job Description Company Description At Mercedes Benz of Calabasas, a Sonic Automotive family dealership, you'll find the opportunities, resources, and support you need to grow and develop professionally. Our 100+ dealerships are concerned with more than moving inventory; they're committed to your success and invested in your future. So read on, and consider a rewarding career with Sonic Automotive, Inc. Hourly pay: $18.00 (The Mercedes-Benz Digital Experience Specialist Position has a Pay Scale consisting of the following elements and ranges. Wages include Base Hourly Compensation of $18.00) Our associates are happy to work here because: We boast the lowest turnover in the industry. We provide award winning training (Training Magazine Top 125, and Brandon Hall Awards). We are committed to developing and promoting within the company. Our benefits are extremely competitive with Medical, dental, vision, HSA, 401k and PTO. We encourage peer to peer teamwork and recognition. Special benefits to purchasing and leasing a car. Personal Automotive Concierge Service. If you want to find out more about the types of jobs we have here, we've highlighted a few. We're proud of what we're doing here. Come and join us! Job Description The Mercedes-Benz Digital Experience Specialist is responsible for assisting dealership customers with the setup, activation, and ongoing use of the Mercedes-Benz me Connect app and connected vehicle services. This position serves as the dealership's primary resource for helping customers understand and maximize their vehicle's digital and connected features. The representative will work closely with the Sales and Service departments to ensure customers have seamless digital experience from vehicle delivery through ownership. Responsibilities include guiding customers through app installation and account registration, pairing vehicles with their Mercedes-Benz account, explaining available connected services, troubleshooting common issues, and providing exceptional customer support. Responsibilities: Assist customers with downloading, registering, and setting up the Mercedes-Benz me Connect app. Guide customers through vehicle pairing, account activation, and connected-service enrollment. Educate customers on Mercedes-Benz digital features, remote vehicle functions, vehicle status, navigation, and other applicable connected services. Troubleshoot common app, account, connectivity, and activation issues and escalate technical concerns when necessary. Partner with Sales Consultants to ensure every new and pre-owned Mercedes-Benz customer receives a complete me Connect introduction during vehicle delivery. Maintain accurate customer and activation information while following dealership and Mercedes-Benz privacy and security procedures. Stay current on Mercedes-Benz connected technology, software updates, app functionality, and new digital products or services. Provide a high level of customer service while creating positive and technology-focused dealership experience. Qualifications Previous experience in customer service, automotive, dealership, technology, or product-support role preferred. Strong understanding and comfort with smartphones, mobile applications, Bluetooth connectivity, and digital technology. Excellent communication skills with the ability to explain technical information clearly to customers with varying levels of technology experience. Strong problem-solving and troubleshooting skills with a patient, solutions-oriented approach. Ability to work effectively with Sales, Service, and management teams in a fast-paced dealership environment. Highly organized, detail-oriented, and capable of managing multiple customer interactions while maintaining accurate records. Professional appearance and demeanor with a strong commitment to delivering an exceptional Mercedes-Benz customer experience. Additional Requirements: Valid driver's license with an acceptable driving record. Must be legally authorized to work in the United States. Ability to successfully complete pre-employment requirements, including background check, motor vehicle record (MVR) review, and drug screening. Additional Information Schedule: Full Time Monday through Saturday availability Sundays off What We Offer: Comprehensive benefits package, including medical, dental, and vision coverage Company-paid life insurance 401(k) retirement plan with company match (Traditional and Roth options) Generous paid time off and paid parental leave Ongoing training and professional development to support career growth A collaborative, performance-driven work environment Learn more: Sonic Automotive is a Fortune 500 leader and one of the largest automotive retailers in the U.S., powering a nationwide network of top-brand dealerships. We're transforming the car-buying experience with a fast-paced, people-first culture, innovative technology, and a relentless drive to win-for our guests and our teammates. All your information will be kept confidential according to EEO guidelines.