Helen Ross McNabb Center
Knoxville, Tennessee
Job Description Job Description Reimbursement Specialist - Insurance Verification (UTMC Program) Help Others, Make a Difference, Save a Life. Do you want to make a difference in people's lives every day? Or help people navigate the tough spots in their life? And do it all while working where your hard work is appreciated? You have a lot of choices in where you work make the decision to work where you are valued! Join the McNabb Center Team as the Reimbursement Specialist - Insurance Verification (UTMC Program) today! The Reimbursement Specialist - Insurance Verification (UTMC Program) JOB SUMMARY The purpose of the Reimbursement Insurance Verification Specialist is to obtain and verify a client's commercial insurance coverage and to ensure procedures are covered by an individual's insurance. Specialist will be responsible for entering data in an accurate manner and updating client benefit information in the organization's billing system and verifying that existing information is accurate. The Specialist will perform a variety of auditing and resolution-centered activities, answering pertinent questions about coverage to internal and external sources, identifying insurance errors, and recommending solutions. Will be required to work regular office hours at the designated facility. JOB DESCRIPTION Employees in this job complete and oversee a variety of professional assignments to evaluate, review, enter, monitor, and update client insurance and billing information. JOB DUTIES/RESPONSIBILITIES NOTE: The job duties listed are typical duties of the work performed. Not all duties assigned to every position are included, nor is it expected that all positions will be assigned to every duty. Reviews the center's Commercial Notification Forms and returns an Insurance Verification Forms to the requesting staff within designated program timeframe. Verifies insurance information is up to date for the next day's client roster and updates any applicable pop-ups in the system For new clients, gives contact information, obtain client photo, updates the EMR with correct information and ensures the appropriate intake packet paperwork has been signed and verified to ensure clients understanding of policies. Prepares and updates the designated facility facesheets with insurance issues, patient responsibilities, outstanding balances, and any non-payment status changes for the next day and places them in HIPAA compliant blue folders for the appropriate providers. Analyzes designated eligibility reports on a daily basis. Communicates with and advises Insurance Verification Team Leader of all problems related to insurance verification. Advises other departments of updated or new insurance information as needed. Adheres to all policies and procedures related to compliance with all federal and state billing regulations. Communicates with billing representatives regarding any insurance issues that may arise. Review and update the Non-Payment status documents for both Med appointments and Therapy appointments Maintains a positive and professional attitude. Reads all emails and responds accordingly in a timely manner. Listens to all voicemails and responds accordingly in a timely manner. Works with members of various teams and/or departments on identifying process improvements. Possess flexibility to work overtime as dictated by department/organization needs. Communicates with clients regarding any benefit and/or billing questions they may have. Performs specified client benefit duties to ensure all required information is obtained for insurance verification, billing, and claims follow-up. Collects all client responsibility balances via cash, check, money order or credit card and issues receipts for payments. Assists in determining proper courses of action for successful resolution to insurance issues. Completes all program related paperwork required for reporting purposes. Possesses problem-solving skills to research and resolve discrepancies, denials, appeals, collections. Reviews patient bills for accuracy and completeness and obtains any missing information. Sets up patient payment plans and works collection accounts. Submits monthly recommendations to supervisor for write-offs with complete documentation by first of the following month all while following the A/R Reference Guide on how to complete write offs. Performs additional duties as requested by Team Leads or Management Team. This job description is not intended to be all-inclusive; and employee will also perform other reasonably related job responsibilities as assigned by immediate supervisor and other management as required. This organization reserves the right to revise or change job duties as the need arises. Moreover, management reserves the right to change job descriptions, job duties, or working schedules based on their duty to accommodate individuals with disabilities. This job description does not constitute a written or implied contract of employment. JOB QUALIFICATIONS Advanced use of computer system software, Excel, Outlook and Microsoft (word processing and spreadsheet application). Knowledge of insurance guidelines for all Commercial, Medicare, Medicare Advantage, TennCare, Federal Medicaid and Private Pay financial classes. Exceptional customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds. Ability to work well in a team environment and alone. Being able to triage priorities, delegate tasks if needed, handle conflict in a reasonable fashion and analyze and resolve claims issues and related problems. Strong written and verbal communication skills. Maintain patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Maintain a good understanding of the state, federal, and payer guidelines on billings, collections, refunds, and overpayments. Knowledge of the center's Policies and Procedures. Ability to maintain records and prepare reports and correspondence related to the position. Ability to work directly with upper leadership regarding claims issues and resolutions. Possess effective communication skills for phone contacts with insurance payers to resolve issues and to communicate effectively with others. COMPENSATION: Starting salary for this position is approximately $19.54/hr based on relevant experience and education. Schedule: Monday - Friday 8am - 5pm Travel : N/A Equipment/Technical Competency : Advanced use of computer system software, Excel, Outlook and Microsoft (word processing and spreadsheet application). QUALIFICATIONS - Reimbursement Specialist - Insurance Verification (UTMC Program) Experience: Extensive knowledge of insurance in relation to proper billing, follow-up and verification duties. Education / License : High school diploma or equivalent required. Location: Knox County, Tennessee Apply today to work where we care about you as an employee and where your hard work makes a difference! Helen Ross McNabb Center is an Equal Opportunity Employer. The Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment. Helen Ross McNabb Center conducts background checks, driver's license record, degree verification, and drug screens at hire. Employment is contingent upon clean drug screen, background check, and driving record. Additionally, certain programs are subject to TB Screening and/or testing. Bilingual applicants are encouraged to apply. Compensation details: 19.54-19.54 Hourly Wage PI73f2ce5-
Job Description Job Description Reimbursement Specialist - Insurance Verification (UTMC Program) Help Others, Make a Difference, Save a Life. Do you want to make a difference in people's lives every day? Or help people navigate the tough spots in their life? And do it all while working where your hard work is appreciated? You have a lot of choices in where you work make the decision to work where you are valued! Join the McNabb Center Team as the Reimbursement Specialist - Insurance Verification (UTMC Program) today! The Reimbursement Specialist - Insurance Verification (UTMC Program) JOB SUMMARY The purpose of the Reimbursement Insurance Verification Specialist is to obtain and verify a client's commercial insurance coverage and to ensure procedures are covered by an individual's insurance. Specialist will be responsible for entering data in an accurate manner and updating client benefit information in the organization's billing system and verifying that existing information is accurate. The Specialist will perform a variety of auditing and resolution-centered activities, answering pertinent questions about coverage to internal and external sources, identifying insurance errors, and recommending solutions. Will be required to work regular office hours at the designated facility. JOB DESCRIPTION Employees in this job complete and oversee a variety of professional assignments to evaluate, review, enter, monitor, and update client insurance and billing information. JOB DUTIES/RESPONSIBILITIES NOTE: The job duties listed are typical duties of the work performed. Not all duties assigned to every position are included, nor is it expected that all positions will be assigned to every duty. Reviews the center's Commercial Notification Forms and returns an Insurance Verification Forms to the requesting staff within designated program timeframe. Verifies insurance information is up to date for the next day's client roster and updates any applicable pop-ups in the system For new clients, gives contact information, obtain client photo, updates the EMR with correct information and ensures the appropriate intake packet paperwork has been signed and verified to ensure clients understanding of policies. Prepares and updates the designated facility facesheets with insurance issues, patient responsibilities, outstanding balances, and any non-payment status changes for the next day and places them in HIPAA compliant blue folders for the appropriate providers. Analyzes designated eligibility reports on a daily basis. Communicates with and advises Insurance Verification Team Leader of all problems related to insurance verification. Advises other departments of updated or new insurance information as needed. Adheres to all policies and procedures related to compliance with all federal and state billing regulations. Communicates with billing representatives regarding any insurance issues that may arise. Review and update the Non-Payment status documents for both Med appointments and Therapy appointments Maintains a positive and professional attitude. Reads all emails and responds accordingly in a timely manner. Listens to all voicemails and responds accordingly in a timely manner. Works with members of various teams and/or departments on identifying process improvements. Possess flexibility to work overtime as dictated by department/organization needs. Communicates with clients regarding any benefit and/or billing questions they may have. Performs specified client benefit duties to ensure all required information is obtained for insurance verification, billing, and claims follow-up. Collects all client responsibility balances via cash, check, money order or credit card and issues receipts for payments. Assists in determining proper courses of action for successful resolution to insurance issues. Completes all program related paperwork required for reporting purposes. Possesses problem-solving skills to research and resolve discrepancies, denials, appeals, collections. Reviews patient bills for accuracy and completeness and obtains any missing information. Sets up patient payment plans and works collection accounts. Submits monthly recommendations to supervisor for write-offs with complete documentation by first of the following month all while following the A/R Reference Guide on how to complete write offs. Performs additional duties as requested by Team Leads or Management Team. This job description is not intended to be all-inclusive; and employee will also perform other reasonably related job responsibilities as assigned by immediate supervisor and other management as required. This organization reserves the right to revise or change job duties as the need arises. Moreover, management reserves the right to change job descriptions, job duties, or working schedules based on their duty to accommodate individuals with disabilities. This job description does not constitute a written or implied contract of employment. JOB QUALIFICATIONS Advanced use of computer system software, Excel, Outlook and Microsoft (word processing and spreadsheet application). Knowledge of insurance guidelines for all Commercial, Medicare, Medicare Advantage, TennCare, Federal Medicaid and Private Pay financial classes. Exceptional customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds. Ability to work well in a team environment and alone. Being able to triage priorities, delegate tasks if needed, handle conflict in a reasonable fashion and analyze and resolve claims issues and related problems. Strong written and verbal communication skills. Maintain patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Maintain a good understanding of the state, federal, and payer guidelines on billings, collections, refunds, and overpayments. Knowledge of the center's Policies and Procedures. Ability to maintain records and prepare reports and correspondence related to the position. Ability to work directly with upper leadership regarding claims issues and resolutions. Possess effective communication skills for phone contacts with insurance payers to resolve issues and to communicate effectively with others. COMPENSATION: Starting salary for this position is approximately $19.54/hr based on relevant experience and education. Schedule: Monday - Friday 8am - 5pm Travel : N/A Equipment/Technical Competency : Advanced use of computer system software, Excel, Outlook and Microsoft (word processing and spreadsheet application). QUALIFICATIONS - Reimbursement Specialist - Insurance Verification (UTMC Program) Experience: Extensive knowledge of insurance in relation to proper billing, follow-up and verification duties. Education / License : High school diploma or equivalent required. Location: Knox County, Tennessee Apply today to work where we care about you as an employee and where your hard work makes a difference! Helen Ross McNabb Center is an Equal Opportunity Employer. The Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment. Helen Ross McNabb Center conducts background checks, driver's license record, degree verification, and drug screens at hire. Employment is contingent upon clean drug screen, background check, and driving record. Additionally, certain programs are subject to TB Screening and/or testing. Bilingual applicants are encouraged to apply. Compensation details: 19.54-19.54 Hourly Wage PI73f2ce5-
Armada Ltd
Philadelphia, Pennsylvania
Job Description Job Description Type: Full Time Location: Philadelphia, PA Overtime Exempt: Exempt Reports To: ARMADA HQ Travel Required: Yes Security Clearance Required: Active Secret Security Clearance CONTINGENT UPON AWARD Duties & Responsibilities: Specialist, Information System Security III (SISS3) will conduct risk and vulnerability assessments of planned and installed systems to identify vulnerabilities, risks and protection needs; conduct systems security evaluation, audits, and reviews; determine the residual risk of a package based on package content and assessment results and documenting for the Security Controls Assessor's (SCA) and higher level review. Execute Security Assessment Plans (SAPs) by conducting on-site testing for afloat and PIT ashore systems. Examples include executing STIGs, SRGs, ACAS scanning, and applying patches assets to obtain cybersecurity compliance and remediate vulnerabilities. Specialist, Information System Security III (SISS3) will conduct systems security reviews, audits, or evaluations, as appropriate, to ensure accreditation documents are accurate and represent the current risk posture of the system. Perform analysis of logs, events, and reporting of various data collections tools including: vulnerability monitoring via Assured Compliance Assessment System (ACAS) and related tools, Host Based Security Systems (HBSS), web content filters, Security Information and event management (SIEM), firewall systems, network devices, server devices, workstations, and intrusion detection and prevention systems (ID/PS). Specialist, Information System Security III (SISS3) will assess impacts from observed risks and report via the Cybersecurity Program chain of command. Executing Security Assessment Plans (SAPs) by conducting on-site testing for afloat and PIT ashore systems. Examples include executing STIGs, SRGs, ACAS scanning, and applying patches assets to obtain cybersecurity compliance and remediate vulnerabilities. Perform the evaluation of system administrator, security engineer, and/or system owner proposed corrections to ensure compliance and best-fit solution. Specialist, Information System Security III (SISS3) will present and submit data to management, develop reports, and produce procedural documentation in a comprehensive and cohesive manner. Perform risk management and security engineering for Research, Development, Testing, and Evaluation (RDT&E) RMF Afloat systems include Information Assurance Vulnerability Management (IAVM) support, remediation, patching, scanning and associated boundary maintenance. Specialist, Information System Security III (SISS3) will document residual risks in a plan of actions and milestones formatted in compliance with the current package system, currently eMASS. Specialist, Information System Security III (SISS3) will maintain current vulnerability scan data and residual risk plan of actions and milestones in Vulnerability Remediation Asset Manager (VRAM). Manage, attend, and support configuration control board practices. Create and verify the accuracy of POA&Ms/RARs as identified by vulnerability actual test results. Specialist, Information System Security III (SISS3) shall write technical documentation such as user manuals, reports, documentation, policies, presentations, Plan of Action and Milestones (POA&Ms), risk assessments, proposals, outlines, and summaries in support of both ashore and afloat systems across multiple platforms. Support developing of technical documents across multiple platforms including configuration management, milestone, issue tracking, web site content management and RMF documentation. Specialist, Information System Security III (SISS3) may be required to travel CONUS (any state in USA) and OCONUS (primarily Japan, and any country in Europe). The estimated number of trips is 14 per year (estimated 25%-30% travel). Other duties as assigned. Knowledge, Skills, and Abilities (KSAs): Ability to travel CONUS (any state in USA) and OCONUS (primarily Japan, and any country in Europe). Proficient in Microsoft Windows Operating System Administration, including Windows 11, Windows 10, Windows 7, and Windows XP (at a minimum). Ability to work as a team member, communicate, perform office functions and use office tools, customer focused and deliver exceptional performance. Possess excellent organizational and file management skills and the ability to plan and execute administrative work with little supervision. Possess excellent oral and written communication skills. Required Certifications: Minimum of one (1) IAT Level II listed certificate required: CompTIA Security+ (CE) CompTIA CySA+ GIAC Security Essentials (GSEC) ISC SSCP (Systems Security Certified Practitioner) Minimum/General Experience: Five (5) years of experience in the following: Cybersecurity, Engineering, Test and Evaluation (T&E) or Authorization and Assessment (A&A) (formerly C&A) related field. Information Assurance tools such as Defense Information Systems Agency (DISA) Enterprise Mission Assurance Support Service (eMASS), Assured Compliance Assessment Solution (ACAS). Command line interface, PowerShell, and performing automated tasking through use of code. Minimum Education: College degree in any technical discipline from an accredited college or university. Disclaimer: The above information has been designed to indicate the general nature and level of work to be performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of the contractor assigned to this position. Applying: If you feel you have the knowledge, skills and abilities for this position visit our careers page at . Special Notes: Relocation is not available for these jobs ARMADA provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. ARMADA complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Must be able to successfully pass a background check, and pre-employment drug testing. Job offers are contingent upon results of background check and drug testing.
Job Description Job Description Type: Full Time Location: Philadelphia, PA Overtime Exempt: Exempt Reports To: ARMADA HQ Travel Required: Yes Security Clearance Required: Active Secret Security Clearance CONTINGENT UPON AWARD Duties & Responsibilities: Specialist, Information System Security III (SISS3) will conduct risk and vulnerability assessments of planned and installed systems to identify vulnerabilities, risks and protection needs; conduct systems security evaluation, audits, and reviews; determine the residual risk of a package based on package content and assessment results and documenting for the Security Controls Assessor's (SCA) and higher level review. Execute Security Assessment Plans (SAPs) by conducting on-site testing for afloat and PIT ashore systems. Examples include executing STIGs, SRGs, ACAS scanning, and applying patches assets to obtain cybersecurity compliance and remediate vulnerabilities. Specialist, Information System Security III (SISS3) will conduct systems security reviews, audits, or evaluations, as appropriate, to ensure accreditation documents are accurate and represent the current risk posture of the system. Perform analysis of logs, events, and reporting of various data collections tools including: vulnerability monitoring via Assured Compliance Assessment System (ACAS) and related tools, Host Based Security Systems (HBSS), web content filters, Security Information and event management (SIEM), firewall systems, network devices, server devices, workstations, and intrusion detection and prevention systems (ID/PS). Specialist, Information System Security III (SISS3) will assess impacts from observed risks and report via the Cybersecurity Program chain of command. Executing Security Assessment Plans (SAPs) by conducting on-site testing for afloat and PIT ashore systems. Examples include executing STIGs, SRGs, ACAS scanning, and applying patches assets to obtain cybersecurity compliance and remediate vulnerabilities. Perform the evaluation of system administrator, security engineer, and/or system owner proposed corrections to ensure compliance and best-fit solution. Specialist, Information System Security III (SISS3) will present and submit data to management, develop reports, and produce procedural documentation in a comprehensive and cohesive manner. Perform risk management and security engineering for Research, Development, Testing, and Evaluation (RDT&E) RMF Afloat systems include Information Assurance Vulnerability Management (IAVM) support, remediation, patching, scanning and associated boundary maintenance. Specialist, Information System Security III (SISS3) will document residual risks in a plan of actions and milestones formatted in compliance with the current package system, currently eMASS. Specialist, Information System Security III (SISS3) will maintain current vulnerability scan data and residual risk plan of actions and milestones in Vulnerability Remediation Asset Manager (VRAM). Manage, attend, and support configuration control board practices. Create and verify the accuracy of POA&Ms/RARs as identified by vulnerability actual test results. Specialist, Information System Security III (SISS3) shall write technical documentation such as user manuals, reports, documentation, policies, presentations, Plan of Action and Milestones (POA&Ms), risk assessments, proposals, outlines, and summaries in support of both ashore and afloat systems across multiple platforms. Support developing of technical documents across multiple platforms including configuration management, milestone, issue tracking, web site content management and RMF documentation. Specialist, Information System Security III (SISS3) may be required to travel CONUS (any state in USA) and OCONUS (primarily Japan, and any country in Europe). The estimated number of trips is 14 per year (estimated 25%-30% travel). Other duties as assigned. Knowledge, Skills, and Abilities (KSAs): Ability to travel CONUS (any state in USA) and OCONUS (primarily Japan, and any country in Europe). Proficient in Microsoft Windows Operating System Administration, including Windows 11, Windows 10, Windows 7, and Windows XP (at a minimum). Ability to work as a team member, communicate, perform office functions and use office tools, customer focused and deliver exceptional performance. Possess excellent organizational and file management skills and the ability to plan and execute administrative work with little supervision. Possess excellent oral and written communication skills. Required Certifications: Minimum of one (1) IAT Level II listed certificate required: CompTIA Security+ (CE) CompTIA CySA+ GIAC Security Essentials (GSEC) ISC SSCP (Systems Security Certified Practitioner) Minimum/General Experience: Five (5) years of experience in the following: Cybersecurity, Engineering, Test and Evaluation (T&E) or Authorization and Assessment (A&A) (formerly C&A) related field. Information Assurance tools such as Defense Information Systems Agency (DISA) Enterprise Mission Assurance Support Service (eMASS), Assured Compliance Assessment Solution (ACAS). Command line interface, PowerShell, and performing automated tasking through use of code. Minimum Education: College degree in any technical discipline from an accredited college or university. Disclaimer: The above information has been designed to indicate the general nature and level of work to be performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of the contractor assigned to this position. Applying: If you feel you have the knowledge, skills and abilities for this position visit our careers page at . Special Notes: Relocation is not available for these jobs ARMADA provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. ARMADA complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Must be able to successfully pass a background check, and pre-employment drug testing. Job offers are contingent upon results of background check and drug testing.