Patient Services Rep MA

" Licensed Psychiatric Nurse Practitioner Wage: Up to $206.36/hour Did you know that you can build a flexible private practice on your terms as a psychiatric nurse practitioner? Whether you want to see patients alongside a full-time job or grow a full-time practice, Headway makes it easy to accept insurance, boost your earnings, and focus on care - without the administrative burden. It's all on one free-to-use platform, no commitment required. About the role This position is for licensed psychiatric nurse practitioners looking to start or grow their private practice. Headway provides the tools, resources, and support to help you navigate insurance, streamline operations, and let you focus on what matters most - your patients. About you • You're a fully licensed psychiatric nurse practitioner with your DEA or CDS number, ANCC or AANP board certification, a valid NPI number and malpractice insurance. • You're looking to start or expand your private practice while maintaining control over your schedule, client load, and work environment. Why partner with Headway? As an independent provider with Headway, you'll gain access to: • Hassle-free insurance credentialing: Get credentialed for free in multiple states within as little as 30 days. • Increased earnings: Secure competitive rates with top insurance plans through our nationwide network. • Predictable bi-weekly payments: Receive reliable payouts directly from Headway. • Built-in EHR tools: Access real-time scheduling, secure client messaging, documentation templates, assessments, and more. • Compliance & audit support: Stay up-to-date with insurance requirements and industry regulations. • Free continuing education: Earn CEUs and expand your expertise through Headway Academy. How Headway supports your patients • Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. • Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Important Notes • This is a 1099 independent contractor role. You'll have full autonomy over your practice, including setting your hours and managing your caseload. • At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license. About Headway We make it easy for mental health providers to take insurance by credentialing you with the nation's largest networks, handling billing and admin paperwork, and helping you earn more stable income with higher rates. With Headway, you can finally focus on what matters most: providing life-changing care. We'll take care of the rest.

Customer Service Rep Associate

Corewell Health · Centralia, WA

Job Summary Inbound call center to assist and educate members, employer groups, providers, colleagues, and/or agents of health plan benefits with accessing services, facilitating and resolving problems, understanding claims, billing and coding, along with other questions. Consistently create an exceptional experience with each contact, via inbound and outbound calls, face-to-face interactions, online chat, email, etc. Essential Functions • Analyzes, evaluates, resolves and responds to service inquires from members, providers, employer groups, colleagues, agents, Elite agents (customers), and others within departmental guidelines. Professional and pleasant interactions are ongoing expectations. • Partnering with internal and external resources, promptly provides customers with information and education concerning benefit clarification, eligibility requirements, verification, authorization, billing and claim status. • Promptly identifies and resolves or escalates customer concerns or complaints to achieve positive outcomes. Places outbound welcome calls to members to educate them on their benefits as needed. Assists walk-in members and agents if assigned by leadership. • Adheres to established procedure and quality guidelines in support of Priority Health service promise, key drivers, performance indicators, as well as Corporate values and codes of excellence. Identifies potential trends or issues that impact health plan members and works with coworkers and leadership resources to suggest process improvements. • Assists members with administrative issues, such as submitting enrollment record changes, providing letter explaining coverage or benefits, and obtaining and relaying certain member information to other departments as needed. • Facilitates claims resolution through follow-up on member calls and correspondence received to appropriate departments. • Effectively tracks and/or documents all service interactions with customers within appropriate systems according to guidelines. • Develops and maintains behaviors of productivity, availability to customers, and adherence to work schedule. • Actively participates in safety initiatives and risk mitigating measures where appropriate and completes all position and unit safety related competencies and requirements on a timely basis. • Performs other duties as assigned. Qualifications Required • High School Diploma or equivalent • 1 years of relevant experience customer-facing service on phone or face to face; customer service, high volume call center, medical billing, insurance environment relevant to benefits, provider contracting, claims processing, and/or managed health care Preferred • Associate's degree About Corewell Health As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence. How Corewell Health cares for you • Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here. • On-demand pay program powered by Payactiv • Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more! • Optional identity theft protection, home and auto insurance • Traditional and Roth retirement options with service contribution and match savings • Eligibility for benefits is determined by employment type and status Primary Location SITE - 1700 Magnavox Way Suite 201 - Fort Wayne Department Name Physicians Health Plan of Northern Indiana Admin - PH Managed Benefits Employment Type Full time Shift Day (United States of America) Weekly Scheduled Hours 40 Hours of Work 8 a.m. to 5 p.m. Days Worked Monday to Friday Weekend Frequency N/A CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief. Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category. An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team. You may request assistance in completing the application process by calling 616.486.7447.

Pharmacy Technician - Prior Authorizations - Work From Home

CVS Health · Centralia, WA

CVS Health Pharmacy Technician We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary - Processes prior authorization requests received by phone, fax, or electronically and utilizes various computer resources, existing criteria, and medication guidelines to perform clinical research to support prior authorization reviews. - Proactively completes prior authorization approvals and denials that are due to expire and maintains complete, timely, and accurate documentation. - Reviews potential prior authorization denial language to ensure NCQA requirements are met. - Follows prior authorization workflow, policies, and procedures during the course of the workday. - Answers a potentially high volume of prior authorization inquiry calls from provider's offices, pharmacies, and internal partners and uses various computer resources to communicate prior authorization status or decisions. - Maintains a balance of productivity, quality and timeliness of work. - Participates in training and continuing education as required. - Participates in team/departmental meetings as required. - Excellent attendance is a must. - Successful pharmacy technicians will be proficient in drug name and diagnosis pronunciation, recognizing medical terminology, and navigating multiple computer resources to document conversations and prior authorization decisions. - Successful pharmacy technicians will possess good written and verbal communication skills. Hours of operation for Aetna Pharmacy Prior Authorization are between 5:00am to 8:30pm (may vary by time zone). Pharmacy Technicians work 8 hours shifts that may fall in between these hours of operations. Overnight shifts may also be available, but not guaranteed. Work schedule is approximate, and hours/days may change based on company needs. All full-time employees are required to complete forty (40) hours per week as scheduled, including on weekends and holidays. Part time positions are not available. Position requires the ability to work extended hours when necessary. Rotating weekend schedule may be required. Candidate must have their own home internet access with minimum speed of 100mbps download (internet can be hard wired with Ethernet cord). Candidate must also have a secure workspace/office in their home. Candidate must have high level skill with working with PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens). Required Qualifications - National Pharmacy Technician certification and Arizona or applicable state Pharmacy Technician license, current and in good standing, are required and must be maintained. - Between 1-5+ years of Pharmacy Prior Authorization processing experience. - Ability to Multi-task and prioritize work. - Ability to adjust based on business or department needs. - Good organization skills Preferred Qualifications - Retail or Hospital experience - Managed Care or Medicaid experience - AS400 experience - Proficiency in using computerized resources and software applications - Proficiency with Microsoft applications (Excel, Word, and Outlook) - Knowledge in pharmacy practices, procedures, and ability to read and understand clinical information - Working knowledge of drug dosage forms, drug strength, generic and brand name equivalent. Education High School diploma, G.E.D. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $18.50 - $35.29 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team. Job Title: Customer Service Advocate, Level I. Location: Baltimore, MD. Job Description: Purpose: • Responsible for answering members, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions in a call center environment. • Proactively provides information and education to members, providers & brokers, as appropriate, about a variety of health, financial, and self-service programs. Provides basic technical assistance and troubleshooting guidance for digital and electronic applications. Essential Functions: • 45% Provides first-level problem resolution to member, provider & broker inquiries via telephone by gathering and researching information; examine claim submissions verifying claim and system accuracy as well as liability, validate customer understanding of information and resolves issues based on applicable policies and procedures. • 25% Uses knowledge of products and the contractual provisions that govern administration to provide customer service and education, to interpret contractual language to the customer for the purpose of providing benefit utilization and limitations, to determine the need for managed care initiatives, and to administer all types of services to customers within the business segment through telephonic inquiries, written and/or electronic inquiries and claims adjustments, if applicable. Appropriately documents all client interactions according to established departmental procedures. • 15% Delivers accurate information to customers in accordance with performance goals and objectives. • 10% Maintains customer records by updating account information by effectively utilizing the business areas enrollment/inquiry tracking system & processes. • 5% Participates in ongoing education related to new services, industry topics, and skills. Qualifications: • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. • The requirements listed below are representative of the knowledge, skill, and/or ability required. • Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Preferred Qualifications: Knowledge, Skills and Abilities (KSAs): • Successful completion of the training provided., Proficient. • Demonstrated skills as an empathetic and compassionate communicator., Proficient. • Ability to quickly gain customer trust and confidence., Proficient. • Demonstrated PC navigation and data entry skills., Proficient. • Strong interpersonal communication skills., Proficient. • Good oral and written communication skills., Proficient. Top 5 Required Skills: • Strong Communication Skills: • Clear verbal and written communication is essential for explaining complex Medicare benefits and resolving member concerns. • Associates must be able to simplify jargon, speak with empathy, and maintain professionalism across diverse populations. • Technical Proficiency: • Comfort with CRM systems, call center software, and Medicare databases is vital. • Associates should be able to navigate multiple systems simultaneously, enter data quickly, and troubleshoot basic tech issues. • Emotional Intelligence and Patience: • Medicare members may be elderly, frustrated, or confused. Associates need active listening skills, patience, and the ability to stay calm under pressure. • Building trust and rapport is key to member satisfaction and retention. • Attention to Detail: • Call center reps must accurately document member interactions, verify personal and plan information, and follow compliance protocols. • Mistakes can lead to coverage issues or HIPAA violations, so precision is non-negotiable. • Knowledge of Medicare Guidelines: • A solid understanding of Medicare Parts A, B, C, and D, eligibility, enrollment periods, and coverage rules is critical. • Associates often handle policy-specific questions, so familiarity with CMS regulations and plan structures helps ensure accurate support. Education Level: • High School Diploma or GED. Experience: • Less than one year's customer service experience. Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veterans or individuals with disabilities.