UNKNOWN

FEED

Validate and verify patient's active insurance benefits, demographics, prior authorization requirements, network status, and financial information for the purpose of guaranteeing reimbursement for services rendered and to minimize collection issues and/or bad debt expense. Assist in researching escalated issues from payers, case managers, revenue cycle team or campuses in a timely and effective manner and provide audit of process to identify system or process failures.

<p>Since 1997, weâ€™ve dedicated ourselves to being the best healthcare company in the Midwest by providing exceptional, comprehensive care to seniors in every community we serve. We operate multiple senior health communities throughout Kentucky, Indiana, Ohio and Michigan. To meet every need of the aging population, we have designed our communities to offer a full range of services, from independent and assisted living, to skilled nursing and rehabilitative services. Whether a resident requires short-term rehabilitative care, or ongoing nursing care, our programs help our residents live the highest quality of life possible. <br/><br/>
					
					At Trilogy Health Services, our motto of being compassionately committed to excellence in customer service is evident in everything we do. We believe that our company culture, values, and superior service standards are what define â€œThe Trilogy Difference.â€ Not only do we provide excellence in customer service to each resident, but we are also committed to serving those around our residents, including our communities and our employees.<br/><br/>
					The Trilogy culture is built upon our Trilogy Service Standards, which emphasize exceeding customer expectations in all areas, including resident activities and programming, fine dining, family care and employee care to name a few. Each service standard is designed to provide an exceptional service experience, whether you are a Trilogy resident, family member, employee or community member. Cultural Leadership is the driver for our success, and our cultural map that guides us on our journey is our Mission Statement.
 </p>

Trilogy Health Services LLC

Payer Services Specialist

FULL_TIME

Company Overview: Commonwealth Pain & Spine is a pain management network dedicated to improving the lives of our patients by treating their pain with the utmost respect and providing them with the most innovative, safe, responsible, and clinically proven pain relief possible. Required Skills & Abilities: • Exceptional communication and interpersonal skills to interact effectively and tactfully with all levels of employees, management staff, patients, vendors and the general public.

Commonwealth Management LLC

Prior Authorization Specialist

<p>SRS Distribution Inc. has the strongest national network of independent roofing distributors with the most talented team of people working together to deliver the industry's best products and services. We have hundreds of locations in 44 states and continue to grow year-over-year. Our website has the latest list of branches.</p>
<p> In addition to our commitment to customer focus, SRS strives to become the preferred employer in the industry with highly-motivated and engaged employees operating in an entrepreneurial culture. This continual growth has established SRS as one of the fastest growing building products distribution companies in the U.S. SRS is a private company sponsored by Leonard Green & Partners and Berkshire Partners LLC, while being led by a management team of industry veterans. Find out more at <a href="http://www.srsdistribution.com">www.srsdistribution.com</a>. </p>
<p>SRS believes in hiring military veterans at any level for any position. We know your service trained you in many of the areas that we value, such as; leadership, teamwork, performance, integrity, and safety. If your experience matches our requirements, we want you to apply today.</p>
<p>Typical Opportunities:</p>
<h4>Branch Operations</h4>
<ul>
<li>Branch Management</li>
<li>CDL Driver</li>
<li>Inside Sales (Sales Administration)</li>
<li>Warehouse Personnel</li>
<li>Roof Top Loader/Striker</li>
</ul>
<h4>Branch Outside Sales</h4>
<ul>
<li>Territory Management</li>
</ul>
<h4>Corporate</h4>
<ul>
<li>Administration</li>
<li>Accounting and Finance</li>
<li>Fleet</li>
<li>FP&A</li>
<li>Financial Services</li>
<li>Human Resources</li>
<li>Information Technology</li>
<li>Legal</li>
<li>Marketing</li>
<li>Pricing</li>
<li>Procurement</li>
<li>Safety</li>
</ul>
<h4>University Programs</h4>
<ul>
<li>Management Trainee</li>
<li>MBA Leadership Development Program</li>
<li>Summer Internship</li>
</ul>
<h4><strong>Benefits:</strong></h4>
<h4>Health</h4>
<ul>
<li>Choice of medical plans (includes a wellness plan and telemedicine)</li>
<li>Vision Plan</li>
<li>Choice of dental plans</li>
<li>Basic Life Insurance paid by SRS</li>
<li>Employee Assistance Program (EAP)</li>
<li>Additional Life Insurance for employee and members of family available</li>
<li>Short-Term Insurance available</li>
<li>Long-Term Insurance available</li>
</ul>
<h4>Financial</h4>
<ul>
<li>401(k) Retirement plan with an opportunity for company match</li>
<li>Compensation plans that include a competitive wage and bonus opportunities</li>
<li>Paid weekly for all salaried and hourly employees</li>
<li>Flexible Spending Account</li>
<li>Dependent Care FSA</li>
<li>Pre-Paid Legal</li>
<li>Identity Theft</li>
<li>Discounts on our products</li>
<li>Vendor discounts</li>
</ul>
<h4>Paid Days Off</h4>
<ul>
<li>Paid vacation</li>
<li>Paid birthday</li>
<li>Paid holidays</li>
<li>Paid day of giving</li>
<li>Personal time off after 1st year</li>
<li>Jury duty</li>
<li>Bereavement pay</li>
</ul>
<h4>Can’t put a price tag on these benefits</h4>
<ul>
<li>Training and development, because we believe in hiring from within.</li>
</ul>
<p>Fun events at corporate and branches.</p>

What You’ll Do The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests. Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds.

HOUR

Onco360

Pharmacy Prior Authorization Specialist

Location: Hybrid1: This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

Elevance Health Inc

Credit & Collections Specialist Sr

With multiple convenient locations throughout the Northern Kentucky region (Kenton, Boone, Campbell, Grant, Carroll, Gallatin, Pendleton, and Owen counties), NorthKey offers a wide array of mental health, substance use, and developmental disabilities services unparalleled in the region. Since 1966, NorthKey Community Care (NorthKey) has provided effective and efficient mental health, substance use, and developmental disabilities services to the Northern Kentucky region with the commitment to providing the right service, at the right time, and in the right place.

NorthKey Community Care

Revenue Cycle Specialist

ea_via_bold

Strong customer service, interpersonal, written, and verbal communication skills; ability to work effectively with employees at all levels and handle sensitive information confidentially. The employer is seeking a candidate with Kentucky work experience and practical knowledge of Kentucky-specific employment requirements and employee relations matters who can contribute with minimal ramp-up time.

YEAR

Actus Consulting Group

Payroll Specialist - Franklin, Kentucky#13168

Manatal

Provides customer service and leave administration support to employees, researching and triaging issues with vendors to resolve concerns in a timely manner. Make a living while you make a difference at Trilogy Health Services - a senior living provider with the continuous goal of being the Best Healthcare Company in The Midwest.

Leave Specialist

Additional expectations to include but not limited to: Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely; comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts. How you will make an impact: Utilizes internal queries, internal resource tools, must initiate delicate-in-nature phone calls to other carriers, members, groups, providers, attorneys, CMS and Medicaid and report to identify members who are or should be enrolled in other coverage.

Elevance Health

Ecob Specialist II

In addition, the Support Level II Specialist is responsible for receipt and ownership of customer service requests, administration of tickets within the service management system and monitoring of field and logistics requirements. Working with field service technicians for troubleshoot visits and installations ensures that all documentation/reporting deliverables are available to customers as required by the contract or SOW.

Creative Realities, Inc.

Support Specialist, Level II

Works with internal and external customers to resolve assigned portfolio of accounts by collecting the balance due or by taking other action (write-offs, billing to another source, in-house collections or referral to attorney or collections agency, etc.) necessary to resolve account and relieve AR in a timely manner. Works with assigned pharmacy locations, nursing home accounts and individual customers in receiving inbound correspondence and mailing outbound collection letters for 90-day active/inactive accounts and discontinuation of service letters.

BrightSpring Health Services

Collections Specialist

Meanwhile, from a regional perspective, The Boston Globe, Courier Journal, and Louisville Business First annually recognize our unwavering commitment to upholding an internal culture of inclusivity, enjoyment, and empathy for our valued employees by listing The Phia Group in their respective lists for the Top Places to Work. Candidates with experience working for or supporting commercial health insurance carriers, payer organizations, Blue Cross Blue Shield plans, managed care organizations, or third-party administrators will be especially well positioned for this role.

The Phia Group

Subrogation Service Onboard & Support Specialist

clearcompany

In accordance with California law, candidates applying for positions located in California that require on-site presence at a Home Medical Device Retailer (HMDR) facility must obtain a California Department of Public Health (CDPH) Exemptee License. This license requires completion of state-approved training and a course completion certificate, as HMDR facilities are required to have an Exemptee physically present during all hours of operation in lieu of a pharmacist.

AdaptHealth

Documentation Specialist

The Corporate Human Resources Specialist is responsible for leading the HR departments within three health care facilities by developing and implementing HR policies and programs, ensuring compliance with employment laws, managing the HR budget and working to improve employee relations. If you are a detail-oriented professional who enjoys human resource administration, problem-solving, and supporting employees, we invite you to apply and become part of a team dedicated to excellence is skilled nursing care!

Ridgewood Terrace a Concord Health Systems facility

Human Resources Specialist (Corporate)

Gethired

Operations Specialist, Driving

As a Technical Specialist, General Liability, you will be responsible for managing and investigating moderate complexity injury and/or property damage claims including customer contact, determining coverage, evaluating liability, assessing damages, establishing timely reserves, and issue timely and accurate payments within appropriate authority and oversight. Gather and thoroughly investigate information by contacting all relevant parties to determine coverage, evaluate liability exposure, assess bodily injury and/or property damage, and establish appropriate reserves in accordance with policy terms and management guidance.

The Travelers Companies

Technical Specialist, General Liability

As a Senior Technical Specialist, General Liability, you will be responsible for managing and investigating complex and higher-severity injury and/or property damage claims including customer contact, determining coverage, evaluating liability, assessing damages, establishing timely reserves, and issue timely and accurate payments within appropriate authority and oversight. Gather and thoroughly investigate information by contacting all relevant parties to determine coverage, evaluate liability exposure, assess bodily injury and/or property damage which may include personal and advertising injury claims, and establish appropriate reserves in accordance with policy terms and management guidance.

Senior Technical Specialist, General Liability

Work collaboratively with clinicians, practice managers, and other team members to obtain clinical notes and documentation necessary for prior authorization approval. The Specialist will obtain, monitor, and maintain authorizations through payer websites, fax, and telephone, including all necessary follow-up and reauthorization activities.

Graves Gilbert Clinic

The position supports the Lyons Magnus Regulatory Department ensuring accurate completion of technical documentation, marketing claims, labeling claims, finished product label development, formula management, and export documentation. Complete technical document requests (statements to include specifications, nutritional composition, GMO, gluten, export certs, etc) to meet customer expectations in documentation turnaround time and accuracy.

Lyons Magnus

Food Labeling Compliance Specialist

The Housing Support Specialist serves as both a client advocate and operational coordinator blending empathetic customer support, strategic vendor coordination, and detailed lease management to ensure uninterrupted, comfortable housing while delivering an elevated service experience with urgency, accountability, and professionalism. Maintain accurate financial and operational records, including updating client ledgers for billing accuracy, tracking extension costs within ALE guidelines, manage move-out coordination when applicable, including vendor pickups, lease terminations, and security deposit reconciliation.

<p>Sedgwick Claims Management Services, Inc., is a leading global provider of technology-enabled risk and benefits solutions. At Sedgwick, caring countsSM; the company takes care of people and organizations by delivering cost-effective claims, productivity, managed care, risk consulting and other services through the dedication and expertise of nearly 15,000 colleagues in some 275 offices located in the U.S., Canada, the U.K and Ireland. Sedgwick facilitates financial and personal health and helps customers and consumers navigate complexity by designing and implementing customized programs based on proven practices and advanced technology that exceed expectations. Sedgwick’s majority shareholder is KKR; Stone Point Capital LLC, La Caisse de dépôt et placement du Québec (CDPQ) and other management investors are minority shareholders.</p>

Insurance Claims Specialist Jobs in Kentucky

Payer Services Specialist Trilogy Health Services LLC

Prior Authorization Specialist Commonwealth Management LLC

Prior Authorization Specialist CPS

Pharmacy Prior Authorization Specialist Onco360

Credit & Collections Specialist Sr Elevance Health Inc

Revenue Cycle Specialist NorthKey Community Care

Payroll Specialist - Franklin, Kentucky#13168 Actus Consulting Group

Leave Specialist Trilogy Health Services LLC

Ecob Specialist II Elevance Health

Support Specialist, Level II Creative Realities, Inc.

Collections Specialist BrightSpring Health Services

Subrogation Service Onboard & Support Specialist The Phia Group

Documentation Specialist AdaptHealth

Human Resources Specialist (Corporate) Ridgewood Terrace a Concord Health Systems facility

Operations Specialist, Driving AdaptHealth

Technical Specialist, General Liability The Travelers Companies

Senior Technical Specialist, General Liability The Travelers Companies

Prior Authorization Specialist Graves Gilbert Clinic

Food Labeling Compliance Specialist Lyons Magnus

Housing Support Specialist Sedgwick Claims Management Services, Inc.

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