-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Bridgeport, US-CT
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:53
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Colorado Springs, US-CO
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:52
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Wilmington, US-DE
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:51
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Sacramento, US-CA
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:51
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Hartford, US-CT
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:50
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Fort Smith, US-AR
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:49
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Los Angeles, US-CA
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:49
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Little Rock, US-AR
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:48
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: San Diego, US-CA
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:48
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: San Francisco, US-CA
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:47
-
Why NHC? We are celebrating our 50-year Anniversary at National HealthCare Corporation!! We offer a culture of recognition, empowerment, and fun.
At NHC, we are all partners (employees) in a family -oriented work atmosphere where growth and opportunities are promoted.
We provide competitive compensation with performance wage rate increases.
Position: Unit Manager Registered Nurse (RN)
Are you looking to make a difference in the lives of others by sharing your care and compassion? Do you enjoy connecting with your patients while getting to know them and their family? Do you enjoy working in a family - oriented atmosphere? Come join our family -oriented team at NHC HealthCare Bluffton! NHC fosters an environment of teamwork and provides opportunities to use your comprehensive Nursing Tools.
Position Highlights:
* Working with the interdisciplinary care team, to assure accurate patient assessment and development/revision of individualized plans of care.
* Maintains open and ongoing communication with patients and families, providing opportunity and encouragement to participate in decision making.
* Supervise LPNs and other nursing partners as assigned
* Perform other duties as assigned by the Director of Nursing
Why NHC? We are celebrating our 50-year Anniversary at National HealthCare Corporation!! We offer a culture of recognition, empowerment, and fun.
At NHC, we are all partners (employees) in a family -oriented work atmosphere where growth and opportunities are promoted.
We provide competitive compensation with performance wage rate increases.
Work Schedule: Dayshift
Job Type: Part Time and Full Time
Experience
South Carolina RN Nursing license
We hire GNs and GPNs
BenefitsEarned Time Off Holiday Incentive PayHealth, Dental, Vision, Disability and Life insurance401k with generous company contributions
Competitive PayUniforms
Tuition Reimbursement OpportunitiesAdvancement Opportunities and more!
Work Location:NHC HealthCare Bluffton3039 Okatie Highway
Okatie, SC 29909
If you are interested in working for a leader in senior care, share NHC's values of honesty and integrity, and have a heart for the geriatric patient, please apply today and find out more about us at nhccare.com/locations/bluffton/
EOE
....Read more...
Type: Permanent Location: Bluffton, US-SC
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:46
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Phoenix, US-AZ
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:45
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Tucson, US-AZ
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:44
-
Freelance Beautician Opportunity
NHC Hendersonville is seeking a skilled and compassionate Beautician to provide professional beauty services to our patients on a freelance/Contract basis.
At National HealthCare Corporation, we are recognized nationwide as innovators in the delivery of quality long-term care.
Our goal is to provide a full range of extended care services designed to maximize the well-being and independence of patients of all ages.
We are dedicated to meeting patient needs through a compassionate, interdisciplinary approach.
Work Hours : Part time or Full time.
Very flexible.
Job Overview
As a freelance Beautician, you will operate independently to deliver personalized hair care and grooming services for patients at NHC Hendersonville.
You will have the flexibility to manage your schedule while ensuring the needs of our patients are met.
Job Responsibilities
* Provide beautician services (e.g., haircuts, styling, grooming) tailored to the needs of our patients.
* Collaborate with the nursing team to determine patient eligibility for services based on physical and/or mental abilities.
* Operate within the beauty shop located at NHC Hendersonville, ensuring the space is utilized in alignment with patient priorities.
* Maintain a written record of appointments and charges to be shared with the bookkeeper.
* Keep your personal cosmetology license current and appropriately displayed.
Freelance Terms
* The Beautician will operate as an independent contractor, not an employee of NHC Hendersonville
* Beautician is responsible for all personal business taxes and maintaining their professional license.
* NHC will provide the beauty shop facility, shop license, and related postings.
* Service pricing will be established collaboratively between NHC and the Beautician.
* Either party may modify or terminate the agreement with a 30-day written notice, unless immediate termination is required due to inappropriate conduct.
Why Join Us?
While you will operate as an independent contractor, you'll have the opportunity to work within the supportive and rewarding environment of NHC.
We are committed to innovation, teamwork, and the well-being of the communities we serve.
We look forward to working with you!
EOE
....Read more...
Type: Permanent Location: Hendersonville, US-TN
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:44
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Mobile, US-AL
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:43
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"A different kind of care that ensures you're surrounded by people who make a difference in your life"
Low partner turnover
High customer satisfaction
Pay Per Visit or Hourly rates
Competitive wages
Position:Registered Nurse - Full-Time NHC HomeCare Lawrenceburg PRN
Licensure:
* Unencumbered current Registered Nurse license in the state where the HomeCare agency is located or compact state, if applicable.
* Minimum one (1) year experience as a RN / professional nurse.
* Experience in home care is desirable.
Position Highlights:
* Utilizes the nursing process to identify and achieve patient goals: assessment, planning, implementation, and evaluation.
* Assesses the physical, psychosocial, and environmental factors that affect a patient's health to develop a comprehensive nursing care plan which will attain the patients desired health outcomes in a culturally comfortable way.
* Collaborates with the interdisciplinary team to assure personal care, medical care and rehabilitation provide for optimal patient health and well-being.
* Teaches patient/caregiver in various aspects of health care and disease management appropriate to needs/level of education and understanding and documents continuing needs and levels of patients/caregivers understanding.
Benefits:Competitive Wages, Insurance, 401K Match, Dental, Vision (All Optional), Fun, Fast Paced Work Environment
NHC HomeCare Lawrenceburg is located at 399 Tripp Rd., Lawrenceburg, TN 38464
If you are interested in working for a leader in senior care and share NHC's values of honesty and integrity, please apply today and find out more about us at nhccare.com/locations/homecare-lawrenceburg/
We look forward to talking with you!! NHC is an Equal Opportunity Employer.
....Read more...
Type: Permanent Location: Lawrenceburg, US-TN
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:43
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Position: Week Night On-Call Registered Nurse, RN
Pay: $70,000 - $75,000 / yearly Depending on Experience
The Caris On Call Registered Nurse is normally scheduled to work "after hours" on week days.
The On Call RN is responsible for the nursing care of patients according to the physician's orders.
The On Call RN is responsible for assessing, planning, implementing, and evaluating total patient care and nursing care plans for each patient.
Caris Healthcare's mission is to provide hospice care with grace.
Serving patients throughout the Southeast region, we support our team members, patients and their families with compassion, accountability, respect, integrity and service.
If you are ready for a rewarding career with a company that offers employees a culture of integrity and excellence, consider joining the Caris Healthcare team
At Caris, you will have a career, not just a job.
Our mission driven culture is evident by our current employees and the impact made on patients and families.
All Caris team members commit to The Better Way, a list of promises we make to each other and our customers.
The Better Way commitment is reflected in the benefits we provide.
Benefits include:
* Competitive Salary
* Bonus Eligibility
* Eligible for benefits within 60 days
* Health Benefits (Medical, Dental, Vision); health savings account
* Earned Time Off
* 401 (K) plan with company match
* Paid Training
* Mileage Reimbursement
* Tuition Reimbursement
* Flexible Scheduling
* Career Advancement Opportunities
Responsibilities
* The On Call RN is scheduled to make patient visits each week.
The On Call RN may be able to resolve some issues by phone.
However, many "after hours" and will require the On Call RN to make a visit.
* The On Call RN agrees to be available for work-related phone calls throughout the scheduled "after hours".
Work related phone calls should be accepted by the On Call RN without allowing it to go to voice mail; unless the On Call RN is assisting a patient or on a phone call with a patient/family.
Qualifications
* Must be a Registered Nurse licensed in the state of operation.
* Nursing experience required, with experience in Hospice or Home Health preferred.
* Must posses a sound knowledge of nursing principles, procedures and elements of patient family teaching.
If you see yourself a good fit and want to join our team apply today! Caris HealthCare is an affiliate of NHC.
EOE
....Read more...
Type: Permanent Location: Big Stone Gap, US-VA
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:42
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Montgomery, US-AL
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:41
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"A different kind of care that ensures you're surrounded by people who make a difference in your life"
Position: LPN, Licensed Practical Nurse - PRN NHC HomeCare Lawrenceburg
Licensure:
* Unencumbered, current Licensed Practical Nurse license in the state where the HomeCare agency is located or compact state if applicable
* Graduate of a state approved LPN program
* Minimum one (1) year clinical experience as an LPN
* Individuals with less than one full year's experience as an LPN will be considered.
* If hired, they will be mentored and provided additional oversight through the end of that 1-year period.
Experience in home health care is desirable.
LPN Position Highlights:
* Under the supervision of a Registered Nurse, provides skilled nursing services as ordered on the plan of care and according to policy/procedures and state practice acts.
* Instructs the patient/caregiver in various aspects of patient care and disease management.
Documents the patient/caregiver comprehension of and compliance with teaching.
* Observes patient response to care/teaching and makes recommendations regarding revision of plan for patient care to the Registered Nurse.
* Provides and documents skilled nursing care according to the established plan of care, policies/procedures, and standards of care.
Performs other duties as assigned by the RN / Clinical Manager.
Benefits: Competitive Wages, Fun, Fast Paced Work Environment
NHC HomeCare Lawrenceburg is located at 399 Tripp Rd, Lawrenceburg, TN 38464
If you are interested in working for a leader in senior care and share NHC's values of honesty and integrity, please apply today and find out more about us at nhccare.com/locations/homecare-lawrenceburg/
We look forward to talking with you!! NHC is an Equal Opportunity Employer.
....Read more...
Type: Permanent Location: Lawrenceburg, US-TN
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:41
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Pharmacist in Franklin, TN
Network HealthCare Pharmacy is a closed-door pharmacy seeking a motivated Part-Time Pharmacist to work Monday and Friday in our Franklin, TN location.
OVERVIEW:A pharmacist is responsible for overseeing the daily operations of the pharmacy by dispensing medications-pharmacy supplies- in accordance with local, state and/or federal mandates.
Work is done in conformance with company policy and procedures governing such mandates.
Strives to meet demands of facility patients as well as work as efficiently as possible to return profits to Network Healthcare.
Oversees pharmacy techs/monitors/verifies their work output as needed.
JOB DUTIES AND RESPONSIBILITIES:
PRIMARY RESPONSIBILITIES
* Review and approve medication orders
* Enter/verify medication through accurate interpretation of physician orders
* Supervision of daily pharmacy operations.
Resolve day to day problems using defined processes.
* Maintenance of QS1 drug records
* Comply with state and federal pharmacy law
* Other duties as assigned
ADDITIONAL RESPONSIBILITIES
* Ability to assist with technician responsibilities, if necessary
* Maintain excellent interpersonal relationship with management, partners, and customers.
KNOWLEDGE/SKILL REQUIREMENTS
* Ability to work independent with minimal direct supervision
* Ability to work with center and pharmacy staff
* Ability to handle frequent interruptions and adapt to changes in workload/workflow
* Ability to set priorities, make critical decisions, and respond quickly
* Ability to exercise sound professional judgement
* Ability to exercise a high degree of discretion dealing with confidential information
* Working knowledge and understanding of all pharmacy policies, procedures, and directives
* Working knowledge of QS1, DocuTrack, Delivery Track, MatrixCare and Parata systems
QUALIFICATIONS:
* B.S.
or Pharm D Degree
* State license for Pharmacist in good standing must be maintained
* Two plus years experience in a retail, hospital and or long term care pharmacy
We are a Long Term Care Pharmacy facility serving nursing homes, assisted living centers, etc.
Huge prescription volume of medications filled daily.
Applicants from retail and/or hospital setting strongly urged to apply! Solid, dependable and verifiable work history required.
You must be self-motivated, team player and enjoy working in harmony with fellow team members.
Must pass background check and drug testing.
We offer competitive PRN rates.
Outstanding work environment and work location in Franklin, Tennessee.
If you are among the "best of the best" we welcome your resume and would look forward to discussing these outstanding opportunities with you.
We are part of National HealthCare Corporation one of the largest long term care companies in the USA.
....Read more...
Type: Permanent Location: Franklin, US-TN
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:40
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'Because of Me, Lives are Improved'
Looking for a career where you can reach your financial goals while helping others? Join the experts on safety and sanitation at a secure environment that will always be vital to the community!
NHC Somerville is looking for a Housekeeper/Laundry Attendant to be part of an exceptional hospitality team! If you have a pleasant and cheerful personality and are ready to learn, come join us! As a Housekeeper at NHC you are the leader in meeting our promise to keep a clean and pleasant environment for our patients!
Make a difference in others' lives!
BENEFITS:
* Competitive Wages
* Uniforms provided
Flexible Schedule
Fun, Fast Paced Work Environment
NHC Somerville is located at 308 Lake Dr., Somerville, TN 38068
If you are ready to join a leader in senior care since 1971, apply online or call (901) 465-9897 if interested in applying in person.
EOE
....Read more...
Type: Permanent Location: Somerville, US-TN
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:39
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Birmingham, US-AL
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:39
-
CERTIFIED PHARMACY TECHNICIAN - Front Fill/Cycle Fill in Greenville, SC
Network HealthCare Pharmacy is a closed-door pharmacy seeking a motivated Certified Pharmacy Technician to work in our Front Fill/Cycle Fill department in our Greenville, SC location.
POSITION OVERVIEW:
* Pull/pick medications from shelving and other medication storage areas (prepack racks)
* Accuracy check of final preparation prior to presenting to pharmacist
* Fill daily drug orders accurately and efficiently and in a timely and prioritized manner, under the supervision of a pharmacist
* Assist in processing returned drugs and recycle/dispose per procedure
* Assist in pre-packing frequently ordered medications; label and stock as needed during low volume times
* Follow all applicable government regulations, including HIPAA
* Maintain clean/organized workstation areas and replenish all stock supplies needed each shift
* Alert pharmacist on duty of any medication/product that is not scanning properly
* Comply with departmental policies regarding safety, attendance, and dress code
* Process First Dose boxes
* Process batch and null labels
* Export of Orders/Center and Patients
* Maintenance of machines used in Cycle Fill (i.e.
Tigger, Roo, Winnie.
Parata)
* Process supplemental fill list and check rolls.
* Run repack and process re-run bags
* Prepare prescription delivery
* Put up order from Wholesaler
* Minimal non-sterile compounding
* Participate in quarterly inventory
* Other duties as assigned; Job duties may vary depending on business needs
PHYSICAL DEMANDS
The physical demands described here are representative of those that should be met by an employee to successfully perform the essential functions of this job:
* May stand up to seven (7) hours per day
* The employee is occasionally required to reach, stoop, kneel, bend, crouch, or walk intermittently
* May be necessary to work extended hours as needed
* May lift and/or move up to 10 pounds
* The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role
QUALIFICATIONS
* High School diploma or equivalent required
* Pharmacy technician licenses required by state regulations and state of practice in good standing
* PTCB or ExCPT certification
* Previous work experience in a pharmacy setting preferably long-term care
* Able to read, write, speak, and understand the English language
* Able to work at a moderate speed
* Able to work during inclement weather
* Reliable
* Good organization/Attention to detail
* Analytical/Problem solver
* Able to physically perform light lifting
....Read more...
Type: Permanent Location: Greenville, US-SC
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:38
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Position: Director of Maintenance - Full Time
NHC Desloge is seeking a Maintenance Director who is able to deal tactfully and effectively with patients, families, fellow employees and visitors.
The qualified applicant for this position must have at least 2 years experience in maintenance and various mechanical, electrical and plumbing systems.
Duties include:
* planning, directing and supervising maintenance program of the physical plant, institutional equipment and vehicles
* training, instructing and supervising other maintenance personnel
* maintaining records of work performed and costs involved
* advising and consulting with administrator on maintenance and repair needs concerning structure, equipment and grounds
* tactfully and effectively dealing with patients and families
Requirements :
-At least 2 years experience in maintenance and various mechanical, electrical and plumbing systems
-Must be able to read and interpret blueprints
and technical manuals
-Must have a knowledge of local codes, ordinances and safety regulations
BenefitsEarned Time Off Holiday Incentive PayHealth, Dental, Vision, Disability and Life insurance401k with generous company contributionsUniformsAdvancement Opportunities
Work Location:NHC Desloge 801 Brim Street
Desloge, MO 63601
If you are interested in working for a leader in senior care and share NHC's values of honesty and integrity, please apply today and find out more about us at nhccare.com/locations/desloge/
EOE
....Read more...
Type: Permanent Location: Desloge, US-MO
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:37
-
Essential Duties and Responsibilities:
- Responsible for completing medical and/or behavioral health assessments within contract requirements.
- Conducts on-site, video call and/or telephonic assessments to determine an individual's needs for services and supports, eligibility, level of care or related outcome.
- Perform all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures.
- Travel may be required based on program contract requirements.
- Performs other related duties as assigned.
- Preferred knowledge may include community support programs, long-term care assessment and level of care in medical, behavioral health or related programs.
- Knowledge and understanding of medical and/or behavioral health diagnoses and prescribed medications.
- Ability to collect data, define problems, establish facts, and draw valid conclusions.
Minimum Requirements
- Education and licensure requirements are based on program contract requirements and are outlined in job posting.
- High School Degree or equivalent required.
- Minimum 2 years of clinical experience required.
- Master's degree in Social Work, Mental Health, or a related field
- Comfort conducting assessments in hospitals, psychiatric facilities, and correctional facilities (including prisons and jails)
- Basic Proficiency with MS office applications (Excel, PowerPoint & Word)
- Willingness and ability to travel daily for in-person assessments throughout Cook County and Lake County
Preferred Requirements
- Licensed professional background as a Social Worker, Psychologist, or Therapist
- Two (2) or more years of experience in adult mental health, social services, or a related discipline
- Advanced proficiency with MS office applications (Excel, PowerPoint & Word)
- Familiarity with Specialized Mental Health Rehabilitation Facility (SMHRF) assessments
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
- Minimum 20 Mbps download speeds/50 Mbps for shared internet connectivity
- Minimum 5 Mbps upload speeds
- Private and secure workspace
#LI-Hybrid
EEO Statement
Maximus is an equal opportunity employer.
We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.
Annual salary is just one component of Maximus's total compensation package.
Other rewards may include short- and long-term incentives as well as program-specific awards.
Additionally, Maximus provides a variety of benefit...
....Read more...
Type: Permanent Location: Chicago, US-IL
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:37
