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Preferred Internal Support Services I

Job Details

As a member of our Internal Support Services team, you will oversee the daily operational activities that support the National Preferred Zones of personal lines account managers. You will manage incoming correspondence, facilitate new business processes, and ensure the accuracy and integrity of clients’ electronic records.

What You’ll Do:

  • Ensure accuracy and consistency in documentation, data entry, and recordkeeping to maintain high-quality outputs.
  • Manage task prioritization, communications, and workflow facilitation for Account Managers.
  • Support policy renewals, monitor expiration dates, and uphold strict confidentiality standards.
  • Monitor and manage all incoming mail and internal communications, ensuring timely distribution to appropriate team members. Follow up on outstanding items to maintain workflow continuity and meet service expectations.
  • Assign and distribute tasks to Account Managers based on workload, client priorities, and service deadlines.
  • Coordinate with Account Managers to ensure timely processing of new business, renewals, and service requests.
  • Maintain confidentiality and handle sensitive information in accordance with company policies and regulatory requirements.
  • Uphold USI’s Best Practices, Core Values, and Risk Management standards in all aspects of work.

What We’re Looking For:

  • Entry-level exposure and/or interest in Personal Lines Insurance, with a desire to grow and develop expertise in the field.
  • High School diploma or equivalent required. College degree preferred.
  • Proficient with internet-based programs and Microsoft Office, including intermediate knowledge of Excel. Knowledge of Sagitta/Work Smart is a plus.
  • Skilled at handling tasks of varied complexities with precision and efficiency.
  • Able to work collaboratively in a fast-paced, team environment.
  • Strong communication skills and the ability to foster relationships with clients, co-workers, and partners.
  • Effective at organizing and managing workflows to ensure timely and accurate task completion.
 
GLDR
 
#LI-JM2
 
#LI-Remote

Why USI?
With approximately $3 billion in revenue and over 10,500 associates across approximately 200 offices nationwide, USI is one of the largest insurance brokerage and consulting firms in the world. At USI, we have created one of the most dynamic personal and professional development cultures in the industry. We invest heavily in our associates, and we take pride in celebrating their growth and success through our one-of-a-kind employee reward and recognition programs. 

Unrivaled Resources and Support
What truly distinguishes USI as a premier insurance brokerage and consulting firm is the USI ONE Advantage®, a game-changing value proposition that delivers to clients a robust set of risk management and benefit solutions with bottom-line financial impact. USI ONE® represents Omni, Network, Enterprise—the three key elements that set USI apart from the competition. Through USI ONE, we develop strategic, timely, and effective risk management and benefit programs in terms that are easy to understand, and we demonstrate how the solutions can have a positive economic impact.

Industry-Leading Programs, Rewards, and Recognition 
In addition to competitive pay, incentives, and benefits, USI recognizes associates through our Summit Awards program, rewarding excellence in those who build our brand each day. USI offers employee programs that recognize outstanding achievement and help our associates lead healthy, productive lives. We turn care into action with our award-winning wellness program, college scholarships for associates’ children, and financial help in times of need. 

Deep Community Engagement
We are committed to giving back to our local communities and supporting a culture of environmental sustainability. From sharing our time, talent, and resources to support local non-profit organizations, animal shelters, and environmental beautification and restoration projects – to partnering with eco-conscious vendors and taking steps to reduce our own environmental footprint – we’re working together as ONE to build a better future.

Committed to a Diverse and Inclusive Workplace
Our award-winning I’m With U diversity and inclusion program educates our associates to help them better understand and serve our clients, prospects, fellow team members, and local communities through curated education and training resources, employee support programs, and community outreach initiatives to build a more diverse, equitable, and inclusive culture.


Nationally Recognized as a Top Insurance Employer

  • Recognized as one of Insurance Business America’s Top Insurance Employers eight consecutive years (2018-2025).
  • Named to Business Insurance’s annual list of the Best Places to Work in Insurance six years in a row (2020-2025).
  • Named to Fortune’s Best Workplaces in Financial Services & Insurance list for the last two years (2024-2025). 
  • Certified as a Great Place To Work two years in a row (2024-2025).

Visit our Awards and Accolades page for a complete list of our latest industry awards and recognitions!

USI is committed to providing a full-suite of competitive benefits for our growing population and its diverse needs. We offer a wide range of health, welfare and financial benefits including medical, wellness, dental and vision, 401(k), flexible spending and health savings accounts, short and long-term disability, life insurance and other unique employer-sponsored and voluntary programs. USI also offers a generous paid time off policy, paid family leave benefit as well as paid holiday time.

$45k & 5% Bonus
 

APPLY HERE: Preferred Internal Support Services I

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Provider Enrollment Coordinator

Job Details

Your career is more than just a job, it’s part of your life. Whether you’re a clinician, or non-clinical professional,  at USACS you’ll feel a sense of connection working with clinicians and office staff who share your interests and values. We want you to love coming to work each day because you believe in what you do and the people with whom you work. We care about your success.

 

USACS also understands that location is important. We offer  career opportunities for clinicians and non-clinical support staff from New York to Hawaii and numerous points in between. Our supportive culture,  outstanding benefits and competitive compensation package is best in class.

 

 

 

 

Job Description

 

 

The Provider Enrollment Coordinator is the first point of contact to staff; resolve enrollment issues by answering questions, making recommendations for resolution and escalation, checking enrollment status, verifying payer enrollment requirements and system implementation, appropriately follow-up on Provider Issue Forms; facilitates group and individual enrollment with commercial and government payers.

 

 

Location: Remote

 

ESSENTIAL JOB FUNCTIONS:

  • Resolves issues and concerns by correctly answering questions from staff and providing appropriate follow-up on issues, escalating to Team Lead and/or Manager, when appropriate.
  • Provides the team with coaching, training, and auditing on assigned tasks. Partner with Team Lead to evaluate team’s performance to improve overall production and facilitate continuous improvement.
  • Assists Team Lead in monitoring inventory and production and facilitates the escalation process as needed.
  • Become proficient in discussions with payors to facilitate closure of any identified issues
  • Research and review individual Provider Issue Forms for appropriate follow-up and resolution.
  • Missing Documents – POC will meet with Lead biweekly to review missing documents risks and concerns.
  • Maintain Matrices – payer enrollment, matrix, SOPs, new site sheets, email templates, welcome letters, etc.
  • Create and distribute reports containing provider credentialing and enrollment data for various departments within the organization
  • Research new state enrollment requirements for group and individual provider enrollment.
  • Assists Contract Implementation staff with accurately documenting enrollment and billing requirements for payer contracts.
  • Assist with IntelliCred Application Mapping
  • Facilitate completion and submission of payer enrollment applications for government and commercial payers
  • Monitor application status process to identify emerging issues and communicate them to Team Lead
  • Monitor enrollment status for group and individuals
  • Performs and assists with other department duties as required

 

KNOWLEDGE, SKILLS AND ABILITIES:

  • Meticulous follow-through of delegated tasks, including follow-up with staff to ensure completion, quality, and meeting deadlines.
  • Ability to exhibit leadership by demonstrating a commitment to team development, adapting to change in a positive manner, and supporting alignment with organizational goals including continuous improvement efforts
  • Ability to pay close attention to detail and produce extremely accurate work.
  • Strong analytical and problem-solving skills.
  • Ability to organize and prioritize job tasks and requirements.
  • Excellent organization skills with the ability to prioritize assigned duties in an efficient amount of time.
  • Ability to effectively perform in a multi-task work environment.
  • Strong communication and interpersonal skills.
  • Ability to effectively use oral and written communication skills with clinicians, external agencies and management in a courteous and professional manner.
  • Must have knowledge of correct English, proper grammar and spelling.
  • Knowledge and skills in using personal computers (Windows) with a strong emphasis on Microsoft Office Programs- Outlook, Word, Excel and Adobe Acrobat
  • Ability to maintain patience and composure in difficult situations.
  • Ability to work well under pressure and meet strict deadlines.
  • Ability to maintain confidentiality.
  • Ability to exhibit a commitment to teamwork, supporting alignment with company and department goals and objectives, assisting others to develop their knowledge of the company and department, and adapting to changes in a positive manner.

 

EDUCATION AND EXPERIENCE: 

  • High school diploma or equivalent
  • Two (2) years office experience or college course work preferred.
  • Knowledge of health plan billing and enrollment preferred.

 

PHYSICAL DEMANDS:

  • While performing the duties of this job, the employee is regularly required to sit for prolonged periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds. 
  • Required to have close visual acuity to perform the job.

 

Hourly Rate: $18.76-$34.70

The starting rate for this position will be $21.50

 

 

Hourly rate may be determined on several factors including but not limited to knowledge, skills, experience, education, geographical location and requirements stated in job description.

 

 

US Acute Care Solutions current and potential employees enjoy best in class benefit programs with a wide array of options.  To learn more, please visit the following link: http://www.usacs.com/benefits-guide  

 

 

Click the red apply button to submit an application and resume. If you are an USACS employee, please apply via the Jobs Hub in the Workday system.

 

APPLY HERE: Provider Enrollment Coordinator

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Patient Engagement Specialist – Remote – Full Time

Job Details

It’s fun to work in a company where people truly BELIEVE in what they’re doing!

 

We’re committed to bringing passion and customer focus to the business.

 

 

Summary

The Patient Engagement Specialist coordinates all appointments with providers for patients, referring physicians, and facilities across multiple states. In addition, the Patient Engagement Specialist communicates key information to patients and staff members including insurance coverage, financial responsibilities, and date/time of appointments.


Schedule: Mondays – Fridays 10:00am – 6:00pm EST
Compensation range: $48,000 – $53,000 *dependent upon relevant experience*

Benefits eligible!

 

 

Description

 

  • Provide warm, friendly, and excellent customer service through all interactions with patients, referral sources and staff members.
  • Communicate directly with patients to schedule, re-schedule and/or cancel their initial and subsequent appointment requests accurately by following practice scheduling protocols and tools.
  • Provide accurate and courteous information regarding our services to physicians and other callers.
  • Respond effectively and promptly to all patient, provider, and team member requests.
  • Maintain/Update patient information and working knowledge of insurance protocols.
  • Utilizes eligibility systems, on-line websites or phone calls to determine insurance benefits. 
  • Provides information to the patient and/or guarantors regarding their benefits and financial obligations.  
  • Handle billing inquiries, collect any out of pocket (deductibles, copays, etc), and process payments accurately.  
  • Explain insurance coverage and financial responsibility to patients in clear language.
  • Communicate when insurance issues arise (inactive coverage, referral needed, etc.)
  • Work with billing teams to correct coverage issues.
  • Maintain insurance panels.
  • Obtain approval for schedule changes or cancellations as appropriate.
  • Meet specified goals and objectives assigned by management.
  • Escalate any problems that may arise to management.
  • Complete other duties as assigned or identified based on patient needs.
  • Ability to adhere to quality and productivity standards.

 

#LI-MC1

 

 

 

Qualifications

  • Experience with insurance eligibility.
  • Bilingual Spanish required.
  • Bachelor’s degree preferred.
  • Attention to detail a requirement.
  • Strong organizational skills.
  • Ability to multi-task and prioritize.
  • Ability to work well with others in a team driven environment.

 

EEO Statement

PM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law.

 

APPLY HERE: Patient Engagement Specialist – Remote – Full Time

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Contact Center Provider Services Remote USA

Job Details

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

 

Summary

We are seeking a dedicated and empathetic professional to join our team in a customer contact role focused on delivering exceptional customer service to members, providers, and other stakeholders. This position involves managing inbound and/or outbound communications via phone, email, chat, portals, and secure correspondence systems. Responsibilities include researching claims, verifying insurance coverage, resolving inquiries, and ensuring compliance with healthcare regulations. The ideal candidate will follow established scripts and guidelines, demonstrate strong attention to detail, and consistently provide high-quality, positive contact experiences.

Your role in our mission

  • Engage promptly and professionally with providers and members through inbound/outbound calls, emails, live chat, and other platforms, addressing inquiries with empathy, accuracy, and composure.
  • Listen carefully to questions and concerns, providing clear and accurate information in alignment with company policies and procedures, and escalate complex issues to leadership when appropriate.
  • Document all interactions, feedback, and resolutions accurately in the CRM or case management system, and share insights on recurring issues to support process improvement
  • Collaborate effectively with team members and supervisors to coordinate support, maintain a positive work environment, and ensure issues are routed to the appropriate departments.
  •  Meet or exceed established KPIs, including call quality, handle time, customer satisfaction, and adherence to scripts, quality standards, and scheduled work hours.

What we’re looking for

  • High school diploma/GED required
  • 1–2 years of experience in customer service, preferably healthcare
  • Demonstrate strong organizational and communication skills, with high attention to detail and the ability to actively listen, show empathy, and respond to member and/or provider concerns with compassion and clarity.
  • Ability to multitask and navigate multiple systems simultaneously.

What you should expect in this role

  • Professional growth through training and mentorship
  • A fast-paced role in a metrics driven environment with direct impact on providers serving the Medicaid programs and benefits
  • Ability to work either 8:00AM – 4:30PM or 8:30AM – 5:00PM EST.
  • #LI-REMOTE
  • #LI-LS2

 

The pay range for this position is $29,100.00 – $41,600.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

 

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

APPLY HERE: Contact Center Provider Services Remote USA

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Grievances and Appeals Representative

Job Details

Become a part of our caring community and help us put health first
 

Join a team where your expertise truly makes an impact! As a Grievances & Appeals Representative, you’ll be a go-to problem solver, turning complex challenges into clear resolutions. In this role, you’ll dive deep into clinical documentation, analyze cases, and determine the best course of action—whether that’s a grievance, appeal, or next steps. You’ll own the process from start to finish, collaborating with clinical experts and internal partners to deliver fair, accurate, and timely determinations. Your contributions will directly support Humana’s commitment to delivering high-quality service and making a positive difference in the lives of those we serve.

 

 

  • Reviews level 1 appeals cases and ensures that information is accurate.
  • Forwards appeals to CMS entity for further review.
  • Investigates and resolves member and practitioner issues.
  • Works within broad guidelines with little oversight.


Use your skills to make an impact
 

Required Qualifications

  • 1+ years of grievances and/or appeals experience.
  • Data entry experience.
  • Intermediate proficiency with Microsoft Word and Excel.
  • Experience in a production driven environment.
  • Experience handling multiple projects and assignments as directed by management.
  • Capacity to maintain confidentiality and work independently in support of the department.
  • Virtual training will start on day one and be Monday – Friday, 8 am – 4:30 pm EST. Following training, candidates must be able to work an 8-hour shift, 5 days/week, Sunday through Saturday between 8am EST to 7pm EST. Shift will be assigned during training.
  • Weekend work may be required based on business needs. There is a 5% shift differential for weekend work.

 

Preferred Qualifications

  • Associate or bachelor’s degree.
  • Previous inbound call center or related customer service experience.
  • 2 – 4 years of grievance and/or appeals experience.
  • Previous experience processing medical claims.

 

Additional Information

  • Workstyle: remote, work from home or in office.
  • Work Location: must reside in Central or Eastern Standard Time Zone (CST or EST).
  • Work Schedule: must be able to work an 8-hour shift, 5 days/week, Sunday through Saturday between 8am EST to 7pm EST.

 

WAH Internet

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
  • Satellite, cellular and microwave connection can be used only if approved by leadership.
  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

 

HireVue

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

 

Limited Geography Remote – This is a remote position but located within a specific geography.
 

 

 

Travel: While this is a remote position, occasional travel to Humana’s offices for training or meetings may be required.

 

Scheduled Weekly Hours

 

40

 

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


 

$48,300 – $65,900 per year


 

 

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

 

 


About us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

 

 

​
Equal Opportunity Employer

 

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

 

APPLY HERE: Grievances and Appeals Representative

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