Adjudicator, Provider Claims-KY-On the phone-closing shift Molina Healthcare IncAdjudicator, Provider Claims-KY-On the phone-closing shiftAdairville, KYAt least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims.
Adjudicator, Provider Claims-on the phone Molina Healthcare IncAdjudicator, Provider Claims-on the phoneKYAt least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims.
Pharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistLouisville, KentuckySkills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.
Business Office Clerk (PRN) Dupont Surgery CenterBusiness Office Clerk (PRN)Saint Matthews, KYPart timep>Under the supervision of the Director Business Operations, is responsible for assuring that duties are accurately performed in completion of, but not limited to, the following areas as assigned: registration and pre-registration of all categories of patients, prepare consent forms appropriately for each procedure; ensure that copies of appropriate documentation are obtained to facilitate the billing and collections processes; give estimates of charges; ensure that co-payments and payments on patients accounts are explained, obtained and processed accurately; complete daily batching of patient payments collected (check, cash or credit card); ensure that all information entered into the automated admitting/registration system is accurate and complete; prepare medical records for all first-time patients and update medical records for return patients as needed; use of the Meditech, or other automated billing systems; post payments; adjustments, rebilling, refunds and write-offs on accounts; account follow-up on all types of payers; receive and deal with patient calls; resolve problem accounts as required; manage correspondence; file as necessary; verify payments to contracted rates; achieve departmental goals regarding collections. Work with medical records clerks, biller and adjudicator, scheduler and registration personnel to maintain accurate records to facilitate valid reports regarding billing and collections.
Business Office Clerk (Prn) Surgery PartnersBusiness Office Clerk (Prn)Saint Matthews, KYUnder the supervision of the Director Business Operations, is responsible for assuring that duties are accurately performed in completion of, but not limited to, the following areas as assigned: registration and pre-registration of all categories of patients, prepare consent forms appropriately for each procedure; ensure that copies of appropriate documentation are obtained to facilitate the billing and collections processes; give estimates of charges; ensure that co-payments and payments on patients accounts are explained, obtained and processed accurately; complete daily batching of patient payments collected (check, cash or credit card); ensure that all information entered into the automated admitting/registration system is accurate and complete; prepare medical records for all first-time patients and update medical records for return patients as needed; use of the Meditech, or other automated billing systems; post payments; adjustments, rebilling, refunds and write-offs on accounts; account follow-up on all types of payers; receive and deal with patient calls; resolve problem accounts as required; manage correspondence; file as necessary; verify payments to contracted rates; achieve departmental goals regarding collections. Work with medical records clerks, biller and adjudicator, scheduler and registration personnel to maintain accurate records to facilitate valid reports regarding billing and collections.
Business Office Clerk (PRN) Surgery Partners IncBusiness Office Clerk (PRN)St Matthews, KYUnder the supervision of the Director Business Operations, is responsible for assuring that duties are accurately performed in completion of, but not limited to, the following areas as assigned: registration and pre-registration of all categories of patients, prepare consent forms appropriately for each procedure; ensure that copies of appropriate documentation are obtained to facilitate the billing and collections processes; give estimates of charges; ensure that co-payments and payments on patients accounts are explained, obtained and processed accurately; complete daily batching of patient payments collected (check, cash or credit card); ensure that all information entered into the automated admitting/registration system is accurate and complete; prepare medical records for all first-time patients and update medical records for return patients as needed; use of the Meditech, or other automated billing systems; post payments; adjustments, rebilling, refunds and write-offs on accounts; account follow-up on all types of payers; receive and deal with patient calls; resolve problem accounts as required; manage correspondence; file as necessary; verify payments to contracted rates; achieve departmental goals regarding collections. Work with medical records clerks, biller and adjudicator, scheduler and registration personnel to maintain accurate records to facilitate valid reports regarding billing and collections.
Dental Hygienist US Department of Health and Human ServicesDental HygienistFort Campbell, KY$37,193–$47,334 / yearThe following meet these requirements: Persons employed by the Federal Government as radiological personnel prior to the effective date of the regulation (January 13, 1986) who show evidence of current or fully satisfactory performance or certification of such from a licensed practitioner such as a doctor of medicine, osteopathy, dentistry, podiatry, or chiropractic who prescribes radiological procedures to others. Persons first employed by the Federal Government as radiological personnel after the effective date of the regulation who (a) received training from institutions in a State or foreign jurisdiction that did not accredit training in that particular field at the time of graduation, or (b) practiced in a State of foreign jurisdiction that did not license that particular field or did not allow special eligibility to take a.
Dental Assistant (EF) US Department of Health and Human ServicesDental Assistant (EF)Fort Campbell, KY$47,675–$68,078 / yearSpecialized Experience: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-04 grade level in the Federal service (obtained in either the private or public sector) performing the following type of work and/or tasks: Providing chairside assistance during dental procedures; performing simple alloy and composite restorations that do not require pin retention or cusp replacement; placing and contouring temporary restorations; placing pit and fissure sealants; performing oral prophylaxis using ultrasonic scaling to remove visible calculus; applying topical fluoride; taking and processing digital intra-oral radiographs; taking and recording vital signs; collecting patient history and assisting with medication reconciliation; performing routine dental laboratory procedures; providing post-treatment instructions and oral health education; maintaining dental instruments and equipment; and following established infection control, sterilization, and safety protocols. Persons first employed by the Federal Government as radiological personnel after the effective date of the regulation who (a) received training from institutions in a State or foreign jurisdiction which did not accredit training in that particular field at the time of graduation, or (b) practiced in a State of foreign jurisdiction which did not license that particular field or which did not allow special eligibility to take a licensure examination for those who did not graduate from an accredited educational program, provided that such persons show evidence of training, experience, and competence, as determined by OPM or the employing agency.
Health Technician (EMT) US Department of Health and Human ServicesHealth Technician (EMT)Fort Campbell, KY$37,193–$59,031 / yearMINIMUM QUALIFICATIONS: GS-4: Your resume must demonstrate at least six (6) months of general experience and six (6) months of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/ or tasks: non-professional work of a technical or support nature in the field of health and medicine such as, recording height/weight; applying sterile dressings; preparing patients for evaluation and treatment; restocking medical supplies; ensuring that medical equipment is in proper operating condition. GS-5: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level (GS-4) in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Taking vitals, patient movement, collecting data on scene to provide detailed reports; Communicating with team members and medical personnel to provide and receive important information about the patients condition: Experience assisting with methods, techniques and protocols in the Emergency Medical Services.
Custodial Worker US Department of Health and Human ServicesCustodial WorkerFort Campbell, KY$18.95–$23.25 / hourCleans various areas such as in-patient rooms, bathrooms, public restrooms, operating rooms, labor & delivery rooms, exam rooms, isolation rooms, pharmacy, emergency room, lab, x-ray, halls, walls, floors, furnishings, equipment, windows, offices, entrances, etc., wiping surfaces using proper cleaning techniques, universal precautions, and chemicals. Refer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Clinical Laboratory Scientist US Department of Health and Human ServicesClinical Laboratory ScientistFort Campbell, KY$72,849–$140,165 / yearBASIC REQUIREMENT(S): Education: A. A Bachelors or graduate/higher level degree from a regionally accredited college/university including courses in biological science, chemistry and mathematics, AND successful completion of a Medical Laboratory Scientist/Clinical Laboratory Scientist program accredited by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained. A Bachelors or graduate/higher level degree from an accredited college/university, including 16 semester hours (24 quarter hours) of biological science (with one semester in microbiology), 16 semester hours (24 quarter hours) of chemistry (with one semester in organic or biochemistry), one semester (one quarter) of mathematics, AND five (5) years of full time acceptable clinical laboratory experience in Blood Banking, Chemistry, Hematology, microbiology, Immunology and Urinalysis/Body Fluids.
Dentist US Department of Health and Human ServicesDentistFort Campbell, KY$123,077–$315,000 / yearExperience must be equivalent to at least the GS-11 level in the Federal service as described: Providing restorative, pediatric, periodontic, endodontic, prosthodontic, diagnostic, surgical, and preventative dental services; Performing oral surgeries, such as extraction of impacted teeth or full mouth extraction; performing prosthodontic cases, including crown/bridges, complete dentures, and relines; performing routine pedodontic procedures, as well as treating cases of rampant caries in children; performing case management and treatment of medically complex cases; and obtaining medical clearances in order to provide comprehensive dental care. Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only."
Nurse (Medical/Surgical) US Department of Health and Human ServicesNurse (Medical/Surgical)Fort Campbell, KY$84,363–$119,961 / yearMINIMUM QUALIFICATIONS: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-7 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Perform complex assessments of patients with acute, chronic, and post-operative conditions and independently identify and respond to changes in clinical status; Manage medication administration for patients with complex medical needs, including high-risk medications, and evaluating therapeutic outcomes; Lead the development, implementation, and evaluation of nursing care plans and nursing diagnoses for patients with multifaceted care requirements; Serve as a clinical resource or preceptor for less experienced nursing staff by providing guidance, mentoring, and clinical support; Participate in interdisciplinary care planning, quality improvement initiatives, and evidence-based practice activities to improve patient outcomes. Career Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ctap_guideline.pdf .
Physician Assistant US Department of Health and Human ServicesPhysician AssistantFort Campbell, KY$110,727–$164,017 / yearBASIC REQUIREMENT(S): All applicants must meet the following basic requirements for all grade levels: Graduation from a physician assistant educational program, accredited by the Accreditation Review Committee on Education for the Physician Assistant (ARC-PA) or its predecessors, at a college, university, or educational institution that is accredited by an accrediting body or organization recognized by the U.S. Department of Education at the time the degree was obtained. Examples of work experience includes: providing comprehensive preventive and therapeutic healthcare services to all age groups that includes assessment, diagnosis and treatment of various illnesses; formulating and implementing treatment plans; prescribing medications; ordering and interpreting diagnostic tests; educating and counseling patients; and collaborating with physicians concerning patient care and management.
Optometrist US Department of Health and Human ServicesOptometristFort Campbell, KY$119,297–$185,885 / yearRefer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference. Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Provided primary eye care services by performing comprehensive ocular examinations.
Registered Respiratory Therapist US Department of Health and Human ServicesRegistered Respiratory TherapistFort Campbell, KY$51,007–$73,432 / yearGS-08: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Performing a variety of difficult respiratory therapy such as administering various medications to patients with acute and chronic respiratory distress. Refer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.