TEMPORARY

FULL_TIME

CONTRACTOR

ADAPTED_NOW

HOUR

Experience:2 years of customer service experience including 1-year claims or appeals processing OR Bachelor's Degree in lieu of work experience. US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.

Job Description:<ul><li>Credit Check Required</li><li>C2 clearance will be required for all workers. It can take up to 6 – 8 weeks to receive clearance</li><li>Onsite position</li><li>Training will be 6 weeks onsite</li><li>Hours are 8am – 5pm (occasional mandatory OT may be required based on business needs).</li><li>Call center is open from 8am - 7pm. Shift may change once training is up.</li><li>Potential for conversion to FTE, Supporting Tricare East</li><li>Interviews will be scheduled for in-person/onsite.</li></ul>  Responsibilities:<ul><li>Responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures.</li><li>Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. Handles situations which may require adaptation of response or extensive research. Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.</li><li>Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Ensures claims are processing according to established quality and production standards.</li><li>Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and reports potential fraud and abuse situations.</li></ul>  Experience:<ul><li>2 years of customer service experience including 1-year claims or appeals processing OR Bachelor's Degree in lieu of work experience.</li></ul>  Skills:<ul><li>Good verbal and written communication skills.</li><li>Strong customer service skills. Good spelling, punctuation and grammar skills.</li><li>Basic business math proficiency.</li><li>Ability to handle confidential or sensitive information with discretion.</li><li>Required Software and Other Tools: Microsoft Office.</li></ul>  Education:<ul><li>High School Diploma or equivalent </li></ul>  About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit <a href="http://www.ustechsolutionsinc.com" rel="nofollow" title="www.ustechsolutionsinc.com">www.ustechsolutions.com</a>.   US Tech Solutions is an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.   AI Statement: By applying, you acknowledge that AI-assisted tools may be used during hiring.

US Tech Solutions, Inc.

Claims Customer Service Advocate II #26-11515

Adjudication

Artificial Intelligence (AI)

Call Centers

Claims Processing

Communication Skills

Customer Relations

Customer Support/Service

Mathematics

Microsoft Office

Presentation/Verbal Skills

Process Analysis

Regulations

Scripting (Scripting Languages)

Time Management

Writing Skills

monster

UNKNOWN

FEED

We are a leading physician group serving South Carolina and Georgia, dedicated to delivering quality healthcare directly to patients in care facilities, homes, clinics, and virtual visits. Interact with patients via email, patient portal, telephone, text, in-person, etc. to gather necessary information, schedule and confirm appointments, and provide pre-appointment instructions.

We are seeking a qualified Licensed Social Worker to assist our hospice and primary care patients in our Grandstrand patients. The Licensed Master-Level Social Worker (LMSW) play a vital role as part of the care team within our organization. This role provides patients with the essential support necessary to cope with chronic, acute, or terminal illnesses.This role would be in person in traveling to patients' homes/facilities daily. You must have reliable transportation as travel is required daily to the Grandstrand area. This is a salary-based position, with the opportunity to receive a monthly bonus. This is a full-time 8-hr position (8:00AM-5:00PM) (Monday-Friday).Coverage area needed:<ul><li>Conway/Murrells Inlet/Goergetown</li></ul>AboutWe are a leading physician group serving South Carolina and Georgia, dedicated to delivering quality healthcare directly to patients in care facilities, homes, clinics, and virtual visits. Our services include comprehensive primary care, specialty services, and pharmacy support, tailored to meet diverse patient needs. Committed to excellence and innovation, our team collaborates closely with facilities and families to ensure accessible, coordinated, and compassionate care.Why Choose a Career at Your Health?Providing high quality care for our patients is the center of what we do, and we provide the same care for our employees. Here are some of the benefits that are available to our employees.<ul><li>Competitive Compensation Package with Bonus Opportunities</li><li>Employer Matched 401K</li><li>Free Visit & Prescriptive Services with HDHP Insurance Plan</li><li>Employer Matched HSA</li><li>Generous PTO Package</li><li>Career Development & Growth Opportunities</li><li>Vehicle Allowance</li></ul>What Are We Looking For?A successful Licensed Social Worker will be able to perform these essential duties and 
responsibilities. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions. 
The following is a list of essential functions, which may be subject to change at any time and without notice. Management may assign new duties, reassign existing duties, and/or eliminate function(s).Areas of Responsibility:<ul><li>Document updates of ongoing care plans.</li><li>Participate in IDG and updates appropriate care plans</li><li>This may involve screening for mental health conditions, substance abuse issues, domestic violence, and other social determinants of health.</li><li>Providing individual, couples and families with counseling or psychotherapy to address mental health concerns such as depression, anxiety, grief, trauma, and adjustment to illness or life changes.</li><li>Develop and implement cognitive assessment care plans tailored to each patient’s unique needs. Integrate social determinants of health and behavioral health into the overall care plan.</li><li>Accurately document and log care management as appropriate and collaborate with the care team to keep patients’ care plans up to date.</li><li>Facilitate integration of behavioral health services into the primary care settings, ensuring patients have access to appropriate mental health and substance abuse resources.</li><li>Facilitate communication and coordinate among the patient’s care team members to ensure a comprehensive and integrated approach to health care delivery.</li><li>Communicate with providers and staff via phone, email, Teams, Athena, or in-person.</li><li>Collaborate closely with care team members to coordinate comprehensive care plans that address both medical and hospice needs.</li><li>Educating patients and their families about mental health conditions, treatment options, coping strategies, and community resources available for support.</li><li>Serving as an advocate for patients to ensure their needs are addressed within the healthcare system and community settings.</li><li>This may involve assisting with access to social services, disability benefits, housing assistance, or legal support.</li><li>Maintaining accurate and confidential documentation of assessments, treatment plans, progress notes, and communication with patients and other healthcare professionals in accordance with legal and ethical standards.</li><li>Recognizing and respecting the cultural, ethnic, and socioeconomic diversity of patients and tailoring interventions and treatment approaches to meet their unique needs and preferences.</li><li>Interact with patients via email, patient portal, telephone, text, in-person, etc. to gather necessary information, schedule and confirm appointments, and provide pre-appointment instructions.</li><li>Respond to patient inquiries, resolve scheduling conflicts, and assist in rescheduling appointments when necessary.</li></ul>Qualifications:<ul><li>Master’s Degree with appropriate licensure for LMSW or LISW-CP. License must be in good standing.</li><li>Experience or certification as a substance use disorder (SUD) specialist is preferred. This includes either formal certification or demonstrated experience working with individuals affected by substance use in clinical or community settings.</li><li>A minimum of one year of experience in a healthcare setting is preferred.</li><li>A minimum of one year of experience in hospice preferred.</li><li>Must be proficient in utilizing technology tools and platforms for remote patient monitoring, telemedicine, and electronic medical records.</li><li>Ability to read and communicate effectively.</li><li>Strong written and verbal skills.</li><li>Basic computer knowledge.</li><li>Ability to manage and demonstrate effective leadership skills.</li><li>Should demonstrate good interpersonal and communication skills under all conditions and circumstances.</li><li>Ability to foster a cooperative work environment.</li><li>Team player with ability to manage multiple responsibilities and demonstrate sound judgment.</li><li>Must be able to work flexible hours and travel between offices, facilities, etc. Must be a licensed driver with an automobile that is insured in accordance with state and/or organizational requirements and is in good working order.</li></ul>

Your Health Organization

Licensed Social Worker - Hospice

Behavioral Health

Calendar Management

Community and Social Services

Disability Accommodations

Diversity

Documentation

Driver's License

Electronic Medical Records

Health Plan

Healthcare

Healthcare Quality

Hospice Care

Insurance

Interpersonal Skills

Leadership

Legal Standards

Legal Support Skills

Patient Assessment

Patient Care

Patient Education

Pharmacy

Primary Care

Psychiatry and Mental Health

Psychotherapy

RMON

Social Work

Substance Abuse

Team Player

Telemedicine

Treatment Plan

Willing to Travel

clearcompany

OTHER

Wage Commensuration: The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to, skill sets, experience, education and training, licensure and certifications, and other business and organizational needs. Assists in providing solutions to social and practical environmental problems, including seeking financial assistance, discharge planning (including collaboration with community agencies) and providing referrals to other community agencies when specialized assistance is required.

Position Summary:
The Social Services Director is responsible for planning, developing, organizing, implementing, evaluating and directing of the social service programs of the facility

Posted Salary Range:
USD $30.00 - USD $35.00 /Hr.

Wage Commensuration:
The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to, skill sets, experience, education and training, licensure and certifications, and other business and organizational needs. 

Duties & Responsibilities:
<ul><li>Responsible for planning, developing, organizing, implementing, evaluating and directing of the social service programs of the facility</li><li>Develops and implement policies and procedures for identifying the medically-related social and emotional needs of the patients/residents</li><li>Assists in providing solutions to social and practical environmental problems, including seeking financial assistance, discharge planning (including collaboration with community agencies) and providing referrals to other community agencies when specialized assistance is required</li></ul>

Qualifications & Requirements:
<ul><li>An individual with a minimum of a bachelor’s degree in social work or a bachelor’s degree in a human services field including, but not limited to sociology, gerontology, special education, rehabilitation counseling, and psychology.</li><li>Must have, as a minimum, one (1) year experience in a human services field in a hospital, skilled nursing care facility or other related medical facility</li><li>Must be able to organize and prioritize many tasks effectively</li><li>Ideal candidate must be a skilled communicator, director and motivator</li><li>Reliable transportation required</li></ul>

Benefits:
All of our employees are valued and receive a competitive wage; full time team members are also offered a comprehensive benefit package which includes: <ul><li>Medical, Dental, Vision, Life and Disability Insurance/ Flexible Spending Accounts</li><li>Tuition Reimbursement & Nursing Loan Repayment Programs</li><li>PerkSpot - Local Deals and Weekly Perks Program</li><li>401(k)</li><li>Paid Time Off Plan</li><li>New Pet Insurance Discount available</li><li>DailyPay option available! – Get your pay, when you need it.</li><li>Purchasing Power - online purchase/payroll deduction</li><li>Tickets at Work - entertainment ticket discounts</li><li>Employee Assistance Plan - easy-to-use services to help with everyday challenges of life (available for all employees and their families) </li><li>Helping Friends Foundation - our employees’ hardship/crisis fund</li><li>Auto and Home Insurance - employee discount available – payroll deduction!</li><li>In-facility education programs and more!</li></ul>

EOE Statement:
Drug Free, Smoke-Free work place. Equal Opportunity Employer, including disability/vets

Advocate Jobs in Surfside, SC

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Advocate Jobs in Surfside, SC

Claims Customer Service Advocate II #26-11515 US Tech Solutions, Inc.

Licensed Social Worker - Hospice Your Health Organization

Social Services Director Prince George Health Care Center

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