Position Background:
The Automation Engineer 2 is responsible for supporting any existing and new project automation systems at Humacyte, an FDA regulated site. This includes daily verifications required for data integrity requirements and modifications to the system configuration as required for process, building or historian automation requirements. There is an expectation that the employee will have a primary system responsibility, either DeltaV, PLC, BAS, or PI focused, but will be able to support all automation system as required .
Remote Work Designation : Not Remote
Major Accountabilities:
Utilizing current engineering skills and knowledge, provide routine automation expertise for the development of custom commercial manufacturing equipment for a human acellular vessel product with the guidance and direction of more senior team members and/or manager
Support and maintain existing PI data historian in existing manufacturing and R&D facilities
In collaboration with Senior Automation Engineer and/or Associate Director, Automation, support the installation and validation of a PI data historian for the commercial manufacturing facility
Support the installation and validation of a DeltaV system for the commercial manufacturing process
Support the installation and validation a building automation system for the commercial manufacturing facility
Support the installation and validation of OEM and custom PLCs for the commercial manufacturing process
Assist process development team in testing prototype equipment and by independently developing automation for custom research and development equipment
Promote transparency around process development activities through routine internal updates to direct manager and/or cross-functional colleagues
Support and troubleshooting automation during development, technology transfer, and commercial manufacturing
Perform thorough system tests to ensure robustness of custom automation
Assist in oversight in transition of automated equipment to comply with regulatory and quality control requirements
Assist in the development of automation documentation, including functional requirements, design documents, test protocols, SOPs and reports
Respond to automation-based alarms during standard office hours and as on-call support, as required
Support regulatory filings as required
Other duties, as assigned
Special Competencies:
Demonstrated knowledge and understanding of developing and supporting automation for commercial manufacturing processes
Familiarity with automation of bioprocess applications in GMP facility
Familiarity and understanding of basic and/or advanced cGMP compliance in the biotech/bioprocessing manufacturing environment
Knowledge of Code of Federal Regulations 21 CFR 1271 a plus
Detail-oriented, self-motivated and scientifically driven
Strong analytical and problem-solving skills
Strong knowledge of GMP quality systems
Excellent communication and interpersonal skills
General Competencies:
Able to communicate effectively in English, both verbally and in writing
Excellent communication and interpersonal skills
Possess a positive roll-up-the-sleeves attitude and optimistic outlook
Strong ability to work in a fast-paced team environment with fluctuating priorities, and collaborate effectively with others
Excellent organizational and time management skills with ability to set own priorities in a timely manner
High degree of flexibility and adaptability
Basic computer skills required, such as knowledge of MS Word, Excel, PowerPoint, and Outlook
Must be able to work as needed to meet tight deadlines and at peak periods
Self-motivated and organized critical thinker with solid interpersonal and business communication skills
Demonstrated ability to work in a cross functional team
Adheres to company and facility specific policies and procedures, including SOP, training and meeting requirements
Always observe safety precautions and regulations in all areas where duties are performed
Responsible for reporting all safety hazards and potential unsafe working conditions
Ensures Humacyte or other required trainings/certifications are up to date
Represents the organization in a positive and professional manner
Reports to work on time and as scheduled
Qualifications:
BS in Mechanical Engineering, Electrical Engineering, Chemical Engineering, or similar field, required
At least 3 years of industry experience in process and equipment automation
At least 3 years of relevant pharma or biotech industry experience
Experience with automation platforms including Allen-Bradley PLC, DeltaV DCS, Beckhoff TwinCAT PLC and/or Johnson Controls
Experience installing and/or supporting PI historian system
Background in Automation, Electrical Engineering or Mechanical Engineering
Knowledge and experience with standard bioprocessing skills as well as use and maintenance of common laboratory procedures and equipment
Will spend time in a clean room environment for manufacturing operations and will be required to meet applicable gowning and personal protective equipment guidelines
Apr 24, 2024
Full time
Position Background:
The Automation Engineer 2 is responsible for supporting any existing and new project automation systems at Humacyte, an FDA regulated site. This includes daily verifications required for data integrity requirements and modifications to the system configuration as required for process, building or historian automation requirements. There is an expectation that the employee will have a primary system responsibility, either DeltaV, PLC, BAS, or PI focused, but will be able to support all automation system as required .
Remote Work Designation : Not Remote
Major Accountabilities:
Utilizing current engineering skills and knowledge, provide routine automation expertise for the development of custom commercial manufacturing equipment for a human acellular vessel product with the guidance and direction of more senior team members and/or manager
Support and maintain existing PI data historian in existing manufacturing and R&D facilities
In collaboration with Senior Automation Engineer and/or Associate Director, Automation, support the installation and validation of a PI data historian for the commercial manufacturing facility
Support the installation and validation of a DeltaV system for the commercial manufacturing process
Support the installation and validation a building automation system for the commercial manufacturing facility
Support the installation and validation of OEM and custom PLCs for the commercial manufacturing process
Assist process development team in testing prototype equipment and by independently developing automation for custom research and development equipment
Promote transparency around process development activities through routine internal updates to direct manager and/or cross-functional colleagues
Support and troubleshooting automation during development, technology transfer, and commercial manufacturing
Perform thorough system tests to ensure robustness of custom automation
Assist in oversight in transition of automated equipment to comply with regulatory and quality control requirements
Assist in the development of automation documentation, including functional requirements, design documents, test protocols, SOPs and reports
Respond to automation-based alarms during standard office hours and as on-call support, as required
Support regulatory filings as required
Other duties, as assigned
Special Competencies:
Demonstrated knowledge and understanding of developing and supporting automation for commercial manufacturing processes
Familiarity with automation of bioprocess applications in GMP facility
Familiarity and understanding of basic and/or advanced cGMP compliance in the biotech/bioprocessing manufacturing environment
Knowledge of Code of Federal Regulations 21 CFR 1271 a plus
Detail-oriented, self-motivated and scientifically driven
Strong analytical and problem-solving skills
Strong knowledge of GMP quality systems
Excellent communication and interpersonal skills
General Competencies:
Able to communicate effectively in English, both verbally and in writing
Excellent communication and interpersonal skills
Possess a positive roll-up-the-sleeves attitude and optimistic outlook
Strong ability to work in a fast-paced team environment with fluctuating priorities, and collaborate effectively with others
Excellent organizational and time management skills with ability to set own priorities in a timely manner
High degree of flexibility and adaptability
Basic computer skills required, such as knowledge of MS Word, Excel, PowerPoint, and Outlook
Must be able to work as needed to meet tight deadlines and at peak periods
Self-motivated and organized critical thinker with solid interpersonal and business communication skills
Demonstrated ability to work in a cross functional team
Adheres to company and facility specific policies and procedures, including SOP, training and meeting requirements
Always observe safety precautions and regulations in all areas where duties are performed
Responsible for reporting all safety hazards and potential unsafe working conditions
Ensures Humacyte or other required trainings/certifications are up to date
Represents the organization in a positive and professional manner
Reports to work on time and as scheduled
Qualifications:
BS in Mechanical Engineering, Electrical Engineering, Chemical Engineering, or similar field, required
At least 3 years of industry experience in process and equipment automation
At least 3 years of relevant pharma or biotech industry experience
Experience with automation platforms including Allen-Bradley PLC, DeltaV DCS, Beckhoff TwinCAT PLC and/or Johnson Controls
Experience installing and/or supporting PI historian system
Background in Automation, Electrical Engineering or Mechanical Engineering
Knowledge and experience with standard bioprocessing skills as well as use and maintenance of common laboratory procedures and equipment
Will spend time in a clean room environment for manufacturing operations and will be required to meet applicable gowning and personal protective equipment guidelines
OBJECTIVE
To provide administrative support to the Human Resources Director assisting them in day-to-day tasks with the primary objective of saving them time and helping alleviate as much stress as possible.
ESSENTIAL FUNCTIONS
Assist the HR Director in all professional and personal needs. Anything you can do to save the HR Director time is a big part of the job.
Professional needs consist of a wide range of avenues, including, but not limited to: setting up and facilitating meetings, answering all incoming phone calls and managing voicemail, calendar, e-mails, and mail, and any projects, tasks, or issues that may be assigned to this position. Reminding HR Director of meetings for the day to be sure not to miss them.
Personal needs consist of a wide range of avenues including but not limited to personal errands, tasks, phone calls, meetings, bills/ invoices, home sitting, picking up children from school, etc.
Process HR Director business card receipt reimbursement. Ensure she is reimbursed for expenses.
Prepare travel arrangements (hotel room, flight, car, etc..)
Process all credit card statements. Review that everything is accounted for, find explanation for unknown charges, and dispute questionable charges.
Protect the confidentiality of information learned by performing the duties of the position.
Interact with and coordinate the completion of tasks with others.
Ensure the HR Director is prepared with all necessary materials and technology for presentations and meetings in which they are involved.
Be the liaison and representative for the executive team regarding all aspects of communications, building relationships with, and operating with all other departments and employees of the Company.
Create and maintain a very organized set of files of correspondence and other documents.
Prepare a variety of correspondence, reports, spreadsheets, and other documents, ensuring proper format, grammar, spelling, and punctuation.
You will be delegated many special projects. Report progress of tasks regularly and complete by date/time requested. You should never need to be asked for an update on a task given to you. You must not lose site of the task and inform assigner of status.
Varied Office Manager-type tasks that are not included on this list.
Assist in front desk relief as needed.
Assist in training for new technology, new software or programs, or new techniques within existing documents, as requested or required by Executive team’s function and operations within the company. (Google Drive, Outlook, etc.)
POSITION REQUIREMENTS
Most important Competencies are bolded.
Attitude – Present a warm and friendly personality and a helpful, positive attitude with clients, other employees, and applicants both in person and on the telephone.
Accuracy – Ensure that you are delivering corrected and complete projects. Proofread your work; give back copies with highlighted new versions checked off. The goal is to keep us from proofing your work. Organization – Have everything labeled and in its place.
Follow Through – as tasks are assigned, it is your responsibility to follow up on these tasks until completion. You cannot just ask someone once and assume it will be done. It is up to you to ask for a projected completion date and follow up until 100% complete. Document and follow up on everything. Communicate along the way to the requesting manager.
Prioritize – Understand what your priorities are by asking the appropriate person.
Anticipation – Anticipate the needs of the executive team so you don’t have to be asked to do each step.
Aptitude – Must have the aptitude to grasp the concept of the projects you are working on. Additionally, you must be able to see the “big picture” and prioritize your work accordingly. Ask why we do things so that you can improve the system.
Time Management – Utilize available email and technology whenever possible so you don’t waste time physically looking for someone to answer your question. Don’t spend hours trying to figure it out yourself if someone can help. Must be able to effectively handle multiple tasks. Must show a sense of urgency with tasks given by the HR Director.
Leadership – Must demonstrate the ability to accept projects, work through them, and correctly complete those projects in a reasonable amount of time.
Stability – Must be able to handle multiple projects without becoming “openly flustered” and get along with everyone we may encounter.
Personal Development – Strive for knowledge, embrace change, welcome challenges, be open to constructive criticism, and enjoy what you are doing.
Technical Knowledge – must possess excellent technical skills, as related to function of computers and office equipment. You should be one of the “go-to” people for questions related to software and programs we use at City Wide.
Openness – Don’t be afraid to come in and talk to your supervisor.
Learning —Desire to grow professionally and personally through increasing knowledge.
EDUCATION
Bachelor’s degree or work equivalent
EXPERIENCE
A minimum of 5 years of experience in administrative/executive assistant role.
TRAVEL REQUIRED
None
KNOWLEDGE, SKILLS, AND ABILITIES
Microsoft Office (Word, Excel, Outlook, PowerPoint, Publisher)
E-mail & Internet
CRM Database helpful
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the company reserves the right to change this job description and/or assign tasks for the employee to perform, as the company may deem appropriate.
Job Type: Full-time
Salary: $20.00 - $22.00 per hour
Expected hours: 40 per week
Benefits:
Dental insurance
Health insurance
Paid time off
Schedule:
Monday to Friday
Education:
Bachelor's (Preferred)
Experience:
Microsoft Powerpoint: 1 year (Preferred)
Administrative Experience: 3 years (Preferred)
Work Location: In person
Edit job
Apr 11, 2024
Full time
OBJECTIVE
To provide administrative support to the Human Resources Director assisting them in day-to-day tasks with the primary objective of saving them time and helping alleviate as much stress as possible.
ESSENTIAL FUNCTIONS
Assist the HR Director in all professional and personal needs. Anything you can do to save the HR Director time is a big part of the job.
Professional needs consist of a wide range of avenues, including, but not limited to: setting up and facilitating meetings, answering all incoming phone calls and managing voicemail, calendar, e-mails, and mail, and any projects, tasks, or issues that may be assigned to this position. Reminding HR Director of meetings for the day to be sure not to miss them.
Personal needs consist of a wide range of avenues including but not limited to personal errands, tasks, phone calls, meetings, bills/ invoices, home sitting, picking up children from school, etc.
Process HR Director business card receipt reimbursement. Ensure she is reimbursed for expenses.
Prepare travel arrangements (hotel room, flight, car, etc..)
Process all credit card statements. Review that everything is accounted for, find explanation for unknown charges, and dispute questionable charges.
Protect the confidentiality of information learned by performing the duties of the position.
Interact with and coordinate the completion of tasks with others.
Ensure the HR Director is prepared with all necessary materials and technology for presentations and meetings in which they are involved.
Be the liaison and representative for the executive team regarding all aspects of communications, building relationships with, and operating with all other departments and employees of the Company.
Create and maintain a very organized set of files of correspondence and other documents.
Prepare a variety of correspondence, reports, spreadsheets, and other documents, ensuring proper format, grammar, spelling, and punctuation.
You will be delegated many special projects. Report progress of tasks regularly and complete by date/time requested. You should never need to be asked for an update on a task given to you. You must not lose site of the task and inform assigner of status.
Varied Office Manager-type tasks that are not included on this list.
Assist in front desk relief as needed.
Assist in training for new technology, new software or programs, or new techniques within existing documents, as requested or required by Executive team’s function and operations within the company. (Google Drive, Outlook, etc.)
POSITION REQUIREMENTS
Most important Competencies are bolded.
Attitude – Present a warm and friendly personality and a helpful, positive attitude with clients, other employees, and applicants both in person and on the telephone.
Accuracy – Ensure that you are delivering corrected and complete projects. Proofread your work; give back copies with highlighted new versions checked off. The goal is to keep us from proofing your work. Organization – Have everything labeled and in its place.
Follow Through – as tasks are assigned, it is your responsibility to follow up on these tasks until completion. You cannot just ask someone once and assume it will be done. It is up to you to ask for a projected completion date and follow up until 100% complete. Document and follow up on everything. Communicate along the way to the requesting manager.
Prioritize – Understand what your priorities are by asking the appropriate person.
Anticipation – Anticipate the needs of the executive team so you don’t have to be asked to do each step.
Aptitude – Must have the aptitude to grasp the concept of the projects you are working on. Additionally, you must be able to see the “big picture” and prioritize your work accordingly. Ask why we do things so that you can improve the system.
Time Management – Utilize available email and technology whenever possible so you don’t waste time physically looking for someone to answer your question. Don’t spend hours trying to figure it out yourself if someone can help. Must be able to effectively handle multiple tasks. Must show a sense of urgency with tasks given by the HR Director.
Leadership – Must demonstrate the ability to accept projects, work through them, and correctly complete those projects in a reasonable amount of time.
Stability – Must be able to handle multiple projects without becoming “openly flustered” and get along with everyone we may encounter.
Personal Development – Strive for knowledge, embrace change, welcome challenges, be open to constructive criticism, and enjoy what you are doing.
Technical Knowledge – must possess excellent technical skills, as related to function of computers and office equipment. You should be one of the “go-to” people for questions related to software and programs we use at City Wide.
Openness – Don’t be afraid to come in and talk to your supervisor.
Learning —Desire to grow professionally and personally through increasing knowledge.
EDUCATION
Bachelor’s degree or work equivalent
EXPERIENCE
A minimum of 5 years of experience in administrative/executive assistant role.
TRAVEL REQUIRED
None
KNOWLEDGE, SKILLS, AND ABILITIES
Microsoft Office (Word, Excel, Outlook, PowerPoint, Publisher)
E-mail & Internet
CRM Database helpful
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the company reserves the right to change this job description and/or assign tasks for the employee to perform, as the company may deem appropriate.
Job Type: Full-time
Salary: $20.00 - $22.00 per hour
Expected hours: 40 per week
Benefits:
Dental insurance
Health insurance
Paid time off
Schedule:
Monday to Friday
Education:
Bachelor's (Preferred)
Experience:
Microsoft Powerpoint: 1 year (Preferred)
Administrative Experience: 3 years (Preferred)
Work Location: In person
Edit job
Imagenet LLC is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. Our core business is helping our clients reduce costs and increase productivity by providing efficient document imaging, data validation, adjudication and on demand retrieval of documents and data.
JOB OVERVIEW
We are seeking an experienced Healthcare Claims Director to oversee our claims processing operations and drive data-driven process improvements. This leadership role will manage a team of claims managers and analysts, ensure compliance, and leverage data analytics to enhance claims performance.
RESPONSIBILITIES
Provide strategic direction and operational oversight for healthcare claims processing across multiple lines of business
Manage a team of claims managers, analysts and supporting staff across multiple locations
Develop and implement policies, procedures and workflows for efficient claims adjudication
Monitor performance metrics and identify opportunities for process optimization
Leverage data analytics tools to analyze claims data, identify trends and generate actionable insights
Develop reporting dashboards and visualizations to share key metrics with leadership
Ensure adherence to regulatory compliance, coding guidelines and revenue cycle best practices
Collaborate with IT, clinical, and business teams on systems improvements and integrations
Manage relationships and resolve escalated issues with healthcare providers and payers
Mentor, coach and provide professional development for team members
Technical Skills/Knowledge
Bachelor's degree in healthcare administration, business or related field
7+ years of management experience in healthcare claims processing
Deep understanding of claims operations, revenue cycle management and compliance
Strong data analytics skills and experience using tools like Tableau, SQL, PowerBI
Proven ability to analyze data, synthesize insights and drive process improvements
Excellent communication, presentation and leadership abilities
Motivated team player with a customer-focused mindset
Job Type: Full-time
Experience:
claims or claims processing, managing: 7+ years (Required)
Work authorization:
United States (Required)
Job Type: Full-time
Pay $90,000-$100,000 per year
Benefits:
We offer a competitive compensation and benefits package commensurate with experience as well as PTO. This is an office-based position
Schedule:
8 hour shift
Day shift
Monday to Friday
Ability to commute/relocate:
Tampa, FL 33618: Reliably commute or planning to relocate before starting work (Required)
Experience:
7+ years of management experience in healthcare claims processing
Deep understanding of claims operations, revenue cycle management and compliance
Strong data analytics skills and experience using tools like Tableau, SQL, PowerBI
Work Location: In person
Apr 09, 2024
Full time
Imagenet LLC is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. Our core business is helping our clients reduce costs and increase productivity by providing efficient document imaging, data validation, adjudication and on demand retrieval of documents and data.
JOB OVERVIEW
We are seeking an experienced Healthcare Claims Director to oversee our claims processing operations and drive data-driven process improvements. This leadership role will manage a team of claims managers and analysts, ensure compliance, and leverage data analytics to enhance claims performance.
RESPONSIBILITIES
Provide strategic direction and operational oversight for healthcare claims processing across multiple lines of business
Manage a team of claims managers, analysts and supporting staff across multiple locations
Develop and implement policies, procedures and workflows for efficient claims adjudication
Monitor performance metrics and identify opportunities for process optimization
Leverage data analytics tools to analyze claims data, identify trends and generate actionable insights
Develop reporting dashboards and visualizations to share key metrics with leadership
Ensure adherence to regulatory compliance, coding guidelines and revenue cycle best practices
Collaborate with IT, clinical, and business teams on systems improvements and integrations
Manage relationships and resolve escalated issues with healthcare providers and payers
Mentor, coach and provide professional development for team members
Technical Skills/Knowledge
Bachelor's degree in healthcare administration, business or related field
7+ years of management experience in healthcare claims processing
Deep understanding of claims operations, revenue cycle management and compliance
Strong data analytics skills and experience using tools like Tableau, SQL, PowerBI
Proven ability to analyze data, synthesize insights and drive process improvements
Excellent communication, presentation and leadership abilities
Motivated team player with a customer-focused mindset
Job Type: Full-time
Experience:
claims or claims processing, managing: 7+ years (Required)
Work authorization:
United States (Required)
Job Type: Full-time
Pay $90,000-$100,000 per year
Benefits:
We offer a competitive compensation and benefits package commensurate with experience as well as PTO. This is an office-based position
Schedule:
8 hour shift
Day shift
Monday to Friday
Ability to commute/relocate:
Tampa, FL 33618: Reliably commute or planning to relocate before starting work (Required)
Experience:
7+ years of management experience in healthcare claims processing
Deep understanding of claims operations, revenue cycle management and compliance
Strong data analytics skills and experience using tools like Tableau, SQL, PowerBI
Work Location: In person
Imagenet LLC is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. Our core business is helping our clients reduce costs and increase productivity by providing efficient document imaging, data validation, adjudication and on demand retrieval of documents and data.
JOB OVERVIEW
Ensure compliance will all corporate and departmental standards. Meet with employees on a regular basis to discuss performance and quality. Report on Key Performance Metrics (KPIs) to the Executive Director of Claims and the Director of Operations to ensure adequate resources and technology are in place. Develop and implement departmental standards and expectations. Analyze and process a variety of claim files to ensure the execution of standardized claim protocol and claim handling.
RESPONSIBILITIES
Oversee the claims adjudication process to assure that the examiners are following all CMS rules and regulations in conjunction with the insurance company guidelines
Ensure that the department practices meet or exceed the client’s processing standards, procedures and service level agreements
Responsible for new Claims Analyst training and auditing of trainee claim processing
Review Medicare services for appropriateness of charges and will apply pre-existing guidelines during claims processing;
Pend claims and order Medical records for review and investigation of possible gross misrepresentation
Authorize claim payments within established limits; otherwise forward to Claims Analyst 2
Oversee and provide secondary review of pending cases and Medical Records ordered by Claims Analyst 1 for appropriate processing;
Process refunds and letters of dual coverage (when applicable);
Must be knowledgeable in CPT-4, ICD-9 and be familiar with medical terminology;
Identify process improvement opportunities within the claim department and recommend system enhancements
Handles any additional responsibility which may be assigned
Technical Skills/Knowledge
Health claims processing
Basic to intermediate math
Medical terminology; ICD-9 & ICD-10
MS Office
Ability to work independently or within a team
Time management
Written and verbal communication
Attention to detail
Must be able to demonstrate sound decision-making
Must be local to Tampa area and work out of the Tampa office
Job Type: Full-time
Experience:
claims or claims processing, managing: 3 years (Required)
Work authorization:
United States (Required)
Job Type: Full-time
Pay: $60,000.00 - $80,000.00 per year
Benefits:
Disability insurance
Schedule:
8 hour shift
Day shift
Monday to Friday
Ability to commute/relocate:
Tampa, FL 33618: Reliably commute or planning to relocate before starting work (Required)
Experience:
Medical billing: 5 years (Required)
Management: 5 years (Required)
Work Location: In person
Apr 08, 2024
Full time
Imagenet LLC is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. Our core business is helping our clients reduce costs and increase productivity by providing efficient document imaging, data validation, adjudication and on demand retrieval of documents and data.
JOB OVERVIEW
Ensure compliance will all corporate and departmental standards. Meet with employees on a regular basis to discuss performance and quality. Report on Key Performance Metrics (KPIs) to the Executive Director of Claims and the Director of Operations to ensure adequate resources and technology are in place. Develop and implement departmental standards and expectations. Analyze and process a variety of claim files to ensure the execution of standardized claim protocol and claim handling.
RESPONSIBILITIES
Oversee the claims adjudication process to assure that the examiners are following all CMS rules and regulations in conjunction with the insurance company guidelines
Ensure that the department practices meet or exceed the client’s processing standards, procedures and service level agreements
Responsible for new Claims Analyst training and auditing of trainee claim processing
Review Medicare services for appropriateness of charges and will apply pre-existing guidelines during claims processing;
Pend claims and order Medical records for review and investigation of possible gross misrepresentation
Authorize claim payments within established limits; otherwise forward to Claims Analyst 2
Oversee and provide secondary review of pending cases and Medical Records ordered by Claims Analyst 1 for appropriate processing;
Process refunds and letters of dual coverage (when applicable);
Must be knowledgeable in CPT-4, ICD-9 and be familiar with medical terminology;
Identify process improvement opportunities within the claim department and recommend system enhancements
Handles any additional responsibility which may be assigned
Technical Skills/Knowledge
Health claims processing
Basic to intermediate math
Medical terminology; ICD-9 & ICD-10
MS Office
Ability to work independently or within a team
Time management
Written and verbal communication
Attention to detail
Must be able to demonstrate sound decision-making
Must be local to Tampa area and work out of the Tampa office
Job Type: Full-time
Experience:
claims or claims processing, managing: 3 years (Required)
Work authorization:
United States (Required)
Job Type: Full-time
Pay: $60,000.00 - $80,000.00 per year
Benefits:
Disability insurance
Schedule:
8 hour shift
Day shift
Monday to Friday
Ability to commute/relocate:
Tampa, FL 33618: Reliably commute or planning to relocate before starting work (Required)
Experience:
Medical billing: 5 years (Required)
Management: 5 years (Required)
Work Location: In person