Job Description

Location: Novato

Employment Status: Temporary 8-10 weeks

The Meritage Call Center Representative provides prompt, accurate and courteous responses to written and telephonic inquiries. These inquiries encompass numerous contacts and originate from subscribers, members, physician offices, and Health Plans; and typically involve a variety of issues including benefits, pricing, claim rejections, authorizations, and claim status.

Required Skills, Knowledge and Abilities

• Ability to research and accurately resolve problematic claim situations
• Multi-task and keyboard while researching, following-up, resolving and documenting telephonic inquires.
• Knowledge of claim benefit interpretation/benefit adjudication logic
• Demonstrate proficiency in medical terminology and coding (ICD10, CPT,)
• Must be proficient in problem solving and detecting trends
• Excellent interpersonal, written and verbal communication skills
• Must be able to read and interpret all types of authorization, medical claim forms and member benefit plans
• Strong demonstrated customer service orientation

Go to application

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Job Requirements

Education and Experience

• High School Diploma or GED required
• 3-4 years previous claims customer service experience or call center
• Familiarity of medical terminology preferred
• Prior experience with medical coding (ICD10, CPT) preferred.
• Customer service experience in a healthcare related field- HMO experience preferred.

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Job Description

Location: Novato

Employment Status: Full Time

General Summary:

The Accounts Payable Specialist is responsible for processing high-volume, full-cycle Accounts Payable, including check runs, vendor communications, and maintenance of accurate accounts payable records.  As needed, the Specialist provides general accounting back-up to support other department needs.

General Summary: 

The Accounts Payable Specialist is responsible for processing high-volume, full-cycle Accounts Payable, including check runs, vendor communications, and maintenance of accurate accounts payable records.  As needed, the Specialist provides general accounting back-up to support other department needs.

Essential Job Responsibilities:

Organizes, codes and processes company invoices following established procedures

Ensures invoices have proper back-up and approval for payment

Inputs invoices into Great Plains (GP) accounting system

Prepares the monthly AP Accruals

Prints batches and reviews them for accuracy (document date, GL code, vendor ID, vendor address, and amount)

Prepares checks to be mailed and/or otherwise distributed

Audits work to ensure there are no duplicate payments, late payments, mis-coded invoices, and over-payments

Checks and verifies vendor information for accuracy

Communicates with vendors about past due payments, account inquiries, missing invoices, etc.

Reconciles company credit card statements to invoices/receipts from card holders

Researches and resolves issues associated with outstanding and lost checks

Works with Payroll and Human Resources to reconcile company group benefits invoices

Assists with vendor and payment analysis; creates and generates reports as needed

Assists in the preparation and distribution of 1099s and management of W-9 records

Performs other duties and responsibilities as assigned, including support for other departments based on volume, projects and company work priorities

Freedom To Act/Accountability:

This position requires the ability to think independently, use professional judgment and initiative to meet deadlines.  This position requires a high degree of analytical thinking and problem-solving skills.  This position requires an individual who is self-motivated and self-directed, yet works well as part of a team.

 

Working Relationships/Contacts:

The incumbent for this position must provide customer service to each employee and provider in the organization.  Day to day contact with Physicians, Senior Management, Directors, Supervisors and Staff is expected.

Go to application

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Job Requirements

Required Education, Experience and Skills:

Associate Degree or college-level coursework in Accounting, Business or related field with a minimum 2-3 years’ related work experience; or an equivalent combination of education and experience

Prior healthcare experience is a bonus

Strong skills in Microsoft Office, especially Excel

Experience with accounting software, Great Plains is a plus

Excellent basic math skills

Strong organizational skills, attention to detail and proven experience meeting deadlines

Demonstrated customer service focus with a positive and respectful work style and professional business demeanor

Strong written, verbal and listening skills with the ability to make customers feel as though they have been heard and that their input, concerns and suggestions are valued and will be taken seriously

 

Physical Requirements:

The physical demands described herein are representative of those that must be met by an employee to perform the functions of this job.  Reasonable accommodation may be made to enable individuals with disabilities to perform the functions of the job

Ability to move 10 lbs. of force frequently and 20 lbs. of force occasionally

Ability to operate equipment as defined by job – including 10-key calculator by touch and keyboard

Ability to sit for long periods of time at a computer workstation

Ability to visually interpret data

Some travel to customer offices or other offsite location (e.g., post office, bank, etc.) may be required

Attendance at arranged committee meetings might require some evening or weekend involvement

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Job Description

Location: Novato

Employment Status: Full Time

Position Summary
This is a professional level position which provides project management and administrative support to the Chief Strategy Officer (CSO) in the areas of strategy, new business development, marketing, public relations, and communications.

Reporting Relationship: Reports directly to the Chief Strategy Officer

Principal Job Duties

Project Management
The Project Manager Project management duties include, but are not limited to:
•Developing communication plans, timelines and work schedules to meet established goal(s);
•Assembling and meeting regularly with the project team, i.e., individuals from all areas/departments who share responsibility for the project;
•Identifying key project milestones and responsible parties;
•Maintaining project plan document, spreadsheets and files, and making such materials available to project team members;
•Following-up on assigned deliverables for responsible persons, and identifying any issues orconcern that may be impacting the person’s ability to meet the goal on time;
•Scheduling and facilitating project plan meetings, materials and communications; and,
•Participating as an accountable party for assigned duties and deliverables.
Handles administrative duties including but not limited to, scheduling appointments and meetings, preparing and disseminating meeting minutes and assignments, reviewing and proofreading documents, drafting and editing documents that support project management responsibilities.
Strategy
This role supports the CSO with the development, planning and execution of the organization’s strategic initiatives. Provides leadership and support to foster departmental initiatives and improvement plans that are cohesive with long-term company goals. As needed, communicates and collaborates internally and externally to ensure strategic initiatives are understood, implemented and sustained.
New Business Development
Assists the CSO with the development of new business opportunities and relationships for the organization, including but not limited to:
•Researching potential business partners to determine organizational and financial strength, culture and community perceptions
•The preparation of business presentations, plans and proposals
Strategy & Communications Project Manager
•Meeting and communication with prospective business partners
•Attracting and retaining new and existing business partners to generate new business
Marketing
Is responsible for assisting the CSO in developing and implementing the internal and external marketing plans for the Meritage organization, its services, service lines and overall capabilities. Serves as a liaison between company and Marketing resources and vendors. Assists the CSO in developing, growing, and monitoring progress with new products/services. Additional marketing activities may include, but are not limited to social media, Search Engine Optimization (SEO), Website design and maintenance, and advertising.
Public Relations & Communications
Assists CSO in reviewing any external facing materials or communications and oversight of the company brand and compliance with established standards. Drafts Press Releases and assists in developing presentations for community and industry events. Designs and coordinates the disseminations of materials for internal and external communications. Serves as a liaison between company and Public Relations vendors.
Plans, organizes, coordinates, promotes and facilitates special events. Schedules and maintains communication with speakers, vendors and participants. Coordinates and monitors event timelines. Reviews and analyzes evaluations. Assists in the preparation of a variety of publications, materials and programs for events.

Works effectively, collaboratively and regularly with the other members of the Meritage team to uphold the mission, vision and values established by the organization (see attached).

Other duties as assigned by the CSO which support and help strengthen the Meritage organization and its goals, objectives and strategic partnerships.

Go to application

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Job Requirements

Knowledge, Skills and Abilities
•The Project Manager should have a proven track record of successfully managing multiple projects,priorities and meeting deadlines.
•Demonstrated skill and experience in producing high quality documents and materials.
•Possess a highly professional, positive, and composed demeanor and have the ability to positively and effectively represent and “sell” the Company.
•Must be highly organized, detail oriented, polished and diplomatic in his/her interactions with others within and external to the company.
•Must have experience, a high comfort level, and project confidence with presenting to large groups of people.
•Possess the ability to manage projects independently as well as with a team, and to know when each work style is required by the work at hand.
•Have strong critical thinking, problem solving and creative thinking skills. Be adaptable to and comfortable with change and skilled at managing priorities in a fast paced and changing work environment.
•Must be able to comfortably and effectively work and communicate with a variety of personalities,work styles and constituencies, e.g., Physicians, providers, executives, analysts, vendors, and front-line staff.
•Additional skills and competencies include excellent verbal, writing, grammar and editing skills,commitment to excellence, and strong time management abilities.

Education, Experience and Qualifications
•A Bachelor’s degree in business, healthcare, administration or related field; Project Management Certification preferred.
•A Graduate degree in any of the above fields strongly preferred.
•A minimum of 3 to 5 years of work experience in a project management role, in healthcare preferred, or an equivalent combination of education and experience.
•Comfortable working knowledge of marketing, public relations and communications.
•Strong skills and experience working with office-based software applications, including but not limited to Word, Excel, Publisher, and PowerPoint.

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Job Description

Location: Novato

Employment Status: Full-Time

The Utilization Management Coordinator LVN serves as a liaison between Meritage Medical Network, our contracted health plans, Network physicians and Members. The incumbent will serve as a resource to other UM team members and is responsible for processing authorizations within the scope of their assignment. This position reports directly to the UM Manager.

Principle Duties and Responsibilities:

• Utilize knowledge and experience to analyze contractual or administrative issues related to the requests.
• Identify additional information needed and ability to research and understand Policy benefits and criteria
• Accurately identify when and how to refer cases to appropriate clinical personnel or take other actions as necessary or required.
• Follow strict guidelines to ensure all work meets ICE standards for accuracy, timeliness, quality and compliance with federal, state and accreditation regulations.
• Coordinate with other insurance coordinators and the medical review staff.
• Consistently meet department productivity and performance metrics.
• Contribute to the efficiency of the department by being flexible and cross-trained on other functions.

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Job Requirements

Minimum Qualifications:

• Two years of current related Utilization Management experience required; Managed Care or health plan experience strongly preferred
• Current and unrestricted CA LVN license; Medical Assistant certificate and additional relevant work experience will be considered in lieu of LVN licensure.
• Must have the ability to understand and use set criteria and approve specific services within the related UM system.
• Familiarity with insurance billing and medical terminology
• Knowledge of CPT/ICD-10 codes.
• Excellent interpersonal skills, including phone, verbal, and written communication.
• Ability to cope in a fast-paced production environment
• Demonstrated knowledge of customer service skills when responding to questions and other inquiries from internal and external customers.
• Strong computer skills with demonstrated proficiency in word processing, spreadsheet, database, presentation and email applications.
• Must be organized and detail oriented

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