-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Savannah, US-GA
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:58
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Boise, US-ID
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:58
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Atlanta, US-GA
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:57
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Jacksonville, US-FL
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:56
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Tallahassee, US-FL
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:56
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Miami, US-FL
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:55
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Dover, US-DE
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:55
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Tampa, US-FL
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:54
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Denver, US-CO
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:53
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Bridgeport, US-CT
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:53
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Colorado Springs, US-CO
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:52
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Wilmington, US-DE
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:51
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Sacramento, US-CA
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:51
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Hartford, US-CT
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:50
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Fort Smith, US-AR
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:49
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Los Angeles, US-CA
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:49
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Little Rock, US-AR
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:48
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: San Diego, US-CA
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:48
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: San Francisco, US-CA
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:47
-
Why NHC? We are celebrating our 50-year Anniversary at National HealthCare Corporation!! We offer a culture of recognition, empowerment, and fun.
At NHC, we are all partners (employees) in a family -oriented work atmosphere where growth and opportunities are promoted.
We provide competitive compensation with performance wage rate increases.
Position: Unit Manager Registered Nurse (RN)
Are you looking to make a difference in the lives of others by sharing your care and compassion? Do you enjoy connecting with your patients while getting to know them and their family? Do you enjoy working in a family - oriented atmosphere? Come join our family -oriented team at NHC HealthCare Bluffton! NHC fosters an environment of teamwork and provides opportunities to use your comprehensive Nursing Tools.
Position Highlights:
* Working with the interdisciplinary care team, to assure accurate patient assessment and development/revision of individualized plans of care.
* Maintains open and ongoing communication with patients and families, providing opportunity and encouragement to participate in decision making.
* Supervise LPNs and other nursing partners as assigned
* Perform other duties as assigned by the Director of Nursing
Why NHC? We are celebrating our 50-year Anniversary at National HealthCare Corporation!! We offer a culture of recognition, empowerment, and fun.
At NHC, we are all partners (employees) in a family -oriented work atmosphere where growth and opportunities are promoted.
We provide competitive compensation with performance wage rate increases.
Work Schedule: Dayshift
Job Type: Part Time and Full Time
Experience
South Carolina RN Nursing license
We hire GNs and GPNs
BenefitsEarned Time Off Holiday Incentive PayHealth, Dental, Vision, Disability and Life insurance401k with generous company contributions
Competitive PayUniforms
Tuition Reimbursement OpportunitiesAdvancement Opportunities and more!
Work Location:NHC HealthCare Bluffton3039 Okatie Highway
Okatie, SC 29909
If you are interested in working for a leader in senior care, share NHC's values of honesty and integrity, and have a heart for the geriatric patient, please apply today and find out more about us at nhccare.com/locations/bluffton/
EOE
....Read more...
Type: Permanent Location: Bluffton, US-SC
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:46
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Phoenix, US-AZ
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:45
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Tucson, US-AZ
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:44
-
Freelance Beautician Opportunity
NHC Hendersonville is seeking a skilled and compassionate Beautician to provide professional beauty services to our patients on a freelance/Contract basis.
At National HealthCare Corporation, we are recognized nationwide as innovators in the delivery of quality long-term care.
Our goal is to provide a full range of extended care services designed to maximize the well-being and independence of patients of all ages.
We are dedicated to meeting patient needs through a compassionate, interdisciplinary approach.
Work Hours : Part time or Full time.
Very flexible.
Job Overview
As a freelance Beautician, you will operate independently to deliver personalized hair care and grooming services for patients at NHC Hendersonville.
You will have the flexibility to manage your schedule while ensuring the needs of our patients are met.
Job Responsibilities
* Provide beautician services (e.g., haircuts, styling, grooming) tailored to the needs of our patients.
* Collaborate with the nursing team to determine patient eligibility for services based on physical and/or mental abilities.
* Operate within the beauty shop located at NHC Hendersonville, ensuring the space is utilized in alignment with patient priorities.
* Maintain a written record of appointments and charges to be shared with the bookkeeper.
* Keep your personal cosmetology license current and appropriately displayed.
Freelance Terms
* The Beautician will operate as an independent contractor, not an employee of NHC Hendersonville
* Beautician is responsible for all personal business taxes and maintaining their professional license.
* NHC will provide the beauty shop facility, shop license, and related postings.
* Service pricing will be established collaboratively between NHC and the Beautician.
* Either party may modify or terminate the agreement with a 30-day written notice, unless immediate termination is required due to inappropriate conduct.
Why Join Us?
While you will operate as an independent contractor, you'll have the opportunity to work within the supportive and rewarding environment of NHC.
We are committed to innovation, teamwork, and the well-being of the communities we serve.
We look forward to working with you!
EOE
....Read more...
Type: Permanent Location: Hendersonville, US-TN
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:44
-
Essential Duties and Responsibilities:
- Monitor the performance of, manage workloads of and perform case assignment for a team of Coordinators and assist with training and staff hiring.
- Develop and maintain processes and procedures at the direction of the director, liaison with Project Directors regarding procedural issues, and communicate with the CA Division of Workers' Compensation (DWC) regarding policy and eligibility issues.
- Manage complex case files from the date received to date closed for Independent Billing Review (IBR) and determine eligibility of CA IBR appeals.
- Respond to requests from Billing for additional information from Claims Administrators as needed.
- Manage complex case files from date received to date closed.
- Determine eligibility of appeals and submit potentially ineligible cases to the CA DWC for final eligibility determination.
- Request additional information from Claims Administrators.
- Draft correspondence regarding eligibility and assignment.
- Manage the workload of all Coordinators to ensure timeliness of IBR reviews.
- Collaborate with the client to address policy issues that arise in the content of review.
- Ensure that process is being completed timely according to contract regulations.
- Work with Systems Development staff regarding Entellitrak updates to enhance IBR process.
- Perform other duties as assigned by management.
Minimum Requirements
- High School diploma or equivalent or Associate degree with 1.5 - 4 years of experience.
- Additional clinical licensure may be required based on project.
- Additional training or education in area of specialization.
- Works on a variety of assignments requiring considerable judgement and initiative.
- As a skilled and experienced specialist, completes tasks in resourceful and effective ways.
- Able to draft or modify training materials and procedural documentation accurately.
- Skilled in handling challenging communications with external contacts for escalated matters.
- Act independently to determine methods and procedures on new assignments.
- Serves as facilitator and team leader, allocating work and providing guidance and training to others in field of specialization.
- Perform quality assurance on work of others in team.
Preferred Requirements
- Experience with reading and reviewing Explanation of Reviews
- Explanation of Benefits, Remittance Advice, or similar payor issued documents.
- Experience in billing and or coding medical claims.
- Experience with Health Plans, as a claims examiner processing medical claims.
- Familiarity with Medical Claim Forms and CPT, HCPCS, ICD-10-CM codes.
- Experience with Medical Claim Appeal Processes, appealing and receiving/reviewing appeals.
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
* Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
* Minimum 5 Mpbs upload speeds
EEO Statement
Maximus is an equal opport...
....Read more...
Type: Permanent Location: Mobile, US-AL
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:43
-
"A different kind of care that ensures you're surrounded by people who make a difference in your life"
Low partner turnover
High customer satisfaction
Pay Per Visit or Hourly rates
Competitive wages
Position:Registered Nurse - Full-Time NHC HomeCare Lawrenceburg PRN
Licensure:
* Unencumbered current Registered Nurse license in the state where the HomeCare agency is located or compact state, if applicable.
* Minimum one (1) year experience as a RN / professional nurse.
* Experience in home care is desirable.
Position Highlights:
* Utilizes the nursing process to identify and achieve patient goals: assessment, planning, implementation, and evaluation.
* Assesses the physical, psychosocial, and environmental factors that affect a patient's health to develop a comprehensive nursing care plan which will attain the patients desired health outcomes in a culturally comfortable way.
* Collaborates with the interdisciplinary team to assure personal care, medical care and rehabilitation provide for optimal patient health and well-being.
* Teaches patient/caregiver in various aspects of health care and disease management appropriate to needs/level of education and understanding and documents continuing needs and levels of patients/caregivers understanding.
Benefits:Competitive Wages, Insurance, 401K Match, Dental, Vision (All Optional), Fun, Fast Paced Work Environment
NHC HomeCare Lawrenceburg is located at 399 Tripp Rd., Lawrenceburg, TN 38464
If you are interested in working for a leader in senior care and share NHC's values of honesty and integrity, please apply today and find out more about us at nhccare.com/locations/homecare-lawrenceburg/
We look forward to talking with you!! NHC is an Equal Opportunity Employer.
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Type: Permanent Location: Lawrenceburg, US-TN
Salary / Rate: Not Specified
Posted: 2026-03-06 08:15:43
