This role will give you the opportunity to:

• Work in a key part in the insurance industry, Reinsurance. The domain knowledge you will gain is in high demand.
• Be a part of an International Team: Our team is spread across USA, Philippines, and India.  
• Work in Cloud: We are heavily invested in Cloud and only getting started.
• Automation: You’ll work on creating new processes and tools that will replace manual processes and add more value to business.

Our CI/CD Stack:
GitHub, GitHub actions, SonarQube, JFrog Xray, ArgoCD

Our QA Stack:
Selenium, Eclipse, Java.

Our Dev Stack:
.NET/SQL Server, Azure

• This role will give you the opportunity to:

  • Work in a key part in the insurance industry, Reinsurance. The domain knowledge you will gain is in high demand.
  • Be a part of an International Team: Our team is spread across USA, Philippines, and India. 

• Work in Cloud: We are heavily invested in SnowFlake Cloud and only getting started.
• Offers an opportunity to showcase Data Visualization strengths in SQL, Power BI and SSRS.
• Great opportunity to come in at the ground level and build out the BI team and structure within a large organization.

Our DB Stack:
.NET, Power BI, Cortex, SSRS, SQL Server, AKS, SnowFlake

The Actuarial Analyst provides Reserving and Pricing support as part of the UK General Insurance Actuarial team.  The candidate will process, validate and interpret data to statistically model and determine results for the business. The candidate will be required to develop, maintain and update reports and communicate results into the Senior members of the Actuarial team.

MedCore Solutions, Bizforce's medical division is currently seeking a Dental Insurance Verifier to join our team. As a Dental Insurance Verifier, you will play a critical role in the dental insurance process by verifying insurance coverage and benefits for patients. You will be responsible for working closely with dental providers, insurance companies, and patients to ensure accurate and timely verification of insurance information.

At MedCore Solutions we prioritize efficiency, accuracy, and excellent customer service. We are looking for a detail-oriented and organized individual who is experienced in dental insurance verification and has a strong understanding of dental terminology and procedures.

Who We Are

MedCore Solutions (MCS) is a single source solution for Healthcare administration. MCS is an industry leader for medical billing, credentialing, scribing, insurance verification, compliance and virtual staffing.

We offer an expansive suite of administrative products and trainings to keep your practice and its employees safe and up to date with compliance and to avoid fines and litigation. Our online compliance center is quick and easy to use, and provides you with an extensive library of training courses, covering OSHA, HIPAA, Human Resources, Health Plan Management, Patient Safety and Regulations, Infection Control, and much more.

Responsibilities:

• Assist and handle incoming calls from members and/or providers
• Verify dental insurance coverage and benefits for patients (and a little of dental claims)
• Communicate with dental providers, insurance companies, and patients to gather necessary information
• Ensure accuracy and completeness of insurance verification
• Enter and update insurance information in the system
• Resolve any discrepancies or issues related to insurance coverage
• Provide excellent customer service to patients by addressing their insurance-related inquiries and concerns

• At least 3 years of experience in dental insurance verification (members and providers) in the US healthcare
• Strong understanding of dental terminology and procedures
• Knowledge of dental insurance plans and coverage
• Detail-oriented with excellent data entry skills
• Strong communication and interpersonal skills
• Ability to work independently and as part of a team
• Proficient in using dental insurance verification software/systems
• Amenable to work in a graveyard shift

Other details:

Start Date: TBD

Schedule: 8 hours shift Monday - Friday; Days off: Saturday and Sunday

Type of Work: Full-time

Location: Permanent Work from Home

Duration: Steady State

Training: At least 1-2 weeks

Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.

Permanent Work From home

Permanent Weekends Off

Great Company Culture and No Micromanagement

Benefits

Our purpose

Here at Datacom, we connect people and technology in order to solve challenges, create opportunities and discover new possibilities for the communities we live in.

The Nitty Gritty

We have over 6,200 people across our global offices, and generate an annual revenue of over $1.2 billion, this makes us one of Australasia’s largest professional IT services companies. We have extensive expertise in operating data centers, providing IT services, software engineering, and application management, as well as payroll and customer service design and operations. With this comes a long list of significant clients Datacom is committed to the hiring, developing and promoting the best talent from a diverse range of backgrounds. We are local at heart, yet world-class in capability.

What you'll do

• Assisting customers with the activation and setup of their product and services
• Validation of the customer’s entitlement for support (e.g. a client’s customer, account is current, level of support service entitlement)
• Logging all customer incidents upon receipt into the approved case management system;
• Providing support to customers by:
• Providing a timely and clear indication of the nature of the incident,
• Communicating what steps will be taken to attempt to resolve the incident,
• Setting the customer’s expectation on what the estimated time to resolve the issue is,
• Providing any potential short-term alternatives or workarounds to the customer,
• Making reasonable efforts to ensure the customers understand the information they have been provided;
• Resolving customer incidents wherever possible; and
• Escalating customer incidents to Tier 2, where not able to be resolved by Tier 1

What you'll bring

• 4-year technical degree or equivalent work experience
• 1-3 years’ experience in technical support or MIS in an Enterprise environment
• Ability to properly use all Microsoft tools including MSSolve, Knowledge Base, Order Entry, Internet and Intranet Resources
• Prior knowledge in at least one of the following disciplines is required: network operations, networking protocols, network authentication, messaging technology or messaging protocols, or other technical skill strengths with an online service or network communications
• Competencies before handling first interaction/call (verified by Vendor after New Hire Training)
• Ability to search and understand KB articles to troubleshoot customer issues
• Working knowledge of Microsoft Windows Desktop Operating Systems (Windows 7 onwards)
• Minimum working knowledge of Microsoft® Windows NT® Server and Windows 2008 Server R2

We have a Hybrid work Arrangement, We also provide Exciting perks such as Spotter Bonus, HMO with 4 Free Dependent, Leave credits, Performance bonuses, and a work-life balance environment

MedCore Solutions, Bizforce's medical division, is seeking for skilled WFH Rheumatology Medical Billers to join our team. As a US Medical AR Specialist, you will manage accounts receivables, coordinate with insurance companies and healthcare providers, handle denied claims, and ensure timely reimbursement of medical expenses. The successful candidate will work from home permanently and will have the opportunity to work with a dynamic team in a fast-paced environment. BizForce & MedCore Solutions allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world.

Who We Are

MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in medical billing, credentialing, scribing, insurance verification, compliance, and virtual staffing. Upon your request our team of certified coders can perform a detailed billing analysis to determine if you are receiving the maximum amount of revenue while conforming to CMS guidelines. Ask how MCS can streamline your hospital or practice making healthcare administration simple, effective, and affordable. We pride ourselves on giving you the best solutions tailored to your practice’s specific needs, so you can focus on your patients and revenue-producing activities.

Responsibilities

• Manage accounts receivables and keep up-to-date records
• Coordinate with healthcare providers and insurance companies for claim submission and follow-up
• Generate revenue by making payment arrangements, collecting accounts, and monitoring and pursuing delinquent accounts
• Collect delinquent accounts by establishing payment arrangements with patients, monitoring payments, and following up with patients when payment lapses occur
• Maintain Medicare bad-debt cost report
• Secure outstanding balance payments for the care of employees
• Verify insurance eligibility for patients and ensure timely payment
• Handle denied claims and appeal if necessary
• Reconcile payments and post to patients' accounts
• Maintain compliance with HIPAA regulations
• Handle patient inquiries regarding their accounts

Other details:

Start Date: TBD

Schedule: 8 hours/day Monday-Friday; 40 hours/week

Days Off: Saturday & Sunday

Time zone: EST

Duration: Full-time Steady state

• At least 3-5 years of experience as a US Medical AR Specialist
• Knowledge of medical billing and coding practices
• Strong understanding of the healthcare billing process
• Familiarity with healthcare insurance plans and related policies
• Experience with HIPAA regulations
• Excellent communication and customer service skills
• Strong attention to detail
• Strong computer skills and experience with medical billing software.
• Amenable to work in any US time zones (graveyard shift)
• At least 1 year of experience in Physical Therapy billing
• Preferably with experience in Agile EMR

Key Results

• Reduce coding and billing error rate
• Achieve the target collections goals set and collections status report
• Reduced number of denials and complaints
• Achieve an accuracy rate of 99%
• Utilization of billing and coding software programs

System Requirements

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5
• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up

Our Commitment to delivering high-quality results for our clients and the only way to do that is by ensuring a rewarding, respectful, and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From Home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education

• Specialized Training

MedCore Solutions, Bizforce's medical division, is seeking for skilled WFH Rheumatology Medical Billers to join our team. As a US Medical AR Specialist, you will manage accounts receivables, coordinate with insurance companies and healthcare providers, handle denied claims, and ensure timely reimbursement of medical expenses. The successful candidate will work from home permanently and will have the opportunity to work with a dynamic team in a fast-paced environment. BizForce & MedCore Solutions allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world.

Who We Are

MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in medical billing, credentialing, scribing, insurance verification, compliance, and virtual staffing. Upon your request our team of certified coders can perform a detailed billing analysis to determine if you are receiving the maximum amount of revenue while conforming to CMS guidelines. Ask how MCS can streamline your hospital or practice making healthcare administration simple, effective, and affordable. We pride ourselves on giving you the best solutions tailored to your practice’s specific needs, so you can focus on your patients and revenue-producing activities.

Responsibilities

• Manage accounts receivables and keep up-to-date records
• Coordinate with healthcare providers and insurance companies for claim submission and follow-up
• Generate revenue by making payment arrangements, collecting accounts, and monitoring and pursuing delinquent accounts
• Collect delinquent accounts by establishing payment arrangements with patients, monitoring payments, and following up with patients when payment lapses occur
• Maintain Medicare bad-debt cost report
• Secure outstanding balance payments for the care of employees
• Verify insurance eligibility for patients and ensure timely payment
• Handle denied claims and appeal if necessary
• Reconcile payments and post to patients' accounts
• Maintain compliance with HIPAA regulations
• Handle patient inquiries regarding their accounts

Other details:

Start Date: TBD

Schedule: 8 hours/day Monday-Friday; 40 hours/week

Days Off: Saturday & Sunday

Time zone: EST

Duration: Full-time Steady state

• At least 3-5 years of experience as a US Medical AR Specialist
• Knowledge of medical billing and coding practices
• Strong understanding of the healthcare billing process
• Familiarity with healthcare insurance plans and related policies
• Experience with HIPAA regulations
• Excellent communication and customer service skills
• Strong attention to detail
• Strong computer skills and experience with medical billing software.
• Amenable to work in any US time zones (graveyard shift)
• At least 1 year of experience in Physical Therapy billing
• Preferably with experience in Agile EMR

Key Results

• Reduce coding and billing error rate
• Achieve the target collections goals set and collections status report
• Reduced number of denials and complaints
• Achieve an accuracy rate of 99%
• Utilization of billing and coding software programs

System Requirements

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5
• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up

Our Commitment to delivering high-quality results for our clients and the only way to do that is by ensuring a rewarding, respectful, and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From Home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education

• Specialized Training

Support the deployment & sustainment of initiatives with data collection, analysis,
summary, recommendations monitoring and reporting that will help to drive repeatable problem solving and leadership routines

• Develop reporting and analysis tools to support Leaders and Teams to sustain continuous improvement in their area including their own management practices and routines.
• Possess good understanding of analytics tools (PowerBI, Alteryx, Excel, PowerPoint etc.) to drive historical data trends, volume analysis, visual representations of the KPIs
• Interpret data, analyze results using statistical techniques and provide ongoing reports
• Help in the Development and implementation of databases, data collection systems, data analytics and other strategies that optimize statistical efficiency and quality
• Acquire data from primary or secondary data sources and maintain databases/data systems
• Locate and define new process improvement opportunities

Support the deployment & sustainment of initiatives with data collection, analysis,
summary, recommendations monitoring and reporting that will help to drive repeatable problem solving and leadership routines

3-5 years of experience using data mining to extract information from data sets and identify
correlations and patterns

• Experience in organizing and transforming information into comprehensible structures
• Ability to leverage data to predict trends in the customer base and the consumer population as a whole
• Technical expertise regarding data models, database design development and data mining
• Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy
• Adept at queries, report writing and presenting findings
• Comfortable using tools and techniques to visualize data in easy-to-understand formats, such as diagrams and graphs
• Prepare reports and present to management
• Identify and recommend new ways to add efficiency by streamlining business processes
• Monitor data quality and remove corrupt data
• Communicate with stakeholders to understand data content and business requirements
• PowerBI, Database Management (SQL, Access, Cloudera), Alteryx, Python or equivalent Analytics Program, Microsoft excel, Lean Six Sigma

Arch is seeking a proactive, results-driven individual to join our Global Internal Audit (“IA”) team as Senior Internal Auditor. As a Senior Internal Auditor, you will gain hands-on experience with business and technology processes, risks, and controls. You will also build direct relationships with key business, technology, and audit leaders as part of your efforts to conduct risk assessments, develop process and control documentation, perform audit/testing procedures, and identify process and control improvement opportunities. The Senior Internal Auditor may also lead aspects of Internal Audit projects and/or SarbanesOxley (“SOX”) program activities. This position offers the opportunity to be a leader now and grow through
demonstrated performance.

• Serve as a team member on Audit/Advisory projects and/or SOX program efforts
• Perform Audit/SOX activities including interviews, walkthroughs, testing, wrap-up, and issue follow up
• May lead certain aspects of Audit/Advisory projects and/or SOX program efforts including engagement
• planning, depending upon skillsets and project requirements
• May oversee Internal Auditor(s) on projects, depending upon skillsets and project requirements
• Participate in the SOX and Audit Plan development process

This primary role is to drive process improvement initiatives across Insurance domain. Work with Operations collaboratively to address client issues and present solutions, projects, progress to Global clients. Deliver projects as per the agreed frameworks (Agile) and governance model. Atleast GB certified • Ability to manage multiple stakeholders and have focused and quality interactions view to drive decisions and mitigate project risks. Sr GroupQuality is expected to lead mid to large scale Quality projects including all aspects like ideation, solution design, development and implementation, closure and benefit realization. The projects managed by the team are in-line with the organization’s priorities on themes like process improvement, operational excellence, automation, migration and restructuring.

#1 PH Workforce Delivering to the US

MedCore Solutions, the Medical Division of Bizforce, is seeking a skilled Prior Authorization Specialist to join our growing team. The Prior Authorization Specialist we be primarily responsible for obtaining all types of prior authorizations. These prior authorizations will include biologic medications, procedures, prescriptions and out-patient testing. The position will require professional and courteous interaction with patients, pharmaceutical representatives, providers, pharmacies and insurance carriers to accurately obtain the required information to process prior authorizations.

Responsibilities

• Review and process prior authorization requests for medical services, procedures, and medications
• Verify insurance (pharmacy) information and eligibility
• Handle patient inquiries regarding authorizations
• Provide necessary prior authorization documentation to patients for completion and signature. Review all forms for completeness and accuracy.
• Accurately document all patient, pharmacy and insurance carrier interactions in EMR.
• Coordinate with healthcare providers and insurance companies to obtain necessary authorizations
• Ensure accurate and timely documentation of authorization requests and approvals
• Collaborate with medical billing team to resolve any issues or denials
• Maintain up-to-date knowledge of insurance guidelines and procedures
• Complete other tasks as assigned by providers through EMR/EHR
• Copy, fax and mail documents and information as requested by insurance carrier
• Schedule follow-up appointments, biologic injections and photodynamic therapy treatments
• Assist pathology department with notifying patients of pathology results via telephone
• Fulfill organizational responsibilities as assigned, which may include but are not limited to: respecting and promoting patient’s rights, responding appropriately to emergency situations, sharing problems relating to patients and/or staff with Care Center Leader in a timely manner
• Provide safe patient-centered, compassionate, and competent care

Other details:

Start Date: TBD

Schedule: 8 hours/day Monday-Friday; 40 hours/week

Days Off: Saturday & Sunday

Time zone: EST

Duration: Full-time Steady state

• Proven 3-5 years of experience as a Prior Authorization Specialist in the US Healthcare

• Strong understanding of medical billing and insurance processes
• Excellent communication and interpersonal skills
• Detail-oriented with strong organizational skills
• Ability to work independently and meet deadlines
• Comfortable working in a remote, work-from-home setup
• Experience handling Physical Therapy practice/account
• Experience using Agile EMR is a bonus
• Amenable to work in a graveyard shift

System Requirements

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5

• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up

Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education
• Specialized Training

Who We Are

MedCore Solutions (MCS) is a single source solution for Healthcare administration. MCS is an industry leader for medical billing, credentialing, scribing, insurance verification, compliance and virtual staffing.

We offer an expansive suite of administrative products and trainings to keep your practice and its employees safe and up to date with compliance and to avoid fines and litigation. Our online compliance center is quick and easy to use, and provides you with an extensive library of training courses, covering OSHA, HIPAA, Human Resources, Health Plan Management, Patient Safety and Regulations, Infection Control, and much more.

#1 PH Workforce Delivering to the US

Bizforce and our medical billing division, MedCore Solutions, are seeking skilled Medical Coders to join our growing team. As a Medical Coder at MedCore, you will be responsible for translating details from a patient's medical documents into medical codes for health insurance claims purposes. Additionally, you will be liaising with the client and team members for coding-related queries and concerns, performing audits for coding denials and missing information, and maintaining a tracking system for coded charts. MedCore allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today!

Who We Are

MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in medical billing, credentialing, scribing, insurance verification, compliance, and virtual staffing.

We offer an expansive suite of administrative products and training to keep your practice and its employees safe and up-to-date with compliance and to avoid fines and litigation. Our online compliance center is quick and easy to use and provides you with an extensive library of training courses, covering OSHA, HIPAA, Human Resources, Health Plan Management, Patient Safety and Regulations, Infection Control, and much more.

Responsibilities

• Translate details from a patient's medical documents into medical codes for health insurance claims purposes
•  Ensures accurate data entry of the coding and claims submission for services provided by physicians, including assigning the correct ICD and CPT codes
• Provides support to clinic/practice managers and staff in determining accurate coding and billing practices
• Liaising with the client/provider and team members for coding-related queries and concerns
• Perform audits for coding denials, missing information, and charts
• Maintain a tracking system for the charts coded and ensure work completion
• Research coding and claims questions thoroughly to maintain high-quality standards

Other Details

• The possible start date will be in 2 weeks or earlier
• 8-hour shift Monday-Friday (graveyard shift)
• Weekend days off
• Duration: Long term; Steady-state

• Must be AAPC/AHIMA certified coder
• At least 3-5 years of clinical experience in Medical Coding
• Knowledgeable in US Insurance Plan Structure and HIPAA regulations
• Good oral and verbal English communication skills as well as listening skills
• Capacity to navigate challenging situations with ease
• Willing to work in a graveyard shift (US time zone)
• Has experience in using NextGen EMR/EHR

System Requirements

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5

• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up
• Peripherals: Headset with noise-canceling feature

Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education
• Specialized Training

MedCore Solutions, Bizforce's medical division, is seeking skilled WFH Rheumatology Coders to join our team. As a Rheumatology Coder, you will be responsible for reviewing and analyzing medical records, assigning appropriate codes for diagnoses and procedures, and ensuring compliance with coding guidelines and regulations. This position offers the flexibility of remote work from home permanently.

Who We Are

MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in medical billing, credentialing, scribing, insurance verification, compliance, and virtual staffing. Upon your request, our team of certified coders can perform a detailed billing analysis to determine if you are receiving the maximum amount of revenue while conforming to CMS guidelines. Ask how MCS can streamline your hospital or practice making healthcare administration simple, effective, and affordable. We pride ourselves on giving you the best solutions tailored to your practice’s specific needs, so you can focus on your patients and revenue-producing activities. 

Responsibilities

• Review and analyze medical records to accurately assign ICD-10-CM, CPT, and HCPCS codes
• Ensure coding accuracy and compliance with coding guidelines and regulations
• Abstract clinical information from medical records and assign appropriate codes
• Collaborate with healthcare professionals to clarify documentation and obtain necessary details
• Stay updated with changes in coding guidelines and regulations
• Meet productivity and quality targets
• Translate details from a patient's medical documents into medical codes for health insurance claims purposes
•  Ensures accurate data entry of the coding and claims submission for services provided by physicians, including assigning the correct ICD and CPT codes
• Provides support to clinic/practice managers and staff in determining accurate coding and billing practices
• Liaising with the client/provider and team members for coding-related queries and concerns
• Perform audits for coding denials, missing information, and charts
• Maintain a tracking system for the charts coded and ensure work completion
• Research coding and claims questions thoroughly to maintain high-quality standards

Other Details

• The possible start date will be in 2 weeks or earlier
• 8-hour shift Monday-Friday (graveyard shift)
• Weekend days off
• Duration: Long-term; Steady-state

• Must be AAPC/AHIMA certified coder
• At least 3-5 years of clinical experience in Medical Coding (Outpatient/Inpatient)
• Knowledgeable in US Insurance Plan Structure and HIPAA regulations
• Good oral and verbal English communication skills as well as listening skills
• Capacity to navigate challenging situations with ease
• Willing to work in a graveyard shift (US time zone)
• Excellent communication and teamwork skills
• At least 1 year of experience in Rheumatology coding
• NextGen system experience - bonus

System Requirements

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5
• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up

Our Commitment to delivering high-quality results for our clients and the only way to do that is by ensuring a rewarding, respectful, and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From Home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education

• Specialized Training

MedCore Solutions, Bizforce's medical division, is seeking skilled WFH Rheumatology Coders to join our team. As a Rheumatology Coder, you will be responsible for reviewing and analyzing medical records, assigning appropriate codes for diagnoses and procedures, and ensuring compliance with coding guidelines and regulations. This position offers the flexibility of remote work from home permanently.

Who We Are

MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in medical billing, credentialing, scribing, insurance verification, compliance, and virtual staffing. Upon your request, our team of certified coders can perform a detailed billing analysis to determine if you are receiving the maximum amount of revenue while conforming to CMS guidelines. Ask how MCS can streamline your hospital or practice making healthcare administration simple, effective, and affordable. We pride ourselves on giving you the best solutions tailored to your practice’s specific needs, so you can focus on your patients and revenue-producing activities. 

Responsibilities

• Review and analyze medical records to accurately assign ICD-10-CM, CPT, and HCPCS codes
• Ensure coding accuracy and compliance with coding guidelines and regulations
• Abstract clinical information from medical records and assign appropriate codes
• Collaborate with healthcare professionals to clarify documentation and obtain necessary details
• Stay updated with changes in coding guidelines and regulations
• Meet productivity and quality targets
• Translate details from a patient's medical documents into medical codes for health insurance claims purposes
•  Ensures accurate data entry of the coding and claims submission for services provided by physicians, including assigning the correct ICD and CPT codes
• Provides support to clinic/practice managers and staff in determining accurate coding and billing practices
• Liaising with the client/provider and team members for coding-related queries and concerns
• Perform audits for coding denials, missing information, and charts
• Maintain a tracking system for the charts coded and ensure work completion
• Research coding and claims questions thoroughly to maintain high-quality standards

Other Details

• The possible start date will be in 2 weeks or earlier
• 8-hour shift Monday-Friday (graveyard shift)
• Weekend days off
• Duration: Long-term; Steady-state

• Must be AAPC/AHIMA certified coder
• At least 3-5 years of clinical experience in Medical Coding (Outpatient/Inpatient)
• Knowledgeable in US Insurance Plan Structure and HIPAA regulations
• Good oral and verbal English communication skills as well as listening skills
• Capacity to navigate challenging situations with ease
• Willing to work in a graveyard shift (US time zone)
• Excellent communication and teamwork skills
• At least 1 year of experience in Rheumatology coding
• NextGen system experience - bonus

System Requirements

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5
• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up

Our Commitment to delivering high-quality results for our clients and the only way to do that is by ensuring a rewarding, respectful, and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From Home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education

• Specialized Training

We are currently seeking a highly motivated and results-oriented Recruitment Specialist to join our team.

As a Recruitment Specialist, you will play a crucial role in identifying and attracting top accounting talent to meet our clients' hiring needs. You will be responsible for sourcing candidates, screening resumes, conducting interviews, and presenting qualified candidates to clients. Additionally, you will contribute to the development and implementation of recruitment strategies, ensuring that our clients have access to the most qualified accounting professionals in the industry.

The ideal candidate will have a strong understanding of the accounting industry and possess excellent communication and interpersonal skills. You will work closely with clients, understanding their unique hiring needs and providing them with tailored recruitment solutions. This is an exciting opportunity for someone who is passionate about recruitment and wants to make a significant impact in the accounting industry.

Responsibilities

• Source, screen, and interview potential candidates for accounting positions
• Proactively build a pipeline of qualified accounting professionals
• Conduct reference checks and background screenings
• Collaborate with clients to understand their hiring needs and develop recruitment strategies
• Utilize various recruitment channels such as job boards, social media, and professional networks to attract top talent
• Develop and maintain strong relationships with accounting professionals to ensure a continuous pool of qualified candidates
• Stay updated on industry trends and market conditions to effectively advise clients on recruitment strategies

• Bachelor's degree in Human Resources, Business Administration, or a related field
• Proven experience as a Recruitment Specialist or similar role
• Strong understanding of the accounting industry and its unique hiring needs
• Excellent communication and interpersonal skills
• Demonstrated ability to build and maintain relationships with clients and candidates
• Proficiency in using recruitment software and applicant tracking systems
• Strong organizational and time management skills
• Ability to work under pressure and meet deadlines

• Training & Development
• Private Health Insurance

MedCore Solutions, Bizforce's medical division, is seeking for skilled WFH Rheumatology Medical Billers to join our team. As a US Medical AR Specialist, you will manage accounts receivables, coordinate with insurance companies and healthcare providers, handle denied claims, and ensure timely reimbursement of medical expenses. The successful candidate will work from home permanently and will have the opportunity to work with a dynamic team in a fast-paced environment. BizForce & MedCore Solutions allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world.

Who We Are

MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in medical billing, credentialing, scribing, insurance verification, compliance, and virtual staffing. Upon your request our team of certified coders can perform a detailed billing analysis to determine if you are receiving the maximum amount of revenue while conforming to CMS guidelines. Ask how MCS can streamline your hospital or practice making healthcare administration simple, effective, and affordable. We pride ourselves on giving you the best solutions tailored to your practice’s specific needs, so you can focus on your patients and revenue-producing activities.

Responsibilities

• Manage accounts receivables and keep up-to-date records
• Coordinate with healthcare providers and insurance companies for claim submission and follow-up
• Generate revenue by making payment arrangements, collecting accounts, and monitoring and pursuing delinquent accounts
• Collect delinquent accounts by establishing payment arrangements with patients, monitoring payments, and following up with patients when payment lapses occur
• Maintain Medicare bad-debt cost report
• Secure outstanding balance payments for the care of employees
• Verify insurance eligibility for patients and ensure timely payment
• Handle denied claims and appeal if necessary
• Reconcile payments and post to patients' accounts
• Maintain compliance with HIPAA regulations
• Handle patient inquiries regarding their accounts

Other details:

Start Date: TBD

Schedule: 8 hours/day Monday-Friday; 40 hours/week

Days Off: Saturday & Sunday

Time zone: TBD (US work hours)

Duration: Full-time Steady state

• At least 3-5 years of experience as a US Medical AR Specialist
• Knowledge of medical billing and coding practices
• Strong understanding of the healthcare billing process
• Familiarity with healthcare insurance plans and related policies
• Experience with HIPAA regulations
• Excellent communication and customer service skills
• Strong attention to detail
• Strong computer skills and experience with medical billing software.
• Amenable to work in any US time zones (graveyard shift)
• At least 1 year of experience in Rheumatology billing
• Preferably with experience in NextGen EMR

Key Results

• Reduce coding and billing error rate
• Achieve the target collections goals set and collections status report
• Reduced number of denials and complaints
• Achieve an accuracy rate of 99%
• Utilization of billing and coding software programs

System Requirements

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5
• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up

Our Commitment to delivering high-quality results for our clients and the only way to do that is by ensuring a rewarding, respectful, and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From Home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education

• Specialized Training

#1 PH Workforce Delivering to the US

Bizforce and our medical billing division, MedCore Solutions, are seeking skilled Medical Coders to join our growing team. As a Medical Coder at MedCore, you will be responsible for translating details from a patient's medical documents into medical codes for health insurance claims purposes. Additionally, you will be liaising with the client and team members for coding-related queries and concerns, performing audits for coding denials and missing information, and maintaining a tracking system for coded charts. MedCore allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today!

Who We Are

MedCore Solutions (MCS) is a single-source solution for Healthcare administration. MCS is an industry leader in medical billing, credentialing, scribing, insurance verification, compliance, and virtual staffing.

We offer an expansive suite of administrative products and training to keep your practice and its employees safe and up-to-date with compliance and to avoid fines and litigation. Our online compliance center is quick and easy to use and provides you with an extensive library of training courses, covering OSHA, HIPAA, Human Resources, Health Plan Management, Patient Safety and Regulations, Infection Control, and much more.

Responsibilities

• Translate details from a patient's medical documents into medical codes for health insurance claims purposes
•  Ensures accurate data entry of the coding and claims submission for services provided by physicians, including assigning the correct ICD and CPT codes
• Provides support to clinic/practice managers and staff in determining accurate coding and billing practices
• Liaising with the client/provider and team members for coding-related queries and concerns
• Perform audits for coding denials, missing information, and charts
• Maintain a tracking system for the charts coded and ensure work completion
• Research coding and claims questions thoroughly to maintain high-quality standards

Other Details

• The possible start date will be in 2 weeks or earlier
• 8-hour shift Monday-Friday (graveyard shift)
• Weekend days off
• Duration: Long term; Steady-state

• Must be AAPC/AHIMA certified coder
• At least 3-5 years of clinical experience in Medical Coding
• At least 6 months experience in Rheumatology coding
• Knowledgeable in US Insurance Plan Structure and HIPAA regulations
• Good oral and verbal English communication skills as well as listening skills
• Capacity to navigate challenging situations with ease
• Willing to work in a graveyard shift (US time zone)
• Experience in using Athena Health EMR/EHR is a bonus

System Requirements

• Own Desktop/Laptop
• Computer Processor: Intel I3/AMD Ryzen 3/MAC Intel I5

• RAM: At least 4GB of RAM (8GB is recommended) with sufficient hard disk space available
• Internet Connectivity: At least 20-25 Mbps and up wired Internet Connection
• Back-up Connections & Power Supply: USB sticks, hotspots, signal-based & wireless connections only for back-up
• Peripherals: Headset with noise-canceling feature

Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education
• Specialized Training

#1 PH Workforce Delivering to the US

MedCore Solutions, is seeking a skilled Prior Authorization Specialist with Medical Billing experience to join our growing team. We are partnering with some of the largest healthcare platforms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today! The traditional model of the office workforce has been shifting as outsourcing has grown in PH at rates never before seen. As global businesses rise out of the pandemic, labor markets have not only tightened but the inflationary rates have caused companies to look for solutions on how to best deliver skilled labor services and results. We are proud to partner with PH and deliver qualified, professional workers, giving our employees the ability to have an unbeatable career and work from home.

Who We Are

MedCore Solutions (MCS) is a single source solution for Healthcare administration. MCS is an industry leader for medical billing, credentialing, scribing, insurance verification, compliance and virtual staffing.

Responsibilities

• Review and process prior authorization requests for medical services, procedures, and medications
• Verify insurance information and eligibility
• Coordinate with healthcare providers and insurance companies to obtain necessary authorizations
• Ensure accurate and timely documentation of authorization requests and approvals
• Collaborate with medical billing team to resolve any issues or denials
• Maintain up-to-date knowledge of insurance guidelines and procedures
• Manage accounts receivables and keep up-to-date records
• Tasks will gradually transition into a Biller/AR task
• Coordinate with healthcare providers and insurance companies for claim submission and follow-up
• Generate revenue by making payment arrangements, collecting accounts, and monitoring and pursuing delinquent accounts
• Verify insurance eligibility for patients and ensure timely payment
• Handle denied claims and appeal if necessary
• Reconcile payments and post to patients' accounts
• Maintain compliance with HIPAA regulations
• Handle patient inquiries regarding their accounts

Requirements:

• Previous experience as a Prior Authorization Specialist in a medical billing setting
• Strong understanding of medical billing and insurance processes
• Excellent communication and interpersonal skills
• Detail-oriented with strong organizational skills
• Ability to work independently and meet deadlines
• Proficient in using medical billing software and MS Office Suite
• High school diploma or equivalent, relevant certifications a plus
• Comfortable working in a remote, work-from-home setup

Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education
• Specialized Training

• Master of end-to-end WFM processes supporting both internal and external stake holders, with specific and proven experience in real-time management, forecasting & planning
• Lead and develop a team of WFM analysts, planners, and schedulers.
• Foster a culture of continuous improvement and performance excellence within the WFM group. Provide guidance, mentorship, and training to team members.
• Develop and deploy effective staffing models to optimize the use of available resources, help create schedules basis the Interval Staffing requirement, ensuring optimum resources utilization
• Highly motivated, hands-on leader with demonstrated ability to drive increased productivity within their organization while supporting and enabling business transformation.
• Proven capability to develop WFM professionals with strong communicative, interpersonal and people development skills.
• Knowledge of analytical and reporting tools
• Familiarity with workforce management software (Aspect, Nice IEX, Genesys, Avaya, Five9 etc.)
• Collaborate with various departments, including Operations, Customer Service, and HR, to ensure alignment with workforce management goals.
• Communicate effectively across all levels of the organization as well as conceptualize programs, benefits and the associated risks including financial impact or benefit.
• Excellent communication, mathematical, logical, analytical and problem-solving skills

13+ Years Overall Experience With a minimum of 5+ years in managing Call Center Operations with Servicing/Origination Operations along with People Management, Including Managing Multiple Teams Across Geographies In Particular Us Mortgage - Strong Exposure To Client Management - Well Versed With The Latest Trends In Us Mortgage Market And A Keen Interest In New Developments Key Deliverables & Accountabilities: - Managed team of 100 to 300+ FTE’s and Responsible For Developing And Executing The Customer Service Mortgage Voice Operations Strategy for Both Inbound and Outbound Campaigns To Achieve Desired Financial Results & Corporate Objectives (Mandate) - Adhering To Client Requirements, Manage Client Relationship Independently, Work With The Client Organization Well To Ensure Target Scores Are Met In The Account - Ensuring That The Team Is Well Equipped, Well Trained, And Motivated To Meet The Sla’s - Need To Be A Strong Motivational Leader And Engage Others To Excel In Their Respective Field Of Work. Effectively Use the Performance Management Tool To Supporting Employee Development - Maintain Open Channels Of Communication And Ensure Efficient Information Flows Across Teams And Relevant Areas; Establish Strong Contacts Internally And Externally - Manage P&L Including Achieving Revenue, Contribution And Margin Targets

#1 PH Workforce Delivering to the US.

MedCore Solutions, is seeking Credentialing Specialists and Medical Billers to join our growing team. BizForce & MedCore allows the best talent in PH to work remotely from home with the latest technology and resources. We are partnering with some of the largest healthcare platforms in the world. If you are looking to advance your career and improve your skills with an industry leader, we encourage you to apply today! The traditional model of the office workforce has been shifting as outsourcing has grown in PH at rates never before seen. As global businesses rise out of the pandemic, labor markets have not only tightened but the inflationary rates have caused companies to look for solutions on how to best deliver skilled labor services and results. We are proud to partner with PH and deliver qualified, professional workers, giving our employees the ability to have an unbeatable career and work from home.

Who We Are

MedCore Solutions (MCS) is a single source solution for Healthcare administration. MCS is an industry leader for medical billing, credentialing, scribing, insurance verification, compliance and virtual staffing.

Responsibilities

• Process applications for healthcare provider enrollment and privileging with insurance companies and various other organizations
• Coordinate and facilitate the credentialing and re-credentialing processes
• Submit and monitor credentialing applications to ensure timely completion
• Review and verify provider credentials and documents for accuracy and completeness
• Communicate with providers, insurance carriers, and organizations to obtain missing or additional information as necessary
• Maintain accurate and up-to-date provider information and credentialing files
• Manage accounts receivables and keep up-to-date records
• Coordinate with healthcare providers and insurance companies for claim submission and follow-up
• Generate revenue by making payment arrangements, collecting accounts, and monitoring and pursuing delinquent accounts
• Verify insurance eligibility for patients and ensure timely payment
• Handle denied claims and appeal if necessary
• Reconcile payments and post to patients' accounts
• Maintain compliance with HIPAA regulations
• Handle patient inquiries regarding their accounts

• Proven work experience as a Credentialing Specialist and/or Medical Biller
• Solid understanding of healthcare provider enrollment and privileging processes
• Experience with billing software and electronic medical records
• Knowledge of medical insurance policies and claim processes
• Must have the ability to multitask and manage time effectively
• Excellent written and verbal communication skills
• Outstanding problem-solving and organizational abilities

Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.

• Permanent Work From home
• Permanent Weekends Off
• Great Company Culture and No Micromanagement
• Continued Education
• Specialized Training

The Reinsurance Accountant will assume primary responsibility for all aspects of accounting for assigned reinsurance contracts. 

• Maintain the accuracy of premium information on reinsurance contracts including endorsements, premium adjustments and cash allocations
• Maintain all aspects of reinsurance contracts including bordereau reporting, claim payments and cash allocations
• Monitor aging of accounts receivable
• Monthly bordereaux reconciliation and data integrity checks
• Prepare monthly/quarterly working papers for journal entries to record activities for the accounting close process
• Review and analysis of cash receipts, payments and applications
• Prepare monthly/quarterly reinsurance account reconciliations to ensure accuracy of the general ledger
• Assist in the preparation of reinsurance cession statements, US GAAP and Statutory reports, regulatory filings, and audits
• Track deliverables and ensures compliance with prescribed due dates
• Other projects and/or tasks as assigned

Business analyst will help achieve the Group actuarial data transformation initiative.  In this position, you will partner with Group Risk Management and Database teams to accomplish data-driven initiatives within the Group Actuarial and Risk Management team.  The successful candidate will demonstrate a strong affinity for data and data-related processes and assist in enhancing the actuarial/financial reporting function.  In this role, the successful candidate will:

• Partner in the successful execution of data transformation initiatives associated with the group global actuarial reporting database.
• Use actuarial and/or financial knowledge to support data-related analysis, including identifying discrepancies between data sources and proposing solutions which will meet multiple, complex business needs.
• Support the development of integration of automated processes into existing reporting.
• Improve Actuarial data by validating and researching data anomalies and proposing solutions to fit within the existing reporting frameworks.

Required Skills/Experience

• 3+ years of experience in (re)insurance, actuarial, accounting, or financial functions.
• Knowledge of data-driven processes and technologies in key financial functions.
• Demonstrated proficiency MS Excel (advanced spreadsheet knowledge, formulas, pivot tables, VBA macros, etc.)
• Working knowledge of Power BI.
• Beginning to intermediate knowledge of SQL and/or Python.
• Actuarial skill set and/or experience. Property/Casualty insurance experience a plus.
• Experience in and knowledge of US GAAP reporting and/or BMA regulatory reporting.

The data analyst is responsible for collection, organization, interpretation, analysis, scrubbing, documentation and dissemination of complex data sets. The candidate will provide analysis, will process and normalize the data to ensure data integrity and will create queries, views and reports. The candidate will review, input reinsurance submission data, set up the Property pricing models, create a comparison to the expiring contract wording, and document files in the directory after business is bound. Communication with the underwriters is essential.