415 Support jobs in Irvine

Job Description

The Appeals Support Representative role directly supports the Clinical Appeals Specialist in the administrative functions of Denials and Appeals within the Utilization Review Team.

_ This is a full-time remote position that will work Monday through Friday, 8:00am-4:30pm EST or 8:30-5:00pm EST. _

Responsibilities:
• Complete outbound calls to payers for status updates on retro authorization requests and appeal submissions.
• Interact with third party insurance representatives and utilize online sites to review retro authorization and appeal status.
• Track and confirm weekly status updates on all outstanding appeal cases until final resolution.
• Request, track, and receive payer correspondence regarding approvals and denials to include acknowledgment letters and determination letters.
• Organize and scan all payer determination letters in KIPU charting system and update the Clinical Appeals Specialist within 24 hours of receipt.
• Document final appeal outcomes as well as case details in KIPU chart system and appeal spreadsheet.
• Responsible for obtaining patient and/or guardian signatures on required payer consent forms.
• Submit retro authorization requests, provide support for retro SCA projects, and follow up on retro auth submissions until final resolution.
• Identify problem cases and escalate issues to Clinical Appeals Specialist as appropriate.
• Attend and participate in all monthly UR Team meetings and all quarterly Denials meetings.
• Adhere to privacy and HIPAA guidelines.
• Perform and/or assist with special projects as assigned.

Qualifications:
Qualifications

• Associate’s degree required or High School Diploma plus 5-7 years of appeals and grievance experience; Bachelor’s degree preferred.
• Ability to work Monday through Friday, 8:00am-4:30pm or 8:30am-5:00pm EST.
• Ability to utilize and navigate Zoom and Microsoft Teams for remote meetings and IM chat.
• Strong Microsoft Office skills (Excel, Word, Outlook)
• Experience with insurance follow up and/or appeals and grievances required.
• Familiarity with medical billing, provider relations, and/or healthcare office experience required.
• Ideal candidate must be a self-starter with strong attention to detail, the ability to multi-task, a high level of organization, and excellent communication skills.
• Ability to remain flexible and adapt to changing situations.
• Excellent customer service skills and strong analytical skills.

Not sure if you meet all the qualifications? Apply anyway! To provide truly innovative care, we need to have a diverse team around us. That’s why Discovery Behavioral Health is committed to creating an inclusive environment. If you find yourself meeting some but not all the above, we’d be happy to consider your application.

Additional Information

We are proud to be an EEO employer M/F/D/V. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, or national origin.

For more information about our company benefits, please visit us at discoverybehavioralhealth.com/careers/

Discovery Behavioral Health seeks to build a diverse staff that is reflective of the patients we serve and the communities where we work. DBH encourages multiple perspectives, experiences, and strives to hire and retain a diverse workforce.

• Provides administrative support to the sales team.
• Identifies leads, prospects, and sales opportunities for the sales team through cold calls and emails.
• Communicate with leads and prospective customers to promote the Company's products and services that can enhance customer's success.
• Coordinates with the sales team to ensure smooth handoffs of qualified leads and prospects.
• Provides support in troubleshooting and resolving customer issues and concerns.
• Generates efficient and productive driving routes for the sales team.
• Inputs, reviews, and modifies customer information in applicable databases to ensure information is current as customer name, address, pick-up/drop-off times, and doctor preferences.
• Coordinates and distributes supplies and marketing materials requests.
• Maintains thorough knowledge of Company products, prices, sales, and promotions.
• Performs other related duties and projects as business needs require at direction of management.

Are you looking for an opportunity to get into sales? Do you love building relationships and helping others? Are you organized, detail oriented, and good at multi-tasking? If so, we should talk.We are Power Plus! A multi-industry leader in providing power when you need it, where you need it through intelligent and efficient power solutions. We work with Fortune 500 companies across the country such as Amazon, Wal-Mart, Costco, and more. We've built a 35-year reputation for excellence through our commitment to developing our people, providing exceptional, relationship-based customer service, and giving back to the community. Our biggest differentiator is the quality of our people, and the working environment we create for them, which really has to be seen to be believed.Currently we are seeking a candidate to join our Construction Services Sales team as a Junior Sales Representative.MedicalDentalVisionTraining and mentoring401(k) with matchingPaid sick leavePaid vacationJob Summary: This position provides essential support to existing sales representatives primarily throughout the Southern California region. This includes assisting multiple reps across various geographic areas and territories and may include support to other remote markets under special circumstances. The primary goal of this role is to streamline and enhance the sales process, enabling representatives to secure new business efficiently. Key responsibilities include coordinating utility company requirements for temporary power service applications, generating quotes, preparing handoff packets, conducting on-site customer meetings, cold calling, providing sales coverage during rep absences, competitor site visits, and proactive lead generation.JOB RESPONSIBILITIES:Build and grow relationships with each of the Sales Representatives in the Southern California market.Manage new sales opportunities at the discretion of sales rep and managementPrepare new quotes and proactively follow up on outstanding proposals.Create budget bids for upcoming projects.Creation of handoff packets once project is awarded.Prepare and submit utility company source verification packets, track their progress, manage revisions and addendums through final approval.Create and submit basic single-line diagrams using company templates provided.Cold calling for new relational development.Adhere to Power Plus! safety and quality standards.Other duties may be assigned as business needs require.COMPETENCIES/REQUIREMENTS:Proficiency in using MS office suite and CRM tools to manage workload.Must have the ability to travel within the Southern California market five days a week.If hired, must be able to verify eligibility to work in the United States and pass a pre-employment drug test.Must have a valid driver's licenseAbility to take direction from a multitude of sources.Eagerness to learn and grow.Strong oral and written communication abilities with the ability to grow and maintain relationships.An affinity for developing strong professional networks.Cross-functional collaboration with operations, sales and back office staff.Prospecting and lead generation using various sources, including social media.Proficiency in using MS office suite and CRM tools to manage workload.Ability to multitask within job duties.Pay Range: $50,000 -$60,000If you've always wanted to really make a difference, have your contributions mean something, and work for a place where loyalty, integrity, and hard work still means something, we want to hear from you!

Are you looking for an opportunity to get into sales? Do you love building relationships and helping others? Are you organized, detail oriented, and good at multi-tasking? If so, we should talk.We are Power Plus! A multi-industry leader in providing power when you need it, where you need it through intelligent and efficient power solutions. We work with Fortune 500 companies across the country such as Amazon, Wal-Mart, Costco, and more. We've built a 35-year reputation for excellence through our commitment to developing our people, providing exceptional, relationship-based customer service, and giving back to the community. Our biggest differentiator is the quality of our people, and the working environment we create for them, which really has to be seen to be believed.Currently we are seeking a candidate to join our Construction Services Sales team as a Junior Sales Representative.MedicalDentalVisionTraining and mentoring401(k) with matchingPaid sick leavePaid vacationJob Summary: This position provides essential support to existing sales representatives primarily throughout the Southern California region. This includes assisting multiple reps across various geographic areas and territories and may include support to other remote markets under special circumstances. The primary goal of this role is to streamline and enhance the sales process, enabling representatives to secure new business efficiently. Key responsibilities include coordinating utility company requirements for temporary power service applications, generating quotes, preparing handoff packets, conducting on-site customer meetings, cold calling, providing sales coverage during rep absences, competitor site visits, and proactive lead generation.JOB RESPONSIBILITIES:Build and grow relationships with each of the Sales Representatives in the Southern California market.Manage new sales opportunities at the discretion of sales rep and managementPrepare new quotes and proactively follow up on outstanding proposals.Create budget bids for upcoming projects.Creation of handoff packets once project is awarded.Prepare and submit utility company source verification packets, track their progress, manage revisions and addendums through final approval.Create and submit basic single-line diagrams using company templates provided.Cold calling for new relational development.Adhere to Power Plus! safety and quality standards.Other duties may be assigned as business needs require.COMPETENCIES/REQUIREMENTS:Proficiency in using MS office suite and CRM tools to manage workload.Must have the ability to travel within the Southern California market five days a week.If hired, must be able to verify eligibility to work in the United States and pass a pre-employment drug test.Must have a valid driver's licenseAbility to take direction from a multitude of sources.Eagerness to learn and grow.Strong oral and written communication abilities with the ability to grow and maintain relationships.An affinity for developing strong professional networks.Cross-functional collaboration with operations, sales and back office staff.Prospecting and lead generation using various sources, including social media.Proficiency in using MS office suite and CRM tools to manage workload.Ability to multitask within job duties.Pay Range: $50,000 -$60,000If you've always wanted to really make a difference, have your contributions mean something, and work for a place where loyalty, integrity, and hard work still means something, we want to hear from you!

Job DescriptionAre you a detail-oriented professional with a knack for managing vendor relationships and ensuring accuracy in order processing? Join our dynamic team as a Sales Support Representative and play a crucial role in our operations.ResponsibilitiesHere's what you'll be doing: Order Management: Review and process customer orders, including completing all necessary forms for transportation, packaging, legal requirements, and financial transactions. Audit and Compliance: Audit all forms and orders to confirm terms, conditions, allowances, and costs, ensuring compliance with company policies. Sales Support: Support ADW programs and maximize sales by understanding Costco objectives and building strong relationships with Costco ICS's and AB's. Invoice Management: Create and submit invoices to the Costco accounting portal, ensuring accuracy and timely submission. E-commerce Coordination: Ensure Costco receives high-resolution photos for every e-commerce item and add items to Instacart. Customs and Compliance: Review copies of CCI's and meat certificates for traceability, complete customs paperwork, and work with Customs Brokers to ensure proper routing of flagged loads. Regulatory Compliance: Complete Canada registration and Blue Bin/Stewardship forms in accordance with Canadian government regulations. International Shipping: Assist with Walk Global account setup for adherence to shipping standards for Japan, Korea, and Taiwan. Vendor Relations: Engage PPD and FOB carriers for status updates on loads and depot appointments, ensuring smooth cross-border shipping. Demo Coordination: Ensure vendor demos are scheduled and performed, tracking all materials needed for each demo. Promotion Management: Work closely with BM and AMM groups on promotion contracts, confirming actuals after events. Customer Support: Track and address member complaints and queries, sending replacement parts when needed. Market Knowledge: Maintain a comprehensive knowledge of the customer's operations and key competitors. Reporting and Documentation: Maintain accurate vendor-specific reports, item setups, and updated files for all item spec sheets and pricing. Team Collaboration: Meet with Business Managers weekly to review vendor support tasks and assist with meeting preparations. Administrative Support: Provide backup coverage for BM desks, assist with vendor and Costco meeting prep, and maintain promotion calendars. Sample Management: Purchase and deliver samples from Costco and other retailers, assisting with monthly competitive shopping. Organizational Maintenance: Maintain the Costco org chart and ensure all documentation is up to date.Qualifications Education: High School Diploma/GED required. Experience: Minimum of three years in business process solutions, customer service, or office administration, preferably in manufacturing, costing, pricing, distribution, or product line management. Proven food broker experience is a plus. Skills: Strong interpersonal, organizational, and administrative skills. Proficiency in MS Office (Word, Excel, Outlook) Attention to detail and strong problem-solving skills are essential. Confidentiality: Ability to protect and secure all confidential and proprietary information. Math Skills: Advanced math calculations to ensure accuracy in unit of measure conversions, pricing issues, weight of product, and multiple currencies. Work Environment and Physical Requirements Physical Effort: Moderate physical effort, including lifting materials and equipment weighing less than 15 pounds. Computer Use: Viewing a computer monitor for more than 30% of the time. Protective Equipment: Personal protective equipment may need to be worn. Join us and be part of a team that values precision, collaboration, and excellence in sales support. Apply today to make a significant impact in our operations!#DiscoverYourPathAbout UsAcosta is a part of Acosta Group - a collective of the industry's most trusted retail, marketing and foodservice agencies reimagining the way people connect with brands at every point in their shopping journey. Specializing in retail sales services, digital strategy, and business intelligence, Acosta empowers brands to thrive in the world of omnichannel shopping. Our sales and digital teams build lasting relationships, ensuring our client brands get the space they deserve in stores and outperform the competition online, while our merch reps make brands shine in retail locations across the world. But it's not just about what we do - it's about who we are. With a team of over 20,000 associates, we're a community of forward-thinking, value-driven professionals committed to an unmatched level of trust and transparency in the industry. And, we understand the importance of work-life balance, which is why many of our field roles provide our associates with flexible scheduling options. Join us and be a part of a team that values growth and making a real impact for our clients, retail partners and their customers. Acosta Group and its subsidiaries believe the posted compensation range accurately reflects this role at the time of posting. Final pay may vary based on qualifications and location, and the range may be updated in the future. Acosta Group is an E-Verify employer. By applying, you agree to our Privacy Statement and Terms of Conditions. US: Canada: We are an equal employment opportunity employer. Acosta is part of Acosta Group. To learn more about Acosta click here: