Formal Job Description:
The main function of the claims specialist is to analyzing claim denials, working with payers to resolve denials, tracking all denials by payer and denial category, trending recurring denials, and recommending process improvement or system edits to eliminate future denials.
Responsibilities:
• Research and re-bill unpaid claims
• Research and resolve accounts appearing on Follow-up Reports.
• Make appropriate decisions and calls to carriers to maximize reimbursement on accounts to be worked.
• Correct all errors on electronic error reports using all available information.
• Meet current production, utilization and quality standards.
• Participates in trainings/meetings with Payers, internal departments, offshore partners, Client contact(s) and TES Management, etc. to address trends in denials or unprocessed claims
• Assists in identifying current and/or potential billing issues specific to outstanding receivable
• Presenting data to appropriate parties and partnering to develop resolutions
• Participates in daily production assignments that will continue to develop understanding and knowledge of processing guidelines and expectations of respective client(s) payer mix
• Ability to take patient phone calls and assist Customer Service when business needs arise
• Review and analyze claim denials in order to perform the appropriate appeals necessary for reimbursement.
• Receives denied claims and researches appropriate appeal steps.
As part of a cross-functional Agile squad, chapter, and Agile Release Train (ART), the Lead Quality Engineer provides leadership and guidance within the Quality Engineering discipline. This role ensures delivery quality through strategic test planning, automation best practices, and mentoring team members. The Lead QE partners with product owners, developers, and other QEs to define quality standards, implement robust test strategies, and drive continuous improvement across the squad and tribe.
Work site address: Remote
Contract Length or Perm: 14 months with possible extension
Years of Experience: 3-20 years
Due to client requirements, applicants must be willing and able to work on a w2 basis. For our w2 consultants, we offer a great benefits package that includes Medical, Dental, and Vision benefits, 401k with company matching, and life insurance.
Rate: $62 - $72 / hr. w2
What you will be doing:
MUST HAVE SKILLS:
Active DirectoryExperience in testing in Identity and Authorization space (PING, OKTA, etc.)OktaPINGWhat you should have:
What will make you stand out:
Skills, experience, and other compensable factors will be considered when determining pay rate. The pay range provided in this posting reflects a W2 hourly rate; other employment options may be available that may result in pay outside of the provided range.
W2 employees of Eliassen Group who are regularly scheduled to work 30 or more hours per week are eligible for the following benefits: medical (choice of 3 plans), dental, vision, pre-tax accounts, other voluntary benefits including life and disability insurance, 401(k) with match, and sick time if required by law in the worked-in state/locality.
Please be advised- If anyone reaches out to you about an open position connected with Eliassen Group, please confirm that they have an Eliassen.com email address and never provide personal or financial information to anyone who is not clearly associated with Eliassen Group. If you have any indication of fraudulent activity, please contact InfoSec@eliassen.com.
About Eliassen Group:
Eliassen Group is a leading strategic consulting company for human-powered solutions. For over 30 years, Eliassen has helped thousands of companies reach further and achieve more with their technology solutions, financial, risk & compliance, and advisory solutions, and clinical solutions. With offices from coast to coast and throughout Europe, Eliassen provides a local community presence, balanced with international reach. Eliassen Group strives to positively impact the lives of their employees, clients, consultants, and the communities in which they operate.
Eliassen Group is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
Don’t miss out on our referral program! If we hire a candidate that you refer us to then you can be eligible for a $1,000 referral check!
Read LessEliassen is looking for a Data Architect to partner with other LOB's to help lead and execute the migration of commercial enterprise data from DB2 to a modern Cloud platform. This role combines hands-on development with strategic planning, ensuring a phased migration with strong data quality and reconciliation.
Work site address: Hybrid – 4 days onsite - Cincinnati, OH 45202
Contract Length or Perm: 8 months with possible extension
Years of Experience: 8-20 Years
Interview Process: Video and/or In-person
Due to client requirements, applicants must be willing and able to work on a w2 basis. For our w2 consultants, we offer a great benefits package that includes Medical, Dental, and Vision benefits, 401k with company matching, and life insurance.
Rate: $75 - $85 / hr. w2
MUST HAVE SKILLS:
Business Intelligence – Data EngineeringDB and SQL KnowledgePrevious large scale migration experienceNICE TO HAVE SKILLS:
Experience with Java and WebSphere Application Server (WAS 9)Familiarity with DevOps for date pipelines and big data frameworks (Spark, Hadoop)Knowledge of data modeling and automation frameworksPython or some ETL language skillsRequirements:
Experience with large-scale database migrations (10K+ customers, multiple LOBs).Strong understanding of Payments and Treasury Management products.Expertise in ETL processes, SQL, and Python for automation.Familiarity with Cloud data services (AWS, Azure, or GCP).Knowledge of data validation, reconciliation, and compliance best practices.Skills, experience, and other compensable factors will be considered when determining pay rate. The pay range provided in this posting reflects a W2 hourly rate; other employment options may be available that may result in pay outside of the provided range.
W2 employees of Eliassen Group who are regularly scheduled to work 30 or more hours per week are eligible for the following benefits: medical (choice of 3 plans), dental, vision, pre-tax accounts, other voluntary benefits including life and disability insurance, 401(k) with match, and sick time if required by law in the worked-in state/locality.
Please be advised- If anyone reaches out to you about an open position connected with Eliassen Group, please confirm that they have an Eliassen.com email address and never provide personal or financial information to anyone who is not clearly associated with Eliassen Group. If you have any indication of fraudulent activity, please contact InfoSec@eliassen.com.
About Eliassen Group:
Eliassen Group is a leading strategic consulting company for human-powered solutions. For over 30 years, Eliassen has helped thousands of companies reach further and achieve more with their technology solutions, financial, risk & compliance, and advisory solutions, and clinical solutions. With offices from coast to coast and throughout Europe, Eliassen provides a local community presence, balanced with international reach. Eliassen Group strives to positively impact the lives of their employees, clients, consultants, and the communities in which they operate.
Eliassen Group is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
Don’t miss out on our referral program! If we hire a candidate that you refer us to then you can be eligible for a $1,000 referral check!
Read Less*Onsite in Cincinnati, OH*
We are seeking a skilled Java Developer to join our team working on the Commercial Loan Notices AI projects. The ideal candidate will have a strong background in Java development and experience in mobile and web development. You will be responsible for managing Java/Java EE application development and providing expertise throughout the full software development lifecycle, from concept and design to testing.
Due to client requirements, applicants must be willing and able to work on a w2 basis. For our w2 consultants, we offer a great benefits package that includes Medical, Dental, and Vision benefits, 401k with company matching, and life insurance.
Rate: $70 - $80 / hr. w2
Skills, experience, and other compensable factors will be considered when determining pay rate. The pay range provided in this posting reflects a W2 hourly rate; other employment options may be available that may result in pay outside of the provided range.
W2 employees of Eliassen Group who are regularly scheduled to work 30 or more hours per week are eligible for the following benefits: medical (choice of 3 plans), dental, vision, pre-tax accounts, other voluntary benefits including life and disability insurance, 401(k) with match, and sick time if required by law in the worked-in state/locality.
Please be advised- If anyone reaches out to you about an open position connected with Eliassen Group, please confirm that they have an Eliassen.com email address and never provide personal or financial information to anyone who is not clearly associated with Eliassen Group. If you have any indication of fraudulent activity, please contact InfoSec@eliassen.com.
About Eliassen Group:
Eliassen Group is a leading strategic consulting company for human-powered solutions. For over 30 years, Eliassen has helped thousands of companies reach further and achieve more with their technology solutions, financial, risk & compliance, and advisory solutions, and clinical solutions. With offices from coast to coast and throughout Europe, Eliassen provides a local community presence, balanced with international reach. Eliassen Group strives to positively impact the lives of their employees, clients, consultants, and the communities in which they operate.
Eliassen Group is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
Don’t miss out on our referral program! If we hire a candidate that you refer us to then you can be eligible for a $1,000 referral check!
Read LessEliassen Group is looking for a Data Products Engineer who bridges business insight and technical expertise. This role focuses on analyzing and leveraging Payments and Treasury Management data to create innovative, automated solutions that deliver value across multiple business areas.
Work site address: Hybrid 4 days onsite - Cincinnati, OH 45202
Contract Length or Perm: 10 months+
Years of Experience: 10-20 Years
Due to client requirements, applicants must be willing and able to work on a w2 basis. For our w2 consultants, we offer a great benefits package that includes Medical, Dental, and Vision benefits, 401k with company matching, and life insurance.
Rate: $62 - $72 / hr. w2
· Analyze commercial data (Payments, entitlements) to identify opportunities for automation and efficiency.
· Design and implement data solutions that enable cross-functional use of data products.
· Act as a liaison between IT and business teams to gather and translate requirements.
· Create and interpret architecture diagrams and perform gap analysis to identify improvements.
· Write optimized SQL queries across Oracle, DB2, and SQL Server.
· Perform data validation and reconciliation testing to ensure accuracy.
MUST HAVE SKILLS
- Business Intelligence – Data Engineering
- Linux and AIX experience
- DB and SQL Knowledge
- Previous large scale migration experience
NICE TO HAVE SKILLS:
- Experience with Java and WebSphere Application Server (WAS 9)
- Knowledge of data modeling and automation frameworks
- Python or some ETL language skills
Qualifications:
· Strong understanding of Payments and Treasury Management products.
· Proficiency in SQL and experience with Oracle, DB2, and SQL Server.
· Ability to collaborate with both technical teams and business stakeholders.
· Experience with architecture documentation and gap analysis.
· Familiarity with data testing and reconciliation processes
Skills, experience, and other compensable factors will be considered when determining pay rate. The pay range provided in this posting reflects a W2 hourly rate; other employment options may be available that may result in pay outside of the provided range.
W2 employees of Eliassen Group who are regularly scheduled to work 30 or more hours per week are eligible for the following benefits: medical (choice of 3 plans), dental, vision, pre-tax accounts, other voluntary benefits including life and disability insurance, 401(k) with match, and sick time if required by law in the worked-in state/locality.
Please be advised- If anyone reaches out to you about an open position connected with Eliassen Group, please confirm that they have an Eliassen.com email address and never provide personal or financial information to anyone who is not clearly associated with Eliassen Group. If you have any indication of fraudulent activity, please contact InfoSec@eliassen.com.
About Eliassen Group:
Eliassen Group is a leading strategic consulting company for human-powered solutions. For over 30 years, Eliassen has helped thousands of companies reach further and achieve more with their technology solutions, financial, risk & compliance, and advisory solutions, and clinical solutions. With offices from coast to coast and throughout Europe, Eliassen provides a local community presence, balanced with international reach. Eliassen Group strives to positively impact the lives of their employees, clients, consultants, and the communities in which they operate.
Eliassen Group is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
Don’t miss out on our referral program! If we hire a candidate that you refer us to then you can be eligible for a $1,000 referral check!
Read LessAccount Executive Position: Cincinnati/Hybrid
TAKE YOUR CAREER TO THE NEXT LEVEL AS AN ACCOUNT EXECUTIVE:
Bring your sales expertise to Eliassen Group! You love to be challenged and will thrive in our collaborative environment as you identify prospects, build relationships with key decision makers, and make placements. This is an opportunity to have a major impact and use your entrepreneurial spirit to grow our business!
ALL ABOUT US
Eliassen Group is a leading strategic consulting company that provides business and IT services for our clients as they seek to transform and execute strategies that will drive exceptional outcomes. Leveraging over 30 years of success, we focus on professional services, talent solutions, and life sciences. Eliassen Group offers local community presence and deep networks. We are committed to positively impacting the lives of our employees, clients, consultants, and the communities in which we operate. Most recently, Energage named Eliassen Group a winner of the Top Workplaces Award, and we have been recognized as a US Best Managed Company. To learn more about our award-winning culture, visit the Eliassen Experience.
ALL ABOUT YOU AS AN ACCOUNT EXECUTIVE
You will become a key member of an exceptional team, all of whom possess a competitive spirit and like to have a lot of fun while enjoying great success.
With your exceptional communication skills, you’ll build client relationships that stand the test of time and ensure that when client needs arise, Eliassen Group will be their partner of choice.
Your work will never be dull as you’ll engage directly with your clients to identify strategic staffing solutions designed to support their business challenges and opportunities.
You will amaze your client with highly qualified candidates perfectly matched against their needs, hand-picked by a team of the top recruiters in the business.
You’ll have many cards up your sleeve empowered with knowledge of Eliassen Group’s extensive business solutions designed to meet the needs of even the most demanding clients.
HERE’S WHAT YOU’LL DO EVERY DAY AS AN ACCOUNT EXECUTIVE:
You will close business opportunities by identifying prospects, developing relationships with prospects, recommending solutions, and making placements.Because you are a driven sales professional, you’ll exceed the minimum activity metrics including calls and visits as outlined by your manager.You will qualify each req appropriately and convey the details to recruiters effectively.You will understand the differentiators and business value of each division within Eliassen Group in order to effectively cross sell our services. And you’ll be a strong team contributor, sharing your work ethic and knowledge.YOUR QUALIFICATIONS AS AN ACCOUNT EXECUTIVE MUST INCLUDE:
You live to sell and are passionate about the sales role in the Recruiting/Consulting industry. You have a proven successful track record of selling IT Staffing Solutions with a strong focus on hunting and developing new business.You have experience working in a staffing agency environment within the past 3 yearsYou possess the ability to work effectively with recruiters to convey accurate temperature of requirements and demonstrate effective level of client control.You work collaboratively with other divisions (Agile/Life Sciences) to effectively cross-sell our services and you love to transfer your work ethic and knowledge to others as you uphold Eliassen Group’s professional standards and reputation.You are a high energy individual with a strong sense of urgency, and you know how to develop repeat business.YOU’RE VERY PROUD OF THE EDUCATION AND SKILLS THAT YOU BRING TO THE TABLE AS AN ACCOUNT EXECUTIVE, INCLUDING:
Presentation Skills & Verbal CommunicationInternal CommunicationsProspecting & Closing SkillsPersistenceMeeting GoalsRecruiting & Interviewing SkillsPeople & Phone SkillsResults DrivenStrong organization and judgmentBase Range: $45,000 - $60,000
The base salary rate will be commensurate with experience level and past success. A competitive, tiered commission structure based on weekly spread is also provided.
W2 employees of Eliassen Group who are regularly scheduled to work 30 or more hours per week are eligible for the following benefits: medical (choice of 3 plans, some with an Employer HSA contribution), dental, vision, pre-tax accounts, other voluntary benefits, basic life and disability insurance, 401(k) with match, and PTO consisting of 10 holidays, 5 sick days (or more if required by law in the state/locality where you work), 15+ days of vacation (based on tenure), bereavement leave, and 6-8 weeks paid maternity/disability leave and 2-4 weeks paid parental leave (based on tenure).
Read Less