9151476 - Claims Examiner Irving, TX 3 Months contract
Sigma Inc. is currently looking for a Claims Examiner in Irving, TX.
Shift Timings: Work Schedule: 5 Days - 8 Hours
Summary:
Responsibilities:
Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.Analyze medical claim information and take appropriate action for payment resolution in accordance with policies and procedures, desktops, processing guidelines, and federal regulations.Process medical claims submitted on CMS-1500 and CMS-1450/UB-04 claim forms from facilities, physicians, Home Health, Durable Medical Equipment providers, laboratories, etc.Work claim projects resulting from overpayments or underpayments related to manual processing errors, benefit updates, and/or contract, fee schedule changes.Process provider refunds, reconsiderations, and direct member reimbursements.Process medical claim adjustments, recovery of claim overpayments, and execution of claim batch adjudication.Solve moderately complex claims and escalate issues to the Claims Team Lead, Supervisor or Manager.Assist with database improvements and testing for system upgrades, conversions, or implementation of new processes.Serves as a resource to assist with training new associates, retraining current associates on new/updated desktops/policies and reports staff progress, deficiencies, and training needs to management.Sets high standards of performance and promotes teamwork to achieve established team goals, while maintaining a positive, professional attitude.Contacting/responding to internal and external customers for resolution on claim issues.Assist claims leadership to identify claim trends, gaps in workflow and create/update desktops and policies and procedures.Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals.Must be able to organize and prioritize work to meet deadlines.Have good judgment, initiative, and problem-solving abilities.Attention to detail is critical to ensure timely and accurate processing of claims.Consistently meet established productivity and quality standards.Follow CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent, or detect unauthorized disclosure of Protected Health Information (PHI).Performs other duties as assigned by management to support claims functions, which are focused on achieving both departmental and organizational objectives.Must be knowledgeable about medical terminology, CPT, HCPCS, ICD-10, Revenue Codes, CMS-1500 and CMS-1450/UB-04 claim forms and reimbursement methodologies.Must have excellent written, verbal, organizational and interpersonal communication skills.Must be proficient in Microsoft Office, Power Point, Excel, Word, Outlook, spreadsheet, and database skills.
Job Requirements:
37442268 Biopharmaceutical Manufacturing Technician, Athens, GA 6 months Contract
Sigma Inc is currently looking for a Biopharmaceutical Manufacturing Technician to work onsite at its clients location in Athens, GA
Shift Schedule : M-F, 8 am - 5 pm
Job Description:
Requirements :
High School Diploma or equivalent. Preferred laboratory experience and manufacturing experience. Working knowledge of cGMP and USDA requirements for Vaccine Manufacturing Results oriented and ability to meet firm deadlines while working in a complex and variable environment Basic math skills, equipment/process trouble shooting skills. Proficient with Microsoft Office and other database software systems. Excellent oral and written communication skills. Ability to work in a team environment. Demonstrated ability to problem solve. Read Less9165142 Credentialing Coordinator Senior , Irving, TX, 3 Months contract
Sigma Inc is currently looking for a Credentialing Coordinator Senior to work onsite with our team located in Irving, TX.
Schedule : 5 Days - 8 Hours Work Type: Full Time
Job Summary
Major Job Responsibilities
High School Diploma required 3 Years Related Experience preferred Licenses, Registrations, or Certifications Certified Provider Credentialing Specialist (CPCS) or Certified Medical Staff Coordinator (CMSC) preferred Responsible for all aspects of credentialing Serves as role model and mentor to others in interfacing relevant roles Preceptor to others in duties related to credentialing Cross trains other staff for major job responsibilities as appropriate for optimum functioning Serves as liaison between staff and administration Oversees credentialing activities Precepts and mentors designated staff personnel Coordinates staff with regulators May facilitate staff meetings May be responsible for the preparation of meetings, including production of agenda, documents for review and for personal review and preparation of staff in advance, as needed to facilitate informed participation. May be responsible for accurate and timely recording of meeting minutes. Assists staff in enforcing bylaws, rules and regulations, policies and procedures, and identifies /communicates the need for revisions and additions. Tracks current licensure required for staff. May record and track meeting attendance as required by staff bylaws for maintaining staff status. May provide support for staff and administration for Due Process Proceedings by attending hearings and appeals meetings and recording proceedings. Tracks monitoring/proctoring documentation necessary for the granting of special or new privileges to staff. Updates the database for the credentials, and keeps computer system current. May help coordinate staff functions Follows the CHRISTUS Guidelines related to the Health Insurance Portability and Protected Health Information ACT (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI). Collaborate with all other departments as appropriate and required to facilitate the completion of tasks/goals. Responsible for all aspects of compliance with the standards of credentialing and accrediting bodies. Communication, Coordination, Collaboration with all customers, internal and external Responsible for at least one major project that contributes to the strategic initiatives of the department. Serves as Liaison to staff in matters of credentialing and related issues. Manages projects and timelines to achieve highest quality work within allotted period.9165142 Credentialing Coordinator Senior , Irving, TX, 3 Months contract174601 Practice Assistant - Administrative, Methuen, MA, 13-Week Contract
Sigma, Inc., is looking for a Practice Assistant - Administrative to work on-site at Methuen, MA.
Shift timings: , 08:00 AM - 05:30 PM
Requirements:
174583 Practice Assistant - Administrative, Wayland, MA, 26-Week Contract
Sigma, Inc., is looking for a Practice Assistant - Administrative to work on-site within the Beth Israel Lahey Health Primary Care at Wayland, MA.
Shift timings: , 08:30 AM - 05:00 PM
Requirements:
14444 1st Shift Production Worker, Neosho, MO 5 Months Contract
Sigma Inc is currently looking for a Production Worker located in Neosho, MO
Shift: M – F 7:00am – 3:30pm (Saturdays when needed)
Steel-toe shoes required!
Pay Rate: $21.75/hr. Interviewing Onsite
"REQUIRED BACKGROUND CHECK AND DRUG TEST MUST BE COMPLETED BEFORE CANDIDATE STARTS THE ASSIGNMENT.
Job Description: -
Responsibilities:
Following daily schedules and work orders; setting up mixes. Scanning bags of ingredients to ensure proper inventory levels. Gathering and weighing pre-determined amounts of specific ingredients adhering to strict quality standards. Fill ingredients into proper containers; bags will require feeding through a sewing machine to close; take samples of ingredients and final products. Measuring and feeding batches of ingredients into production machinery. Using lifting equipment and forklift trucks. Packaging finish products and entering data into internal system (computer, scanner, and bar code software). Gathering and stacking bags in proper patterns for shipments; inspecting each bag to meet company's strict quality standards. Approve and release finish goods; wrap and move good to designated locations. Conducting product inspection and quality control; performing quality checks General housekeeping; cleaning and maintaining work areas and machineryRequirements:
High school diploma or equivalent Steel Toed Shoes Required. Ability to effectively communicate in one-on-one and in group situations; able to follow oral and written instructions. Understand, record, and verbalize detailed information accurately; basic math calculation skills. Able to lift up to 70 pounds, complete repetitious work, and work on feet for prolonged periods of time in a fast paced environment. Basic computer skills including use of scanners and bar code software. Must be able to pass a forklift training testShift Timings: 07.00 AM- 3:30 PM, 32 hpw, includes a 30 min break.
Weekend and Holiday Rotation Required
Week 1: Monday, Tuesday, Wednesday, Thursday, Saturday
Week 2: Sunday, Tuesday, Wednesday, Thursday, Friday
Job Description:
Major Responsibilities:
Register patients and accurately enter demographic, insurance, and related information into patient registration systemsObtain required patient signatures including HIPAA and Consent to Treat documentationVerify insurance eligibility, referrals, pre-authorizations, and pre-certificationsResolve insurance discrepancies and obtain required coverage informationVerify workers' compensation and automobile insurance coverage when applicableSchedule and arrive Radiology, Laboratory, and ancillary service appointmentsComplete Emergency Department and Labor & Delivery registrationsCoordinate services across multiple departments to support patient careCollect patient financial responsibilities including copays, deductibles, coinsurance, balances, and self-pay amountsPerform Surgical Day admissionsManage bed control, transfers, admissions, and discharge activitiesProvide patients with preparation instructions for scheduled services and proceduresAssess patient financial needs and coordinate referrals to financial counselingPerform clerical duties including records retrieval, faxing, filing, typing, transcribing, and mailingMaintain accurate records, logs, files, and departmental documentationComplete online death certificate registry documentationReceive and secure patient valuablesMonitor Patient Access and Revenue Cycle work queues to support accurate and timely billingMaintain compliance with departmental policies, quality standards, and safety regulationsParticipate in meetings, training, and continuous improvement initiativesPerform additional duties as assignedRequired:
Associate Degree or Healthcare-related certificate1–2 years of hospital registration, patient access, admissions, insurance verification, scheduling, or revenue cycle experienceEmergency Department, Labor & Delivery, or inpatient admissions experiencePrevious insurance authorization or verification experienceMinimum 1 year of healthcare patient access, patient registration, admissions, scheduling, insurance verification, medical front office, or healthcare customer service experience requiredExperience working in a fast-paced, high-volume healthcare environmentExperience collecting and verifying patient demographic and insurance informationStrong customer service and communication skillsStrong data entry skills with attention to detailTechnical Skills :
Experience with hospital registration systems (Epic, Cerner, Meditech, or similar)Knowledge of medical terminologyBilingual speaking, reading, and writing skills Proficient computer and data entry skillsExperience using Windows-based systems and navigating multiple applicationsAbility to accurately document and maintain patient informationOther Requirements:
Ability to work effectively in a team-oriented environmentEnglish speaking, reading, and writing proficiencyReliable attendance and punctualityAbility to work onsite in a hospital outpatient and Emergency Department environmentPreferred:
1-2 years of data entry and/or customer service experience Experience in hospital admissions, insurance, billing, scheduling or telephone customer service. Previous insurance verification experience. Bilingual speaking, reading, and writing skills. Demonstrated knowledge of medical terminology. Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.
Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents.
Physical Demands and Environmental Conditions:
Work is considered moderate. Position requires work indoors hospital outpatient and Emergency Department environment
3677 - Dental Hygienist , Boston, MA 6 Months Contract
Sigma Systems is currently looking for a Dental Hygienist to work onsite with our team in Boston, MA
Shift Schedule: MON - FRI 8:30am - 4:30pm
Responsibilities:
Requirements:
Vocational, Technical or Associates Degree and 1-3 years of relevant experience. Licensure as a Dental Hygienist under the state of Massachusetts. VENDOR shall ensure that all personnel assigned to UNIVERSITY have current licensing and/or certification throughout the term of the assignment.Provide Proof of Immunity (provider documentation or lab report) for the following: Measles, Mumps Rubella (MMR) ?vaccine #1 and #2 dates or titers indicating immunity; Hepatitis B - vaccine #1, #2, and #3 dates and Hepatitis B Surface Antibody titer indicating immunity, signed declination, or lab results indicating disease history; Varicella-zoster (Chicken Pox) - vaccine #1 and #2 dates; or provider documentation of disease, or titer indicating immunity; Adacel (Tdap; tetanus, diphtheria, acellular pertussis) given since 2005; Recent Tuberculosis (TB) skin test results, which is to be given once per year. Documentation of TST results must include dates given and read, and the millimeter (mm) of induration.
Read Less9159260 Provider Enrollment Specialist, Irving, TX, 3 months Contract
Sigma. Inc is currently looking for a Provider Enrollment Specialist to work onsite with our team located in Irving, TX.
Shift timings: Monday - Friday, 8 am - 5 pm, 40 hrs/week
Summary
Responsibilities
Collects and maintains data on providers for Medicare and Medicaid enrollment Prepares and submits applications to Medicare and Medicaid for new provider enrollments and existing provider updates; follows up by telephone or in writing, with carriers regarding application status Complies with Medicare and Medicaid provider enrollment guidelines Requests NPI numbers for providers and clinics as necessary and maintains NPI files Follows up, either by telephone or in writing, with insurance companies and patients regarding the processing of outstanding claims and/or appeals Generates various reports to identify outstanding claims issues with provider numbers and non-payment Communicates information to appropriate personnel Educates staff on corrections, e.g.. front-end entry errors in a positive, constructive manner Collects and reviews managed care contracts for correct billing and payment terms Identifies problem accounts and follows through to completion Reviews Athena correspondence and unpostables. Participates in company sponsored enrollment/credentialing meetings and other educational activities Participates in Billing System Training exercises and updates Assists in training on the Billing System software package when necessary Serves as a Superuser of the Billing System to be available to answer questions from the various clinics Follows the clients guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI) Maintains strict confidentiality Uses oral and written communication skills to effectively convey ideas in a clear, positive manner that is consistent with the Clients Mission Maintains established clients policies, procedures, objectives, quality assurance, safety, environmental and infection control Implements job responsibilities in a manner that is consistent with the clients Mission and Code of Ethics and supportive of clients Physician Group's cultural diversity objectives Performs other related work as required Other InformationEducation/Skills
High School Diploma or equivalent 1-3 years of Payer Enrollment experience Solid knowledge and utilization of PC applications to include WORD, EXCEL, ACCESS Excellent written and verbal communication skills Excellent organization and planning skills with demonstrated teamwork skills Proven ability to interact with all levels of management and other Associates Read Less9126747 Member Services Specialist, Irving, TX, 3 Months temp to permanent
Sigma Inc. is currently looking for a Member Services Specialist to work onsite with our team in Irving, TX.
Shift Timings: Monday to Friday 8 am to 5 PM
Summary:
Responsibilities:
Meets expectations of the applicable client competencies: leader of self, leader of others, or leader of leaders. Respond to inbound calls, emails, and member chat messages regarding healthcare-related questions and concerns. Adhere to established service level agreements (SLAs) and quality standards to consistently deliver excellent customer service about insurance benefits, claims, coverage, and other related inquiries. Assist members in navigating the healthcare system and understanding their rights and responsibilities. Investigate and resolve member complaints, issues, and escalations promptly and satisfactorily. Document all customer interactions and issue resolutions accurately and comprehensively in the CRM system. Collaborate with internal departments to facilitate issue resolution and ensure a seamless customer experience. Explain insurance plans, policies, and procedures to members, ensuring they understand their benefits and coverage clearly. Provide guidance on accessing healthcare services, locating in-network providers, and understanding pre-authorization requirements. Continuously enhance product knowledge and stay updated on industry trends and changes. Identify process improvement opportunities and provide recommendations to enhance the overall member experience. Proactively contribute to the development and implementation of customer service best practices. Collaborate with team members and management to improve operational efficiency and streamline workflows and customer satisfaction. Support USFHP, HIX, and NCHD LOB as needed. Participate in training sessions and professional development activities to enhance knowledge and skills.Requirements:
A High School diploma or equivalent is required. 0-2 years of customer service experience is preferred. Read Less