Remote Clinical Assistant & Analyst – LPN/LVN

Job Overview

  • Clinical License LPN
  • State(s) Nationwide

Full job description

Wellfleet, a Berkshire Hathaway company, delivers customer-centric accident and health insurance, with quality service and uncompromising ethics. Wellfleet works to protect people against risk throughout every stage of life – from grade school to college to the workplace.

Founded in 1993 as Consolidated Health Plans (CHP), Wellfleet, headquartered in Springfield, Mass., is one of the nation’s leading providers of health and accident insurance products to the higher education market.

The Clinical Assistant and Analyst is responsible for supporting the Clinical team with various activities and tasks. A primary focus is data entry, collection, aggregation, auditing, analysis, and summarization to support clinical quality oversight and regulatory reporting needs. Another area of focus is support with appeals and fraud, waste, and abuse activities. This individual will be tasked with clinical research, data analysis, and review of medical coding/billing and medical records, so applicable healthcare experience is essential.

In this role, you will…

  • Assist with triage of emails and tasks sent to Clinical email and claims system inboxes.
  • Enter, collect, aggregate, audit, analyze, and summarize vendor, clinical, and claims data as needed and assigned to support the preparation of regulatory submissions and mental health parity analyses.
  • Gather case management reports and related records for nurse review.
  • Conduct outgoing calls to health care provider offices and facilities to gather information necessary for nurse review.
  • Assist Clinical staff with utilization management and case management oversight.
  • Assist company with detection of high cost claimants and prediction of future costs on an ongoing basis.
  • Support Appeals and Payment Integrity/Fraud, Waste, and Abuse activities.
  • Administrative support with facilitation of Wellfleet’s Quality Management Program and assigned subcommittee(s).
  • Coordinate with applicable vendors/delegates to address organizational objectives and maintain compliance.
  • Works to continuously refine and improve processes and workflows surrounding Clinical job duties.
  • Assist Pharmacy team with related data analysis, reporting, and clinical research tasks as assigned.
  • Perform other duties as assigned.

We are looking for candidates with…

  • Requires 3+ years of experience with office management as a Certified Medical Assistant, or an equivalent combination of education and experience.
  • Licensed Practical Nurse or Certified Nursing Assistant preferred.
  • Desired skills include medical data entry, medical coding/billing, and medical record review.
  • Working familiarity with ICD-10, CPT/HCPCS codes, and medical terminology.
  • Excellent computer skills, including MS office products and strong proficiency with Excel.
  • Strong analytical and organizational skills with attention to detail, accuracy, and timeliness.
  • Proficient interpersonal and collaboration skills with the ability to work independently.

Why Wellfleet?

Here at Wellfleet, we foster a culture of growth that enables engaged and high-performing professionals to be empowered to deliver our mission and vision.

Our employees are a team devoted to providing customer service that exceeds expectations of our members and clients. Successful team members continually look for ways to improve product delivery and value.

Wellfleet offers a competitive compensation package and comprehensive benefits package including life, health and dental, vision, 401K retirement plan, short- and long-term disability coverage, flexible/dependent care spending account, tuition reimbursement, and business casual dress.

Are you interested in exploring a career at Wellfleet? Explore our open positions.

General:

Wellfleet is part of the MedPro Group family. As such, all Wellfleet team members are employees of MedPro Group Inc. We are an Equal Opportunity Employer. The annual gross base salary range is $58,000 to $65,000. This range anticipates the low and high end of the salary for this position. Actual salaries will vary and are based on factors such as a candidate’s qualifications, skills and competencies. Salary is one component of Wellfleet’s total compensation and benefits package, which includes medical, vision and dental insurance options, life and accident insurance, 401(k), and short-term and long-term disability insurance. For a more detailed overview, visit our careers website at: wellfleetinsurance.com/about/careers.

 

Thanks for visiting!

The Remote Nurse is a large online community and Job Board specializing in Remote Clinical Jobs for Nurses, Nurse Practitioners, and Physician Assistants.

Follow us!