Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment ... assist team members in their analysis of data sets and trends. * Responsible for documenting ...
Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment ... assist team members in their analysis of data sets and trends. * Responsible for documenting ...
Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment ... assist team members in their analysis of data sets and trends. * Responsible for documenting ...
Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment ... assist team members in their analysis of data sets and trends. * Responsible for documenting ...
Remote Assistant Editor information
How does a Remote Assistant Editor typically collaborate with the post-production team to ensure smooth workflow?
As a Remote Assistant Editor, you will frequently interact with editors, producers, and other post-production staff via digital collaboration tools. Your responsibilities often include organizing footage, syncing audio and video, preparing project files, and managing file transfers to keep the editing process on track. Strong communication skills and proficiency with cloud-based platforms are essential to quickly address any workflow bottlenecks. While working remotely offers flexibility, it also requires proactive coordination to ensure everyone is aligned on project timelines and deliverables.
What are the key skills and qualifications needed to thrive as a Remote Assistant Editor, and why are they important?
To thrive as a Remote Assistant Editor, you need a solid background in editing, attention to detail, and a relevant degree in English, journalism, or communications. Familiarity with industry-standard editing tools like Adobe Creative Suite, Microsoft Office, and content management systems is typically required. Strong time management, communication, and the ability to work independently are essential soft skills for this remote role. These abilities ensure high-quality content production, efficient workflow, and effective collaboration with dispersed editorial teams.
What are Remote Assistant Editors?
Remote Assistant Editors are professionals who support the post-production process of films, television shows, or digital content from a remote location. Their responsibilities often include organizing footage, syncing audio and video, preparing project files for editors, managing media assets, and ensuring all technical aspects of editing run smoothly. They collaborate with editors and production teams using cloud-based tools and secure file-sharing platforms. This role requires strong technical skills, attention to detail, and effective communication, as well as familiarity with industry-standard editing software. Remote Assistant Editors play a crucial part in keeping the editing workflow efficient and organized, even when working from different locations.
What is the difference between Remote Assistant Editor vs Remote Content Writer?
| Aspect | Remote Assistant Editor | Remote Content Writer |
|---|---|---|
| Credentials | Editing certifications, degree in journalism or communications | Writing samples, degree in English, journalism, or related field |
| Work Environment | Collaborates with editors, publishers, and writers remotely | Creates original content independently or for clients remotely |
| Industry Usage | Publishing, media, online platforms | Marketing, blogging, media outlets |
| Search Intent | Editing, proofreading, content refinement | Content creation, article writing, blogging |
Remote Assistant Editors focus on reviewing and refining content, ensuring quality and consistency, often working closely with writers and publishers. Remote Content Writers primarily produce original content for various platforms. While both roles require strong writing skills, Assistant Editors emphasize editing and proofreading, whereas Content Writers concentrate on creating new material.
What are the most commonly searched types of Remote Editor jobs in Iowa? The most popular types of Remote Editor jobs in Iowa are:
What are popular job titles related to Remote Assistant Editor jobs in Iowa? For Remote Assistant Editor jobs in Iowa, the most frequently searched job titles are:
What job categories do people searching Remote Assistant Editor jobs in Iowa look for? The top searched job categories for Remote Assistant Editor jobs in Iowa are:
Lead Overpayment Recovery Analyst, Payment Integrity - Health Plan (Remote)
Passport Health Plan by Molina HealthcareDes Moines, IA • Remote
Full-time
Posted 24 days ago
Job description
JOB DESCRIPTION Job Summary
Provides lead level analyst support for health plan payment integrity activities. Partners with leaders and functional representatives to drive health plan financial performance through evaluation and execution of operational initiatives tied to payment integrity (PI) and provider claims accuracy. Makes recommendations that inform decisions which contribute to health plan strategy, and acts as a trusted voice in assessing and assisting resolution of complex business challenges that impact cost-containment and regulatory compliance.
Essential Job Duties
Business Leadership & Operational Ownership
Assists with and executes projects and tasks to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay edits, post-payment datamining, and overpayment recovery, to improve encounter submissions, reduce general and administrative (G&A) expenses, and drive positive operational and financial outcomes for all payment integrity (PI) solutions.
Manages scorable action items (SAIs) related to pre-pay editing, post-pay audit, and overpayment recovery initiatives to ensure health plan SAI targets are met.
Leads efforts to improve claim payment accuracy and financial performance without needing extensive oversight.
Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.
Serves as a thought partner to health plan leadership and provides well-reasoned recommendations that support short- and long-term business goals.
Partners with the network team to communicate recovery projects to ensure provider relations is informed and able to respond to provider inquiries.
- Analyze data to identify and develop new recovery opportunities
- Analyze data from Payment Integrity and Vendors against contracts, billing, and processing guidelines
- Collaborates with operational teams, enterprise stakeholders, and finance partners to proactively identify issues and implement resolution strategies.
- Conduct peer reviews of recovery concepts and offer recommendations for logical improvements; assist team members in their analysis of data sets and trends.
- Responsible for documenting policies and procedures related to concept approvals
- Conduct trainings and prepare training documentation for teams
- Other duties as assigned
Strategic Business Analysis
Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps.
Applies understanding of health care regulations, managed care claims workflows, and provider reimbursement models to shape payment integrity related recommendations and action plans.
Translates strategic needs into clear requirements, workflows, and solutions that drive measurable improvement.
Partners with finance and compliance to develop business cases and support reporting that ties operational outcomes to financial targets.
Applied Analytical Support
Uses data analysis tools/systems to support business analysis.
Validates findings and tests assumptions through data, and leads with contextual knowledge of claims processing, provider contracts, and operational realities.
Creates succinct summaries and visualizations that enable faster leadership decision-making.
Required Qualifications
At least 4 years of business analyst experience in a managed care organization (MCO), and at least 2 years of experience in Medicaid and/or Medicare programs, or equivalent combination of relevant education and experience.
Proven experience owning operational projects from concept to execution, especially in the areas of provider reimbursement and claims payment integrity.
Strong working knowledge of managed care claims coding (Current Procedural Terminology (CPT), International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules.
Strong data analysis/queries experience, and ability to analyze data to inform business decisions.
Strong business judgment, cross-functional coordination, and ownership of high-value deliverables.
Demonstrated ability to work independently and apply business judgment in a highly regulated, cross-functional environment.
Strong written and verbal communication skills, including ability to synthesize complex information.
Microsoft Office suite (including advanced Excel), and applicable software program(s) proficiency.
- Claims processing background
- Experience with Medicare, Medicaid, and/or Marketplace lines of business.
- Payment integrity (PI) programs
Preferred Qualifications
Experience with Medicare, Medicaid, and/or Marketplace lines of business.
Certified Business Analysis Professional (CBAP) or Certified Coding Specialist (CCS) certification.
Project management experience.
Familiarity with Medicaid-specific scorable action items (SAIs), operational cost-management efforts, payment integrity (PI) programs, and regulatory/compliance adherence.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $83,252 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.