The Daily Signal Media Group seeks an experienced journalist to serve as a news reporter covering Virginia state government and politics. This position will focus on delivering accurate and timely reporting on legislative sessions, policy developments, and political movements that affect citizens' daily lives. This is an independent contractor position and does not include benefits.

Position Overview

As our Virginia correspondent, you will be responsible for producing original news coverage that examines how government actions and policies impact communities. You will work independently to develop sources, identify newsworthy stories, and deliver compelling content that helps readers understand complex political issues.

Key Responsibilities

• Monitor and report on legislative sessions, committee hearings, and executive actions.
• Develop and maintain relationships with legislators, officials, policy experts, and other key sources.
• Write clear, accurate news stories on tight deadlines about state government activities.
• Produce in-depth analysis pieces examining major policy initiatives and their implications.
• Cover breaking political news and developments.
• Identify emerging trends in policy and politics that deserve coverage.
• File public records requests and analyze government documents.
• Maintain an active presence on social media platforms to share stories and engage with readers.
• Collaborate with editors on story development and editorial planning.

Location and Schedule

• Must be based in Virginia or willing to travel to Richmond.
• Position requires regular presence at the Virginia General Assembly during legislative sessions.
• Flexible schedule with availability for evening/weekend coverage as news warrants.

Rate / Salary

$300/article. Competitive contract rate commensurate with experience. Payment structure based on story production and performance. Travel expense reimbursement for approved coverage outside the capital region.

The Daily Signal is a digital-first news publication committed to factual, in-depth reporting on politics and policy.

Description of assignment (DoA) details

Attention! Please note that this is an Online Volunteering assignment. It's a short-term, task-based and non-contractual remote assignment; Online Volunteers are not UN Volunteers and do not receive any allowance or entitlements as part of the Online Volunteer assignment but receive a certificate of appreciation after successful completion. In addition, UNV is not involved in the selection process or collaboration.

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IOM21 hours ago

Monitorear noticias sobre panorama informativo con énfasis en migración

Venezuela (Bolivarian Republic of)

12 weeks

3

assignment(s)

Competitive recruitment

Advertisement end date:25/06/2026

General

Description of assignment title

Monitorear noticias sobre panorama informativo con énfasis en migración

Assignment country

Venezuela (Bolivarian Republic of)

Expected start date

Invalid Date

Number of Assignments

3

For how many hours per week will the volunteer be required?

16 - 20 hours per week

Host entity

IOM

Modality

Online

Duration

12 weeks

Sustainable Development Goal

• Reduced inequalities
  
  

Details

Mission and objectives

Establecida en 1951, la OIM es una organización que forma parte de las Naciones Unidas y, como la agencia líder de la ONU en el campo de la migración, trabaja en estrecha colaboración con socios gubernamentales, intergubernamentales y no gubernamentales. La OIM se dedica a promover la migración humana y ordenada en beneficio de todos. Lo hace brindando servicios y asesoramiento a gobiernos y migrantes.

Context

La Organización Internacional para las Migraciones (OIM) es la principal organización intergubernamental en el ámbito de las migraciones y forma parte del Sistema de Naciones Unidas. Desde su creación en 1951, la OIM trabaja en estrecha colaboración con los Estados y socios para promover una migración ordenada, segura y digna, en beneficio de las personas migrantes y las sociedades. Para fortalecer la toma de decisiones, la gestión de riesgos y la comunicación estratégica, es necesario contar con un monitoreo constante del ecosistema informativo del país. El apoyo de Voluntarios/as en Línea permitirá: Apoyar a anticipar riesgos reputacionales. Identificar narrativas que afectan la movilidad humana. Analizar menciones y visibilidad de acciones de la OIM. Proveer insumos para equipos técnicos y de gestión. Fortalecer la capacidad de respuesta comunicacional en situaciones sensibles.

Task description

Los/las Voluntarios/as en Línea apoyarán a la OIM Venezuela en el monitoreo diario de medios nacionales, regionales e internacionales, así como de redes sociales, para identificar noticias, tendencias y menciones relevantes sobre migración, alojamiento temporal, protección, gobernanza, salud, WASH, y actividades de la OIM en Venezuela, incluyendo estados claves como: Zulia, Bolívar, Táchira, Amazonas, Caracas, Apure y Falcón. También apoyarán a grupos de comunicación interagenciales del Sistema ONU en el monitoreo de noticias claves. Los principales entregables serán:

• Boletín diario (lunes a viernes) con titulares, resumen y enlaces de noticias identificadas en medios nacionales, regionales e internacionales.
• Monitoreo diario de redes sociales, con énfasis en menciones a OIM, temas migratorios, protección y tendencias asociadas.
• Alertas inmediatas cuando surjan temas críticos relacionados con movilidad, riesgos de protección o menciones sensibles a la OIM.
• Este apoyo permitirá fortalecer la toma de decisiones, la comunicación estratégica y la gestión de riesgos de la organización. El Voluntario(a) en Línea seleccionado estará supervisado y se le brindará la guía necesaria antes de comenzar la contribución. Al finalizar el apoyo el voluntario recibirá un certificado de reconocimiento por el apoyo realizado. Al finalizar la colaboración recibirán una evaluación y un certificado de apreciación emitido por UNV, para más información sobre las asignaciones en línea le recomendamos revisar el siguiente enlace: https://www.unv.org/become-online-volunteer
  
  

Assignment requirements

Required Experience

Formación o experiencia en comunicación, periodismo, análisis de datos, ciencias sociales o áreas afines. Capacidad para identificar información relevante y producir resúmenes claros. Manejo de herramientas de monitoreo digital, redes sociales y verificación de información. Habilidad para trabajar con palabras clave y metodologías de clasificación temática. Español avanzado (obligatorio). Disciplina para entregar productos a tiempo y trabajar de manera coordinada con un equipo remoto.

Languages

Spanish, Level: Native language, Required

Other information

Volunteerism is understood as a wide range of activities undertaken of free will, for the general public good, for which monetary reward is not the principal motivating factor.

Inclusivity statement

United Nations Volunteers is an equal opportunity programme that welcomes applications from qualified professionals. We are committed to achieving diversity in terms of gender, care protected characteristics. As part of their adherence to the values of UNV, all UN Volunteers commit themselves to combat any form of discrimination, and to promoting respect for human rights and individual dignity, without distinction of a person’s race, sex, gender identity, religion, nationality, ethnic origin, sexual orientation, disability, pregnancy, age, language, social origin or other status.

Scam warning

The United Nations does not charge any application, processing, training, interviewing, testing or other fee in connection with the application or recruitment process. Should you receive a solicitation for the payment of a fee, please disregard it. Furthermore, please note that emblems, logos, names and addresses are easily copied and reproduced. Therefore, you are advised to apply particular care when submitting personal information on the web.

Description of assignment (DoA) details

Attention! Please note that this is an Online Volunteering assignment. It's a short-term, task-based and non-contractual remote assignment; Online Volunteers are not UN Volunteers and do not receive any allowance or entitlements as part of the Online Volunteer assignment but receive a certificate of appreciation after successful completion. In addition, UNV is not involved in the selection process or collaboration.

Skip To Content

Select Section

Select Section

NO IMAGE AVAILABLE

IOM21 hours ago

Monitorear noticias sobre panorama informativo con énfasis en migración

Venezuela (Bolivarian Republic of)

12 weeks

3

assignment(s)

Competitive recruitment

Advertisement end date:25/06/2026

General

Description of assignment title

Monitorear noticias sobre panorama informativo con énfasis en migración

Assignment country

Venezuela (Bolivarian Republic of)

Expected start date

Invalid Date

Number of Assignments

3

For how many hours per week will the volunteer be required?

16 - 20 hours per week

Host entity

IOM

Modality

Online

Duration

12 weeks

Sustainable Development Goal

• Reduced inequalities
  
  

Details

Mission and objectives

Establecida en 1951, la OIM es una organización que forma parte de las Naciones Unidas y, como la agencia líder de la ONU en el campo de la migración, trabaja en estrecha colaboración con socios gubernamentales, intergubernamentales y no gubernamentales. La OIM se dedica a promover la migración humana y ordenada en beneficio de todos. Lo hace brindando servicios y asesoramiento a gobiernos y migrantes.

Context

La Organización Internacional para las Migraciones (OIM) es la principal organización intergubernamental en el ámbito de las migraciones y forma parte del Sistema de Naciones Unidas. Desde su creación en 1951, la OIM trabaja en estrecha colaboración con los Estados y socios para promover una migración ordenada, segura y digna, en beneficio de las personas migrantes y las sociedades. Para fortalecer la toma de decisiones, la gestión de riesgos y la comunicación estratégica, es necesario contar con un monitoreo constante del ecosistema informativo del país. El apoyo de Voluntarios/as en Línea permitirá: Apoyar a anticipar riesgos reputacionales. Identificar narrativas que afectan la movilidad humana. Analizar menciones y visibilidad de acciones de la OIM. Proveer insumos para equipos técnicos y de gestión. Fortalecer la capacidad de respuesta comunicacional en situaciones sensibles.

Task description

Los/las Voluntarios/as en Línea apoyarán a la OIM Venezuela en el monitoreo diario de medios nacionales, regionales e internacionales, así como de redes sociales, para identificar noticias, tendencias y menciones relevantes sobre migración, alojamiento temporal, protección, gobernanza, salud, WASH, y actividades de la OIM en Venezuela, incluyendo estados claves como: Zulia, Bolívar, Táchira, Amazonas, Caracas, Apure y Falcón. También apoyarán a grupos de comunicación interagenciales del Sistema ONU en el monitoreo de noticias claves. Los principales entregables serán:

• Boletín diario (lunes a viernes) con titulares, resumen y enlaces de noticias identificadas en medios nacionales, regionales e internacionales.
• Monitoreo diario de redes sociales, con énfasis en menciones a OIM, temas migratorios, protección y tendencias asociadas.
• Alertas inmediatas cuando surjan temas críticos relacionados con movilidad, riesgos de protección o menciones sensibles a la OIM.
• Este apoyo permitirá fortalecer la toma de decisiones, la comunicación estratégica y la gestión de riesgos de la organización. El Voluntario(a) en Línea seleccionado estará supervisado y se le brindará la guía necesaria antes de comenzar la contribución. Al finalizar el apoyo el voluntario recibirá un certificado de reconocimiento por el apoyo realizado. Al finalizar la colaboración recibirán una evaluación y un certificado de apreciación emitido por UNV, para más información sobre las asignaciones en línea le recomendamos revisar el siguiente enlace: https://www.unv.org/become-online-volunteer
  
  

Assignment requirements

Required Experience

Formación o experiencia en comunicación, periodismo, análisis de datos, ciencias sociales o áreas afines. Capacidad para identificar información relevante y producir resúmenes claros. Manejo de herramientas de monitoreo digital, redes sociales y verificación de información. Habilidad para trabajar con palabras clave y metodologías de clasificación temática. Español avanzado (obligatorio). Disciplina para entregar productos a tiempo y trabajar de manera coordinada con un equipo remoto.

Languages

Spanish, Level: Native language, Required

Other information

Volunteerism is understood as a wide range of activities undertaken of free will, for the general public good, for which monetary reward is not the principal motivating factor.

Inclusivity statement

United Nations Volunteers is an equal opportunity programme that welcomes applications from qualified professionals. We are committed to achieving diversity in terms of gender, care protected characteristics. As part of their adherence to the values of UNV, all UN Volunteers commit themselves to combat any form of discrimination, and to promoting respect for human rights and individual dignity, without distinction of a person’s race, sex, gender identity, religion, nationality, ethnic origin, sexual orientation, disability, pregnancy, age, language, social origin or other status.

Scam warning

The United Nations does not charge any application, processing, training, interviewing, testing or other fee in connection with the application or recruitment process. Should you receive a solicitation for the payment of a fee, please disregard it. Furthermore, please note that emblems, logos, names and addresses are easily copied and reproduced. Therefore, you are advised to apply particular care when submitting personal information on the web.

Description of assignment (DoA) details

Attention! Please note that this is an Online Volunteering assignment. It's a short-term, task-based and non-contractual remote assignment; Online Volunteers are not UN Volunteers and do not receive any allowance or entitlements as part of the Online Volunteer assignment but receive a certificate of appreciation after successful completion. In addition, UNV is not involved in the selection process or collaboration.

Skip To Content

Select Section

Select Section

NO IMAGE AVAILABLE

IOM21 hours ago

Monitorear noticias sobre panorama informativo con énfasis en migración

Venezuela (Bolivarian Republic of)

12 weeks

3

assignment(s)

Competitive recruitment

Advertisement end date:25/06/2026

General

Description of assignment title

Monitorear noticias sobre panorama informativo con énfasis en migración

Assignment country

Venezuela (Bolivarian Republic of)

Expected start date

Invalid Date

Number of Assignments

3

For how many hours per week will the volunteer be required?

16 - 20 hours per week

Host entity

IOM

Modality

Online

Duration

12 weeks

Sustainable Development Goal

• Reduced inequalities
  
  

Details

Mission and objectives

Establecida en 1951, la OIM es una organización que forma parte de las Naciones Unidas y, como la agencia líder de la ONU en el campo de la migración, trabaja en estrecha colaboración con socios gubernamentales, intergubernamentales y no gubernamentales. La OIM se dedica a promover la migración humana y ordenada en beneficio de todos. Lo hace brindando servicios y asesoramiento a gobiernos y migrantes.

Context

La Organización Internacional para las Migraciones (OIM) es la principal organización intergubernamental en el ámbito de las migraciones y forma parte del Sistema de Naciones Unidas. Desde su creación en 1951, la OIM trabaja en estrecha colaboración con los Estados y socios para promover una migración ordenada, segura y digna, en beneficio de las personas migrantes y las sociedades. Para fortalecer la toma de decisiones, la gestión de riesgos y la comunicación estratégica, es necesario contar con un monitoreo constante del ecosistema informativo del país. El apoyo de Voluntarios/as en Línea permitirá: Apoyar a anticipar riesgos reputacionales. Identificar narrativas que afectan la movilidad humana. Analizar menciones y visibilidad de acciones de la OIM. Proveer insumos para equipos técnicos y de gestión. Fortalecer la capacidad de respuesta comunicacional en situaciones sensibles.

Task description

Los/las Voluntarios/as en Línea apoyarán a la OIM Venezuela en el monitoreo diario de medios nacionales, regionales e internacionales, así como de redes sociales, para identificar noticias, tendencias y menciones relevantes sobre migración, alojamiento temporal, protección, gobernanza, salud, WASH, y actividades de la OIM en Venezuela, incluyendo estados claves como: Zulia, Bolívar, Táchira, Amazonas, Caracas, Apure y Falcón. También apoyarán a grupos de comunicación interagenciales del Sistema ONU en el monitoreo de noticias claves. Los principales entregables serán:

• Boletín diario (lunes a viernes) con titulares, resumen y enlaces de noticias identificadas en medios nacionales, regionales e internacionales.
• Monitoreo diario de redes sociales, con énfasis en menciones a OIM, temas migratorios, protección y tendencias asociadas.
• Alertas inmediatas cuando surjan temas críticos relacionados con movilidad, riesgos de protección o menciones sensibles a la OIM.
• Este apoyo permitirá fortalecer la toma de decisiones, la comunicación estratégica y la gestión de riesgos de la organización. El Voluntario(a) en Línea seleccionado estará supervisado y se le brindará la guía necesaria antes de comenzar la contribución. Al finalizar el apoyo el voluntario recibirá un certificado de reconocimiento por el apoyo realizado. Al finalizar la colaboración recibirán una evaluación y un certificado de apreciación emitido por UNV, para más información sobre las asignaciones en línea le recomendamos revisar el siguiente enlace: https://www.unv.org/become-online-volunteer
  
  

Assignment requirements

Required Experience

Formación o experiencia en comunicación, periodismo, análisis de datos, ciencias sociales o áreas afines. Capacidad para identificar información relevante y producir resúmenes claros. Manejo de herramientas de monitoreo digital, redes sociales y verificación de información. Habilidad para trabajar con palabras clave y metodologías de clasificación temática. Español avanzado (obligatorio). Disciplina para entregar productos a tiempo y trabajar de manera coordinada con un equipo remoto.

Languages

Spanish, Level: Native language, Required

Other information

Volunteerism is understood as a wide range of activities undertaken of free will, for the general public good, for which monetary reward is not the principal motivating factor.

Inclusivity statement

United Nations Volunteers is an equal opportunity programme that welcomes applications from qualified professionals. We are committed to achieving diversity in terms of gender, care protected characteristics. As part of their adherence to the values of UNV, all UN Volunteers commit themselves to combat any form of discrimination, and to promoting respect for human rights and individual dignity, without distinction of a person’s race, sex, gender identity, religion, nationality, ethnic origin, sexual orientation, disability, pregnancy, age, language, social origin or other status.

Scam warning

The United Nations does not charge any application, processing, training, interviewing, testing or other fee in connection with the application or recruitment process. Should you receive a solicitation for the payment of a fee, please disregard it. Furthermore, please note that emblems, logos, names and addresses are easily copied and reproduced. Therefore, you are advised to apply particular care when submitting personal information on the web.

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At peopleworth, we support work where people and performance thrive. As part of our Employer Group, we work with a variety of forward-thinking partners and are excited to share this opportunity that sits within our growing group.

We are seeking an experienced Strategic Partnerships Director to lead and strengthen key partner relationships, drive operational excellence, and support the successful delivery of strategic education-focused initiatives. This role is ideal for a commercially minded relationship leader who combines strong account management capabilities with project coordination expertise and a passion for delivering exceptional stakeholder outcomes.

Role Overview

The Strategic Partnerships Director is responsible for managing and developing strategic partner relationships while ensuring the successful coordination and delivery of activities across multiple stakeholders. The role focuses on governance, reporting, risk management, stakeholder engagement, and identifying opportunities to strengthen long-term partnerships and support sustainable growth.

Working closely with internal teams and senior external stakeholders, you will act as a trusted advisor, ensuring commitments are delivered, issues are resolved efficiently, and partnership objectives are achieved.

Key Responsibilities

• Manage strategic partner relationships and act as a trusted point of contact for senior stakeholders
• Support the overall success of partnership engagements through proactive account management and stakeholder collaboration
• Oversee operational planning, risk management, and delivery activities across key phases of partner engagements
• Identify, manage, and resolve escalated issues while ensuring timely communication and effective outcomes
• Coordinate cross functional teams to ensure commitments are delivered and activities remain aligned with partnership objectives
• Prepare and present governance reports, business reviews, and performance updates for internal and external stakeholders
• Provide strategic insights and recommendations to improve partnership performance and long-term value creation
• Coach and guide internal teams on effective partner engagement practices and account management approaches
• Develop a deep understanding of partner objectives and identify opportunities to expand support and strengthen relationships
• Contribute to the development and improvement of partnership management processes, systems, and operational frameworks
  
  

Requirements

• Demonstrated experience in senior account management, partnership management, or client relationship leadership roles
• Minimum two years of experience managing key accounts, strategic partnerships, or complex stakeholder relationships
• Experience coordinating projects involving multiple internal and external stakeholders
• Strong client service orientation with a proven ability to build productive and trusted relationships
• Knowledge of digital education, online learning, higher education, or related sectors would be advantageous
• Excellent written and verbal communication skills, including the ability to prepare reports, presentations, and proposals
• Strong organisational skills with exceptional attention to detail and the ability to manage competing priorities
• Experience working independently while effectively collaborating with geographically distributed teams
• Demonstrated problem solving, decision making, and risk management capabilities
• Commitment to continuous learning, improvement, and professional development
  
  

Benefits

Collaborative, people-centred performance culture.

Opportunities to grow in a fast-paced environment.

Exposure to strategic stakeholder engagement and partnership leadership opportunities.

Opportunity to work with diverse teams across multiple regions and time zones.

Our Recruitment Process

The peopleworth Employer Group follows a fair, transparent, and multi-stage recruitment process designed to ensure mutual fit.

• Application Submission: Complete the online form and answer brief application questions.
• Initial Screening: Your application is reviewed for role alignment; successful candidates move to the longlist.
• Video Interview Stage: You'll be invited to record short responses to 3-4 role-specific questions.
• Live Interviews: Shortlisted candidates join first-round interviews (and, where applicable, second or third rounds depending on the role).
• Final Shortlist & Verification: Reference and background checks are completed.
• Offer & Contracting: Successful candidates receive formal offers and contract documents.
• Pre-boarding & Onboarding: Once accepted, you'll complete a pre-boarding process before officially joining your employing organisation within the Employer Group.
  
  

Throughout every stage, we value clear communication, respectful engagement, and timely feedback.

Let’s do great things, together!

About Moda

Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Position Summary

Investigates and processes claim adjustments for all medical lines of business and COB claim adjustments for Medicare/Medicaid plans. Also processes adjustments related to overpayment recovery, underpayment adjustments and other corrections. Performs COB updates (excluding Commercial), file reviews, issues adjustment related letters to members and providers, performs payment offsets and also validates and completes stop payment requests. Assists in customer service inquiries regarding contractual and administrative policies and applies excellent customer service when a phone call is needed to complete an adjustment or other support work. This is a FT WFH role.

Pay Range

$21.30 - $23.96 hourly, DOE.

• Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.
  
  

Please fill out an application on our company page, linked below, to be considered for this position.

https://j.brt.mv/jb.do?reqGK=27778915&refresh=true

Benefits

• Medical, Dental, Vision, Pharmacy, Life, & Disability
• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays
  
  

Required Skills, Experience & Education

• High School diploma or equivalent.
• Minimum of 6 months medical claim processing or customer service dealing with all types of plans/claims and consistently exceeding performance levels
• At least 12 months experience as a Processor I and consistently performing at an exceeding level of performance. Support Processor I designation may also be obtained through equivalent work experience and knowledge level at Moda Health or when recruiting externally.
• Professional and effective written and verbal communication skills
• 10-key proficiency of 135 wpm net on a computer numeric keypad.
• Type a minimum of 35 wpm net on a computer keyboard.
• Ability to show a pattern of maintaining balanced performance, which consistently exceeds expectations in areas of production and quality.
• Strong and proficient organizational abilities and the ability to handle a variety of functions
• Ability to efficiently multitask and work well under pressure and meet timelines.
• Ability to maintain confidentiality internally and externally and project a professional business image always.
• Strong analytical, problem solving, decision making and detail-oriented skills with ability to shift priorities as needed.
• Strong proficiency in claims processing systems; Facets, Word, and Excel.
• Excellent knowledge and understanding of Moda Health administrative policies affecting claims and customer service.
• Demonstrates work habits that consistently exceeds Moda Health standards of attendance and punctuality as well as high flexibility.
• Consistently communicates in a positive and effective manner, both written and verbal, to co-workers and management.
• Receives and carries out tasks in a cooperative manner and demonstrates a spirit of teamwork.
  
  

Primary Functions

• Performs basic and moderately complex claim adjustments within the system while interpreting coding and understanding medical terminology in relation to diagnosis and procedures as well as member plan benefits.
• Review, analyze, and resolve claims issues through the utilization of available resources for moderately complex claims.
• Analyze and apply plan concepts to claims that include deductible, coinsurance, copay, COB, and out of pocket, etc.
• Examines claims to determine if further investigation is needed from other departments and routes claims appropriately through the system.
• Adjudication and adjustment of claims to achieve quality and production standards applicable to this position.
• Release claims and adjustments by deadline to meet company, state regulations, contractual agreements, and group performance guarantee standards.
• Reviews Policies and Procedures (P&Ps) for process instructions to ensure accurate and efficient claims processing as well as providing suggestions for potential process improvements.
• Monitors and maintains unit inventory through adjustments, refunds, telephone calls and reports.
• Prepares and sends refund requests and other form letters.
• Reviews files, analyzes results, and organizes multiple adjustments and/or accumulator updates as needed.
• Processes voided checks, reissues payment or manual checks, and works stop payments of checks. Issues follow up correspondence letters as needed.
• Communicates via telephone with claimants, policyholders, providers, and other insurance carriers.
• Thoroughly documents actions as required by internal procedure and market conduct guidelines.
• Assists internal departments with programming issues as needed.
• Responds and follows up using Facets, Content Manager and E-mail.
• Provides back up to Medical Customer Service, COB and Medical Claims when requested.
• Performs all job functions with a high degree of discretion and confidentiality in compliance with federal, state, and departmental confidentiality guidelines.
• Perform other duties as assigned.
  
  

Working Conditions & Contact With Others

• Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need.
• Internally with Claims, Customer Service, Healthcare Services, Membership Accounting, Information Technology, and Professional Relations. Externally with Providers, Members, Vendors, and Insurance companies. May serve on committees and appeals.
  
  

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.

For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.

Let’s do great things, together!

About Moda

Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Position Summary

Investigates and processes claim adjustments for all medical lines of business and COB claim adjustments for Medicare/Medicaid plans. Also processes adjustments related to overpayment recovery, underpayment adjustments and other corrections. Performs COB updates (excluding Commercial), file reviews, issues adjustment related letters to members and providers, performs payment offsets and also validates and completes stop payment requests. Assists in customer service inquiries regarding contractual and administrative policies and applies excellent customer service when a phone call is needed to complete an adjustment or other support work. This is a FT WFH role.

Pay Range

$21.30 - $23.96 hourly, DOE.

• Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.
  
  

Please fill out an application on our company page, linked below, to be considered for this position.

https://j.brt.mv/jb.do?reqGK=27778915&refresh=true

Benefits

• Medical, Dental, Vision, Pharmacy, Life, & Disability
• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays
  
  

Required Skills, Experience & Education

• High School diploma or equivalent.
• Minimum of 6 months medical claim processing or customer service dealing with all types of plans/claims and consistently exceeding performance levels
• At least 12 months experience as a Processor I and consistently performing at an exceeding level of performance. Support Processor I designation may also be obtained through equivalent work experience and knowledge level at Moda Health or when recruiting externally.
• Professional and effective written and verbal communication skills
• 10-key proficiency of 135 wpm net on a computer numeric keypad.
• Type a minimum of 35 wpm net on a computer keyboard.
• Ability to show a pattern of maintaining balanced performance, which consistently exceeds expectations in areas of production and quality.
• Strong and proficient organizational abilities and the ability to handle a variety of functions
• Ability to efficiently multitask and work well under pressure and meet timelines.
• Ability to maintain confidentiality internally and externally and project a professional business image always.
• Strong analytical, problem solving, decision making and detail-oriented skills with ability to shift priorities as needed.
• Strong proficiency in claims processing systems; Facets, Word, and Excel.
• Excellent knowledge and understanding of Moda Health administrative policies affecting claims and customer service.
• Demonstrates work habits that consistently exceeds Moda Health standards of attendance and punctuality as well as high flexibility.
• Consistently communicates in a positive and effective manner, both written and verbal, to co-workers and management.
• Receives and carries out tasks in a cooperative manner and demonstrates a spirit of teamwork.
  
  

Primary Functions

• Performs basic and moderately complex claim adjustments within the system while interpreting coding and understanding medical terminology in relation to diagnosis and procedures as well as member plan benefits.
• Review, analyze, and resolve claims issues through the utilization of available resources for moderately complex claims.
• Analyze and apply plan concepts to claims that include deductible, coinsurance, copay, COB, and out of pocket, etc.
• Examines claims to determine if further investigation is needed from other departments and routes claims appropriately through the system.
• Adjudication and adjustment of claims to achieve quality and production standards applicable to this position.
• Release claims and adjustments by deadline to meet company, state regulations, contractual agreements, and group performance guarantee standards.
• Reviews Policies and Procedures (P&Ps) for process instructions to ensure accurate and efficient claims processing as well as providing suggestions for potential process improvements.
• Monitors and maintains unit inventory through adjustments, refunds, telephone calls and reports.
• Prepares and sends refund requests and other form letters.
• Reviews files, analyzes results, and organizes multiple adjustments and/or accumulator updates as needed.
• Processes voided checks, reissues payment or manual checks, and works stop payments of checks. Issues follow up correspondence letters as needed.
• Communicates via telephone with claimants, policyholders, providers, and other insurance carriers.
• Thoroughly documents actions as required by internal procedure and market conduct guidelines.
• Assists internal departments with programming issues as needed.
• Responds and follows up using Facets, Content Manager and E-mail.
• Provides back up to Medical Customer Service, COB and Medical Claims when requested.
• Performs all job functions with a high degree of discretion and confidentiality in compliance with federal, state, and departmental confidentiality guidelines.
• Perform other duties as assigned.
  
  

Working Conditions & Contact With Others

• Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need.
• Internally with Claims, Customer Service, Healthcare Services, Membership Accounting, Information Technology, and Professional Relations. Externally with Providers, Members, Vendors, and Insurance companies. May serve on committees and appeals.
  
  

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.

For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.

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