US Openings

• Develop easily-followed, well-structured work plans for analytical projects.
• Write efficient, logical programming code to implement data analyses.
• Produce clear, effective information displays for clients.
• Write project proposals, reports, and summary documents for delivery to client.
• Attend regular meetings with clients to arrive at a final product.
• Supervise supporting employees across various departments and experience levels.
• Manage workflow of multiple projects simultaneously.

• Experience with healthcare administrative data, healthcare benefit systems and insurance concepts.
• Familiarity with computer and statistical programming, especially SAS
• Advanced knowledge of Excel or related spreadsheet software.
• Attention to detail and a good sense for reasonable results.
• Excellent problem-solving, organizational and communication (written and verbal) skills.

This position requires a Bachelors degree in Mathematics, Statistics, Finance, Actuarial Science, or other related field with at least 2-3 years of experience. Master’s degree and/or other accreditations would be a plus.

• Prior experience in healthcare subrogation, property casualty insurance, workers compensation or law office work related to healthcare claims
• Prior experience in call center environment and track record of achieving goals and meeting client’s service level agreements
• Applicants with experience that demonstrate attention to detail, ability to communicate with a diverse range of customers and an ability to learn on the job
• Medical terminology knowledge along with knowledge of ICD-9 and CPT4 codes.
• The ability to communicate with a wide array of parties including members, medical providers, attorneys and insurance carriers
• Initiative, make things happen rather than reacting to situations
• Perseverance, try alternatives when first efforts fail
• Decision making, ability to make sound and timely decisions
• Organization, attention to detail, good fit with department culture
• Able to work in a fast paced environment with patters and workflows that change daily

A High school diploma with at least one year of experience as a call center representative or previous experience in subrogation, claims, medicals or insurance industries.

• Identify/work files to be audited through a query process
• Perform an extensive review accounts to determine if correct payments were made
• Review provider contracts/fee schedules, etc. to determine correct payment methodology
• Accurately re-price claims
• Document audit findings
• Evaluate current procedures for efficiency and accuracy. Recommend solutions for process improvements

• Minimum of 2-4 years of Medical Claim Processing, Coding or Billing experience
• Knowledge CMS pricing guidelines
• Strong knowledge of HCPC, CPT and other coding methodologies
• Spreadsheet, word processing, and database knowledge

• Transforming raw client data into standardized data warehouse tables
• Assessment of data quality and completeness
• Development of analytic approach and project plan
• Execution of analytic programming, interpretation and communication of findings

We are looking for strong analytical and planning skills, creativity, and excellent communication skills.

• Develop clear and well-structured analytic plans
• Create efficient and reusable SAS code to manipulate and analyze data
• Structure data displays to clearly communicate findings
• Summarize results in clear, succinct ways for senior level audiences

The successful applicant will be able to demonstrate programming skill, focus and initiative in learning and applying parts of the SAS system. Although SAS experience is preferred, we may waive the requirement for candidates with strong analytic and/or technical backgrounds. The following qualifications are desired:

• Healthcare or related experience
• Experience using an analytic package to process large volume data
• Ability to plan and design analytic activities
• Proven ability to manage multiple projects and competing deadlines
• Ability to analyze and solve complex problems
• Strong written and oral communication skills
• Ability to communicate complex data analytics clearly in written and oral presentations
• Ability to get and stay organized in a fast-paced environment
• Ability to work in a team environment and be flexible in taking on various projects
• Strong attention to detail
• Ability to deal responsibly with confidential information
• Bachelor’s degree in related field
• Record of academic and/ or business achievement

• Work with the program leads to recruit, interview and select the most suitable candidate for position vacancies
• Recruit and contract external contractors for review services
• Plan and conduct on-boarding and new employee orientation
• Conduct termination procedures and exit interviews for employee terminations
• Administer job descriptions, classification, job banding and salary for all positions within the organization
• Serve as a liaison between management and associates by handling questions, interpreting and administering policies and procedures and help resolve work-related problems/questions and disciplinary issues
• Provide current and prospective employees with information about policies and procedures, job responsibilities, compensation, opportunities for career advancement, and employee benefits
• Develop and/or administer special projects in areas such as market surveys, environmental studies, etc. to determine impact on Human Resource functions and policies and procedures
• Values continuous learning and fosters a climate for learning and development of self and others
• Special projects as assigned by the Director of Human Resources

A Bachelor’s degree with 3-4 years of human resources experience is a requirement. This employee must have experience with consultant recruiting and familiarity with an HRIS system (Paychex).

SCIOinspire offers a competitive salary and benefits package that includes Medical, Dental, and Vision benefits with Short term and Long term disability, Vacation time, and a 401(k) plan with a company match.

• Determine source of issues (hardware, software, user access, network etc.)
• Advise staff on appropriate action
• Provide recommendations on company hardware, software purchases
• Analysis and presentation of root cause data
• Log all requests and document resolutions for future reference
• Software and hardware Installations as needed
• Asset and software management
• Compliance with CMS Information Security Risk Assessment Methodology (RA)
• Assist and own complex items received from Level 1&2 support

• 4 Year college degree or equivalent.
• Working knowledge of fundamental operations of relevant software, hardware and other equipment; including but not limited to:

Virtualization-Xenserver

• Jumbo frames, management interfaces/isolation of networks, Iscsi management, Chassis management for blade, vlan, bonded adapters, pooled servers

Iscsi- San/NAS

• Dell Equalogic, creating and managing iscsi targets and luns, security based off IQN, thin provisioning, Buffalo NAS

Windows 2008/2003

• General member server configs encompassing multiple roles
• Active Directory
• Terminal Server including legacy 2003 server management, locked down applications through security groups/ACL, application optimization,/installation, static routing, MS licensing, licensing server

MS Exchange

• Server management, InfoStore management/backup, mailbox management Linux
• Debian and Centos, Apache, Squid using Kerberos/ntlm authentication, SPlunk, PureFTP
• General Linux setup, configuration, management Networking
• Primarily Cisco Switches, Cisco Network assistant and ASDM, VPN, Firewall rules, DMZ, Catalyst Switches and 4500 VOIP
• Fonality VOIP phone system general setup and configuration Hardware
• Dell Chassis/Blades/Fabric Cards
• RAID, DR, etc
• General Server hardware knowledge
• Rack management
• Cat5 cabling
• Other
• Sonicwall SSLVPN appliances, LANDesk Internet Gateway appliance, ZixVPM email encryption, Sonicwall CDP appliance, Dell Idrac, General Printer Networking (Dell, HP, Minoltas)
• WSFTP server, ESET Antivirus, PGP
• Knowledge of relevant call tracking applications
• Knowledge and experience of customer service practices
• Related experience and training
• Excellent technical and business analysis skills
• Must have hands on technical skills to create solutions while maintaining a positive attitude under sometimes stressful circumstances.
• Good oral and written communication

• Provide overall administrative leadership for marketing and lead/nurture a dynamic team
• Build a deep understanding of SCIOinspire’s services, products, and markets
• Assist with market segmentation, targeting and positioning of SCIOinspire’s services and products
• Build marketing material including white papers, case studies, and marketing communications
• Work closely with sales and product management teams to fine-tune positioning
• Build and nurture strong relations with key consulting and research organizations and business partners
• Implement best practices within the team and mentor new members
• Lead SCIOinspire’s public relations and work closely with contracted agencies (agency management)

• Must be from the healthcare industry (e.g. payer, provider, IT services, consulting, solution marketing, product marketing, presales, bid management)
• 6-8 years related experience, with a minimum of 2 years in a similar role managing a team
• Experience in Payer Analytics, Care Management and marketing to health plans, PBMs is a plus
• Strong understanding of US payer healthcare and PBM segments
• Strong communication, presentation, and logical reasoning skills
• Ability and track record of working cohesively with different departments including technology, operations, products, and internal/external stakeholders to meet marketing goals
• Strong appreciation for technology, networking, hosted/non-hosted solution and services built around platforms
• Should be proficient in all core marketing functions
• MBAs and Advanced Degrees strongly preferred

• Audit medical records to verify services were provided and charges are accurate
• Identify and document unbilled charges
• Maintain timely communication with Audit Coordinator regarding scheduling, completion and submission of audits
• Identify and communicate facility and provider specific issues that will impact audits
• Report any problems in the audit process to Manager for resolution
• Compile concise records and documentation on all audits performed
• Monitor facility profile for assigned facilities and update as needed
• Adhere to National Audit conduct code and professional performance standards
• Adhere to all National Audit policies and procedures as described in the National Audit Employee Handbook
• Comply with HIPAA and other regulations regarding confidentiality of patient information
• Perform other duties as assigned

• RN or LPN with current active license
• Minimum of 2 years experience with MDS completion/process
• Knowledge of RUG IV and RUG III Medicare reimbursement systems
• RAC-CT Certified Preferred
• Previous Auditing Experience
• Knowledge related to the billing of RUGs (HIPPS codes, Days of billing for each assessment type)
• Basic computer skills
• Detailed Oriented
• Knowledge of Skilled Nursing Facilities
• Familiarity with UB claim form
• Ability to identify and establish the skill (acuity) that establishes level of care.
• Medical Surgical nursing experience

• Audit medical records to verify services were provided and charges are accurate
• Identify and document unbilled charges
• Maintain timely communication with Audit Coordinator regarding scheduling, completion and submission of audits
• Identify and communicate facility and provider specific issues that will impact audits
• Report any problems in the audit process to Manager for resolution
• Compile concise records and documentation on all audits performed
• Monitor facility profile for assigned facilities and update as needed
• Adhere to National Audit conduct code and professional performance standards
• Adhere to all National Audit policies and procedures as described in the National Audit Employee Handbook
• Comply with HIPAA and other regulations regarding confidentiality of patient information
• Perform other duties as assigned

• RN or LPN with current active license
• Minimum of 5 years diverse clinical experience
• Previous auditing experience internal or external
• CPC, CCS or CMAS desired
• Basic computer skills
• Knowledge of Skilled Nursing Facilities
• Ability to identify and establish the skill (acuity) that establishes level of care.
• Medical Surgical nursing experience

• Perform administrative tasks in support of the office
• Coordinate all issues with landlord and any vendors providing services including janitors, water delivery, etc.
• Design, implement and monitor office policies and procedures
• Monitor and maintain office supplies inventory
• Procure office equipment for the office
• Oversee the telephone system
• Working with the CFO and other finance staff, maintain a complete and systematic set of records of business transactions. Manage expense reports, checks, and bills. Prepare related reports.
• Perform all billing and invoicing
• Keep track of time tracking systems
• Coordinate office staff activities to ensure maximum efficiency
• Manage current filing systems and ensure that they are maintained and current
• Ensure security and confidentiality of data

• Maintain company’s client revenue forecast and sales pipeline
• Develop and maintain active company client list (contacts, etc.)
• Provide account support for 1-2 clients
• Assist in development of client marketing communications
• Review, develop and edit PowerPoint presentations for senior management team
• Provide ongoing support to the client service team

• Four year college degree or equivalent
• 1-2 years work experience
• Strong skills in Microsoft applications (Word, Excel and PowerPoint)
• Accounting experience
• Knowledge of business and management principles

• Integration of healthcare data in various forms into comprehensive SAS-based warehouses for analysis
• Assessment of data quality using advanced statistics-based testing and validation techniques
• Interprets and analyzes outcomes data to accurately assess and demonstrate program performance of various healthcare interventions
• Coordinates and prioritizes analytic projects including client communication, planning, and identifying operational process flow
• Performs advanced statistical analyses including opportunity assessments, clinical and financial risk tracking, trend identification and predictive modeling exercises
• Provides interpretation of findings to both the internal executive team as well as client representatives using clear and concise methods

• The ideal applicant will have a strong background in mathematics and/or statistics with experience in healthcare analytics, outcomes research, and data mining/integration
• Applicants with experience that demonstrates excellent attention to detail
• Ability to communicate with a diverse range of customers and an ability to learn on the job
• Proven ability to manage various types of projects and the capability to work independently
• This employee must take the initiative to make things happen rather than reacting to situations
• Ability to plan and design analytic activities as well as analyze and solve complex problems
• Strong ability to communicate complex data analytics clearly in written and oral presentations
• Competency in SAS is strongly preferred.

This position requires a Bachelors or Masters degree in mathematics, statistics, epidemiology, biostatistics, or other related field with at least 2-3 years of experience in healthcare data analysis and/or healthcare data warehousing.

• Prior experience in healthcare subrogation, property casualty insurance, workers compensation or law office work related to healthcare claims
• Applicants with experience that demonstrates attention to detail
• Ability to communicate with a diverse range of customers and an ability to learn on the job
• Proven ability to manage various types of projects
• This employee must take the initiative to make things happen rather than reacting to situations
• Creative/lateral thinking - ability to identify alternative paths for investigating files and identify less obvious potential recovery sources
• Perseverance - try alternatives when first efforts fail
• Decision making - ability to make sound and timely decisions

An Associate’s degree with 2-3 years of administrative experience is a requirement. Bi-lingual (Spanish) is a plus.