Sagility Remote Part Time Jobs Salary Jobs in Usa

5 positions found

UM RN Appeals Coordinator - Work from Home
$50 per hour
NY, WFH 6 days ago
Job title UM RN Appeals Coordinator - Work from Home About Sagility

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title:

UM RN Appeals Coordinator - Work from Home

Job Description:

About Sagility

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job Description:

BroadPath, a Sagility Company, is hiring UM RN Appeals Coordinator to join our remote team! Claims Processors are responsible for the accurate and timely entry, review, and resolution of medical claims ranging from simple to moderately complex. This includes reviewing front-end claims and validating information submitted by patients or providers seeking reimbursement from the insurance company. All claim processing must align with CMS guidelines and client-specific policies and procedures.

Schedules, pay rates, and program details may vary based on business needs and client assignment.

Compensation Highlights

  • Base Pay: up to $50 per hour
  • Pay frequency: Weekly pay

Schedule Highlights

  • Training Schedule: 2 weeks, Monday – Friday; 8:00 AM - 5:00 PM CST
  • Production Schedule: Monday – Friday; 8:00 AM - 5:00 PM CST (Flexible)

Responsibilities

A. Performs necessary review to ensure compliance with HHSC and other regulatory entities

  • Collaborate: Partners with the physician team to identify strategies for action and determine appropriate guideline citations or responses based on the category of denial
  • Develop: Creates training materials and examples for nursing staff to enhance understanding of criteria application, benefit use, and the appeal, External Medical Review (EMR), and Fair Hearing processes
  • Coordinate: Ensures continuity of care needs are met and advocates on behalf of Members and families for out-of-network authorization approvals
    Implement: Identifies problems, barriers, and opportunities within processes and develops resolutions or revisions as needed
  • Evaluate: Conducts quarterly assessments of appeal status and program activities, preparing reports for both the State of Texas and internal review
  • Analyze: Reviews requests against regulatory and decision-making guidelines and benefit allowances, implements actions in collaboration with the physician reviewer panel, and monitors timeliness, decision-making, and processing of appeals, EMRs, and State Fair Hearings in accordance with regulatory and accrediting standards

B. Performs all necessary communication and documentation functions

  • Communicates with internal staff, Members/LARs, physicians, hospital representatives, and other
  • Providers regarding case status, due process, rationale, and regulatory requirements
  • Coordinates Fair Hearing requests through TIERS when a Member/LAR or Provider requests an EMR or Fair Hearing
  • Utilizes an Independent Review Organization as needed for specialty or external reviews
  • Oversees documentation and recordkeeping of all case communications in compliance with accrediting requirements
  • Documents all activities and interactions in electronic and event tracking systems
    Generates appeal determination letters as appropriate

C. Collaborates with clinical reviewers, medical directors, external physician reviewers, and network Providers

  • Communicates with physicians on each case to establish the most appropriate course of action
  • Provides education to nurse and therapist reviewers regarding appeal updates and process changes
  • Maintains flexibility in scheduling, including evenings and weekends, to address pharmacy-related denials
  • Educates physician reviewers and clinical review staff on managed care and Medicaid policies and procedures

D. Conducts staff and medical director audits on appeal activities

  • Assists with appeal file preparation for NCQA file reviews
  • Supports the development of corrective action plans based on trended audit findings

E. Provides data for internal and external reporting

  • Analyzes quarterly trends in appeal types and sources
  • Reports appeal activity, type, and resolution, ensuring timely communication standards are met
  • Assists with state reporting in the required format and ensures timely submission to HHSC to avoid financial penalties

Knowledge and Skills

  • Demonstrates proficiency in applying advanced principles, concepts, and techniques central to nursing and ancillary therapy services within managed care, with emphasis on complex pediatrics and obstetrics
  • Ability to comprehensively assess Member and family medical needs, develop and implement plans of care, provide ongoing evaluation and monitoring, and deliver education to Members, families, Providers, and staff
  • Exemplary verbal and written communication skills, with proficiency in computer operation, word processing programs, fax machines, photocopiers, and multi-line telephones
  • Strong customer service orientation and advanced interpersonal communication skills with all levels of internal and external stakeholders, including medical staff, patients and families, clinical personnel, support staff, outside agencies, and community partners

Qualifications

  • RN license in an eNLC (Enhanced Nurse Licensure Compact) state with multistate privileges
  • 3+ years Nursing experience
  • 1+ years’ Utilization Management experience
  • Familiarity with medical terminology, utilization management guidelines, and clinical documentation standards
  • Proficiency in Microsoft Office and experience working with healthcare systems or electronic medical records
  • Strong organizational and time management skills with the ability to work independently
  • Excellent written and verbal communication skills

At BroadPath, a Sagility Company, we believe that transparency, authenticity, and collaboration are the keys to building strong, connected remote teams. If you are someone who values open communication, connection, and teamwork, you will thrive in our environment where showing up authentically matters.

Benefits:

  • Medical, Dental, and Vision coverage.
  • Life Insurance.
  • Short-Term and Long-Term Disability options.
  • Flexible Spending Account (FSA).
  • Employee Assistance Program.
  • 401(k) with employer contribution.
  • Paid Time Off (PTO).
  • Tuition Reimbursement.

BroadPath, a Sagility Company, may conduct background checks, previous employment verifications, and education verifications, based on position requirements


Diversity Statement

At BroadPath, a Sagility Company, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!

Equal Employment Opportunity/Disability/Veterans

If you need accommodation due to a disability, please email us at . This information will be held in confidence and used only to determine an appropriate accommodation for the application process

BroadPath, a Sagility Company is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.

Compensation: BroadPath a Sagility Company has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.

Location:

USAUnited States of America
Remote working/work at home options are available for this role.
Not Specified
View & Apply
Remote - Healthcare Customer Service Specialist
🏢 Sagility
$14 per hour
NY, Remote 2 weeks ago
Job title Healthcare Customer Service Specialist - Work from Home About Sagility

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title:

Healthcare Customer Service Specialist - Work from Home

Job Description:

BroadPath a Sagility Company is hiring experienced Healthcare Customer Service Specialists to join our remote team! These roles support healthcare members, patients, and providers by handling inbound and outbound calls, resolving inquiries, scheduling services, and ensuring a positive, professional experience.

We are looking for customer focused professionals with healthcare, insurance, or call center experience who can adapt quickly, communicate clearly, and deliver exceptional service.

Compensation Highlights

  • Base Pay: Starting at $14 per hour for training, with an increase after transitioning to production
  • Pay frequency: Weekly pay

Schedule Highlights

  • Schedules can fall between the hours of 8:00 AM - 9:00 PM Eastern Time and will be assigned based on business needs

Responsibilities

  • Answer inbound calls and place outbound calls to assist members or patients with inquiries, benefits, scheduling, and service coordination
  • Provide accurate information about health plan benefits, eligibility, and coverage
  • Schedule, reschedule, and confirm appointments with healthcare providers
  • Process referrals, authorizations, prescription renewals, and other requests
  • Assist members or patients with claims questions, billing inquiries, and account updates
  • Review insurance or plan eligibility and update records in the system
  • Maintain accurate documentation in electronic systems, including EMR or CRM tools
  • Communicate with providers and internal teams via phone, secure messaging, or email
  • Protect member and patient confidentiality and follow HIPAA or applicable privacy guidelines
  • Escalate complex issues to the appropriate team or supervisor for resolution

Qualifications

  • High School Diploma or equivalent
  • 1+ year of call center customer service experience handling high call volume
  • 1+ year of healthcare or health insurance experience (member services, patient services, provider services, benefits support, or similar)
  • Previous job tenure of at least 6 months per role, reflecting stability and reliability
  • Knowledge of privacy regulations and the ability to manage sensitive customer and account information with discretion, ensuring full compliance in a remote work environment
  • Strong verbal and written communication skills
  • Ability to navigate multiple systems and maintain accuracy while handling calls
  • Comfortable working in a remote environment with a designated, private workspace
  • Demonstrated stable work history with a track record of reliability
  • Commitment to a long-term role and building a career with the organization
  • Reliable high-speed internet

Preferred Qualifications

  • Experience with appointment scheduling or benefits inquiries
  • Familiarity with electronic medical records (EMR) or customer relationship management (CRM) systems
  • Experience with EPIC, Facets, or similar applications
  • Knowledge of medical and/or insurance terminology

At BroadPath a Sagility Company, we believe that transparency, authenticity, and collaboration are the keys to building strong, connected remote teams. Being on camera is an integral part of our culture. It is how we build relationships, share ideas, and stay engaged. If you are someone who values open communication, connection, and teamwork, you will thrive in our environment where showing up authentically matters.


What to Expect:

  • On-camera participation during interviews, training, team meetings, and regular check-ins.
  • Face-to-face discussions sparking collaboration and engagement
  • A supportive atmosphere where you can express yourself openly and be part of a team that values your contributions.

Benefits:

  • Medical, Dental, and Vision coverage.
  • Life Insurance.
  • Short-Term and Long-Term Disability options.
  • Flexible Spending Account (FSA).
  • Employee Assistance Program.
  • 401(k) with employer contribution.
  • Paid Time Off (PTO).
  • Tuition Reimbursement.

BroadPath a Sagility Company may conduct background checks, previous employment verifications, and education verifications, based on position requirements


Diversity Statement

At BroadPath a Sagility Company, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!

Equal Employment Opportunity/Disability/Veterans

If you need accommodation due to a disability, please email us at . This information will be held in confidence and used only to determine an appropriate accommodation for the application process

BroadPath a Sagility Company is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.

Compensation: BroadPath a Sagility Company has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.

Location:

USAUnited States of America
Remote working/work at home options are available for this role.
permanent
View & Apply
Healthcare Customer Service Specialist - Remote
🏢 Sagility
$14 per hour
NY, Remote 2 weeks ago
Job title Healthcare Customer Service Specialist - Work from Home About Sagility

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title:

Healthcare Customer Service Specialist - Work from Home

Job Description:

BroadPath a Sagility Company is hiring experienced Healthcare Customer Service Specialists to join our remote team! These roles support healthcare members, patients, and providers by handling inbound and outbound calls, resolving inquiries, scheduling services, and ensuring a positive, professional experience.

We are looking for customer focused professionals with healthcare, insurance, or call center experience who can adapt quickly, communicate clearly, and deliver exceptional service.

Compensation Highlights

  • Base Pay: Starting at $14 per hour for training, with an increase after transitioning to production
  • Pay frequency: Weekly pay

Schedule Highlights

  • Schedules can fall between the hours of 8:00 AM - 9:00 PM Eastern Time and will be assigned based on business needs

Responsibilities

  • Answer inbound calls and place outbound calls to assist members or patients with inquiries, benefits, scheduling, and service coordination
  • Provide accurate information about health plan benefits, eligibility, and coverage
  • Schedule, reschedule, and confirm appointments with healthcare providers
  • Process referrals, authorizations, prescription renewals, and other requests
  • Assist members or patients with claims questions, billing inquiries, and account updates
  • Review insurance or plan eligibility and update records in the system
  • Maintain accurate documentation in electronic systems, including EMR or CRM tools
  • Communicate with providers and internal teams via phone, secure messaging, or email
  • Protect member and patient confidentiality and follow HIPAA or applicable privacy guidelines
  • Escalate complex issues to the appropriate team or supervisor for resolution

Qualifications

  • High School Diploma or equivalent
  • 1+ year of call center customer service experience handling high call volume
  • 1+ year of healthcare or health insurance experience (member services, patient services, provider services, benefits support, or similar)
  • Previous job tenure of at least 6 months per role, reflecting stability and reliability
  • Knowledge of privacy regulations and the ability to manage sensitive customer and account information with discretion, ensuring full compliance in a remote work environment
  • Strong verbal and written communication skills
  • Ability to navigate multiple systems and maintain accuracy while handling calls
  • Comfortable working in a remote environment with a designated, private workspace
  • Demonstrated stable work history with a track record of reliability
  • Commitment to a long-term role and building a career with the organization
  • Reliable high-speed internet

Preferred Qualifications

  • Experience with appointment scheduling or benefits inquiries
  • Familiarity with electronic medical records (EMR) or customer relationship management (CRM) systems
  • Experience with EPIC, Facets, or similar applications
  • Knowledge of medical and/or insurance terminology

At BroadPath a Sagility Company, we believe that transparency, authenticity, and collaboration are the keys to building strong, connected remote teams. Being on camera is an integral part of our culture. It is how we build relationships, share ideas, and stay engaged. If you are someone who values open communication, connection, and teamwork, you will thrive in our environment where showing up authentically matters.


What to Expect:

  • On-camera participation during interviews, training, team meetings, and regular check-ins.
  • Face-to-face discussions sparking collaboration and engagement
  • A supportive atmosphere where you can express yourself openly and be part of a team that values your contributions.

Benefits:

  • Medical, Dental, and Vision coverage.
  • Life Insurance.
  • Short-Term and Long-Term Disability options.
  • Flexible Spending Account (FSA).
  • Employee Assistance Program.
  • 401(k) with employer contribution.
  • Paid Time Off (PTO).
  • Tuition Reimbursement.

BroadPath a Sagility Company may conduct background checks, previous employment verifications, and education verifications, based on position requirements


Diversity Statement

At BroadPath a Sagility Company, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!

Equal Employment Opportunity/Disability/Veterans

If you need accommodation due to a disability, please email us at . This information will be held in confidence and used only to determine an appropriate accommodation for the application process

BroadPath a Sagility Company is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.

Compensation: BroadPath a Sagility Company has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.

Location:

USAUnited States of America
Remote working/work at home options are available for this role.
permanent
View & Apply
Healthcare Customer Service Specialist - Work from Home
🏢 Sagility
$14 per hour
NY, WFH 2 weeks ago
Job title Healthcare Customer Service Specialist - Work from Home About Sagility

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title:

Healthcare Customer Service Specialist - Work from Home

Job Description:

BroadPath a Sagility Company is hiring experienced Healthcare Customer Service Specialists to join our remote team! These roles support healthcare members, patients, and providers by handling inbound and outbound calls, resolving inquiries, scheduling services, and ensuring a positive, professional experience.

We are looking for customer focused professionals with healthcare, insurance, or call center experience who can adapt quickly, communicate clearly, and deliver exceptional service.

Compensation Highlights

  • Base Pay: Starting at $14 per hour for training, with an increase after transitioning to production
  • Pay frequency: Weekly pay

Schedule Highlights

  • Schedules can fall between the hours of 8:00 AM - 9:00 PM Eastern Time and will be assigned based on business needs

Responsibilities

  • Answer inbound calls and place outbound calls to assist members or patients with inquiries, benefits, scheduling, and service coordination
  • Provide accurate information about health plan benefits, eligibility, and coverage
  • Schedule, reschedule, and confirm appointments with healthcare providers
  • Process referrals, authorizations, prescription renewals, and other requests
  • Assist members or patients with claims questions, billing inquiries, and account updates
  • Review insurance or plan eligibility and update records in the system
  • Maintain accurate documentation in electronic systems, including EMR or CRM tools
  • Communicate with providers and internal teams via phone, secure messaging, or email
  • Protect member and patient confidentiality and follow HIPAA or applicable privacy guidelines
  • Escalate complex issues to the appropriate team or supervisor for resolution

Qualifications

  • High School Diploma or equivalent
  • 1+ year of call center customer service experience handling high call volume
  • 1+ year of healthcare or health insurance experience (member services, patient services, provider services, benefits support, or similar)
  • Previous job tenure of at least 6 months per role, reflecting stability and reliability
  • Knowledge of privacy regulations and the ability to manage sensitive customer and account information with discretion, ensuring full compliance in a remote work environment
  • Strong verbal and written communication skills
  • Ability to navigate multiple systems and maintain accuracy while handling calls
  • Comfortable working in a remote environment with a designated, private workspace
  • Demonstrated stable work history with a track record of reliability
  • Commitment to a long-term role and building a career with the organization
  • Reliable high-speed internet

Preferred Qualifications

  • Experience with appointment scheduling or benefits inquiries
  • Familiarity with electronic medical records (EMR) or customer relationship management (CRM) systems
  • Experience with EPIC, Facets, or similar applications
  • Knowledge of medical and/or insurance terminology

At BroadPath a Sagility Company, we believe that transparency, authenticity, and collaboration are the keys to building strong, connected remote teams. Being on camera is an integral part of our culture. It is how we build relationships, share ideas, and stay engaged. If you are someone who values open communication, connection, and teamwork, you will thrive in our environment where showing up authentically matters.


What to Expect:

  • On-camera participation during interviews, training, team meetings, and regular check-ins.
  • Face-to-face discussions sparking collaboration and engagement
  • A supportive atmosphere where you can express yourself openly and be part of a team that values your contributions.

Benefits:

  • Medical, Dental, and Vision coverage.
  • Life Insurance.
  • Short-Term and Long-Term Disability options.
  • Flexible Spending Account (FSA).
  • Employee Assistance Program.
  • 401(k) with employer contribution.
  • Paid Time Off (PTO).
  • Tuition Reimbursement.

BroadPath a Sagility Company may conduct background checks, previous employment verifications, and education verifications, based on position requirements


Diversity Statement

At BroadPath a Sagility Company, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!

Equal Employment Opportunity/Disability/Veterans

If you need accommodation due to a disability, please email us at . This information will be held in confidence and used only to determine an appropriate accommodation for the application process

BroadPath a Sagility Company is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.

Compensation: BroadPath a Sagility Company has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.

Location:

USAUnited States of America
Remote working/work at home options are available for this role.
permanent
View & Apply
Work from Home: Customer Service Representative (Healthcare)
🏢 Sagility
$11 to $14 per hour
Dallas, TX, WFH 1 month ago
Job title Work from Home: Customer Service Representative (Healthcare) About Sagility

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

Job title:

Work from Home: Customer Service Representative (Healthcare)

Job Description:

Elevate Your Career with Sagility
Sagility, a global leader in business process management, is dedicated to enhancing the member and patient experience. By combining cutting-edge technology with decades of healthcare expertise, we deliver exceptional results for our clients.

Become Part of a Team That S.O.A.R,s!

  • S Spark Curiosity
  • O One Team, One Direction
  • A Action for Results
  • R Right by Right Purpose

We are passionate about shaping careers and are hiring Remote Customer Service Representatives for our call center team. Be the compassionate

human connection that makes our service exceptional.

Benefits You Will Enjoy:

  • Competitive pay: $11.00 to $14.00/hour (bilingual representatives: $15.00/hour).
  • Performance-based incentives.
  • Paid training in a cutting-edge virtual training environment.
  • Comprehensive health coverage (available after 90 days).
  • Employee wellness and engagement programs.
  • Career advancement opportunities: 90% of our leaders started as Customer Service Representatives.

Your Role:

  • Handle incoming calls promptly and professionally.
  • Research and provide effective resolutions to customer inquiries.
  • Accurately document call details.
  • Communicate empathetically and diplomatically with clear, professional articulation.
  • Meet team goals for quality and customer satisfaction daily.

What You Bring to the Table:

  • Commitment to excellence and a positive attitude.
  • Strong communication and interpersonal skills.
  • Comfort in a fast-paced, team-oriented environment.
  • Proficiency in navigating computer applications.
  • Desire to exceed customer expectations and grow professionally.
  • Previous healthcare experience is a plus.
  • At least 1 year of experience in a call center environment is required.

Job Requirements:

  • Must be 18 years or older.
  • High School Diploma or equivalent.
  • Minimum of 1 year at a single job, preferably in customer service.
  • Reliable attendance, with no absences in the first 90 days.
  • Typing at least 25 WPM.
  • Hardwired internet connection with minimum speeds of 10 Mbps upload and 25 Mbps download.
  • Secure, private work area at home.
  • Flexible availability, including weekends.

Additional Perks:

  • Daily Pay.
  • Medical, Dental, and Vision coverage.
  • Life Insurance.
  • Short-Term and Long-Term Disability options.
  • Flexible Spending Account (FSA).
  • Employee Assistance Program.
  • 401(k) with employer contribution.
  • Paid Time Off (PTO).
  • Tuition Reimbursement.

Sagility is an Equal Opportunity Employer/Vet/Disability.

Location:

Texas (CST)United States of America
Remote working/work at home options are available for this role.
Not Specified
View & Apply
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