Own the end-to-end lifecycle of enrollment data, from inbound 834 file processing through system validation and data entry to ongoing maintenance.
Perform systematic data validation and quality assurance, identifying anomalies, duplicates, and discrepancies while executing scheduled and ad-hoc audits.
Lead targeted data cleanup projects and collaborate cross-functionally with engineering, claims, and population health teams to resolve data issues.
Review assigned TEFCA directory entries against authoritative corroboration sources and apply the approved review methodology.
Research, validate, and reconcile healthcare directory data across multiple reference sources, documenting findings in Jira.
Classify entries using a four-tier disposition taxonomy and escalate exception-path entries to the Lead Analyst.
Broadway Ventures is an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB) that provides expert program management, technology, and consulting solutions to government and private sector clients. As a small business, they emphasize integrity, collaboration, and excellence in their tailored solutions.
Attend new client implementation meetings to discuss eligibility requirements and protocols.
Serve as a point of coordination for member eligibility issue identification and resolution with internal teams and external partners.
Proactively monitor system status and eligibility data to identify potential abnormalities impacting quality and accuracy.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including pharmacy benefit management and health benefit management. They are rebuilding trust in healthcare in the U.S. and value a diverse workplace, providing equal employment opportunities to all employees.
Perform accurate code assignments for ED records (facility and profee) while working remotely.
Be flexible, detail-oriented and have the ability to work independently.
Meet client productivity targets while maintaining coding quality of 95% or greater.
UASI is a company that values its employees! They have been awarded the Top Workplace award by the Cincinnati Enquirer in 2022 and 2023. Their 40 years in business contributes to the long tenure of their team.
Review and update client data accurately based on provided Style Guides.
Research and validate information using internal and external data sources.
Resolve data discrepancies and merge duplicate records.
Harbor provides expert services in strategy, legal technology, operations, and intelligence. With a globally integrated team of over 900 strategists, technologists, and specialists, they serve leading law firms and corporations, fostering a culture of deep knowledge and mutual respect.
Responsible for the review and processing of claims within the claims transactional system, according to plan benefits and contractual reimbursement terms.
Follows established policies and procedures to pay, pend for additional information, or deny claims.
Accountable to meet and maintain established department production and quality standards.
Evry Health is on a mission to bring humanity to health insurance by expanding benefits, increasing access and transparency, and featuring a personalized, human approach. Evry Health is the major medical division of Globe Life (NYSE:GL) with more than 3,000 corporate employees and 15,000 agents.
Validate incoming client files and ensure data quality.
Build reports and partner with teams to resolve data issues.
Urrly specializes in healthcare data ingestion and process improvement to drive patient outcomes. They operate a remote-first team with a focus on ownership and fairness in hiring.
Transfer data from vendor websites and internal Verse systems to finance spreadsheets
Track profitability of new customers
Great communication, ability to learn new things and take feedback when provided by leaders
Verse Medical is building the modern software infrastructure to make it happen. The platform connects the dots between providers, payors, and patients, ensuring people get the high-quality care they need, reliably and right where they live. We're growing fast and looking for people who are driven by this mission to join us!
Monitor and interpret CMS guidance for Medicare, Medicaid, and other healthcare programs.
Partner with internal teams to ensure compliance with regulations and contract obligations.
Maintain regulatory tracking documentation and support development of training materials.
HealthEdge provides healthcare software and services to payers and providers. It is a growing company with a focus on compliance and innovation, fostering a collaborative and remote-friendly culture.
Serve as primary coordinator for the Med-Psych Management Program, managing reports, member enrollment, and community resource databases.
Handle high-volume inbound communications and provide administrative support to ensure continuity of care.
Collaborate with internal teams and external partners to streamline workflows and act as a liaison between members and health plans.
Mindoula Health is a healthcare organization focused on behavioral health management, providing support through multidisciplinary teams and health plan partnerships. The company operates as part of a specialty population health management team with a culture that values collaboration and data-driven outcomes.
Handle inbound calls regarding STAT medical record requests.
Ensure prompt and courteous responses within performance standards.
Maintain accurate records and escalate issues as needed.
This organization manages the release of medical records in urgent timeframes. It maintains a remote workforce focused on customer service and compliance.
Analyze and investigate practitioner information using health information systems to distribute credentialing and enrollment packets.
Prepare and distribute data for state, federal, and commercial carriers, ensuring compliance with legal and regulatory requirements.
Collaborate with internal departments and partners to achieve accurate credentialing, timely enrollment, and compliant billing status.
OHSU is Oregon's only public academic health center, combining patient care with groundbreaking research and training the next generation of healthcare professionals. As Portland's largest employer, OHSU offers opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington, fostering an inclusive, anti-racist multicultural institution.
Act as main contact for assigned accounts, reviewing and verifying FMLA and Disability forms for compliance.
Pull and complete forms ensuring accuracy, handle high call volumes, and maintain production goals.
Log detailed information, update disclosures, and provide excellent customer service while protecting patient privacy.
MRO Clinics provides management and release of protected health information to healthcare facilities. The company focuses on compliance, accuracy, and world-class customer service.
Provides front desk support and customer service for the Admissions Department.
Assists with pre-screening and pre-qualifying potential students to ensure smooth admissions processing.
Performs clerical, data entry, and record-keeping tasks while maintaining confidentiality.
American Career College has educated students for careers in healthcare for over 40 years. The company has a collaborative, student-centric culture focused on professional growth.
Enter and update data accurately into company databases and spreadsheets
Review records for errors, inconsistencies, and missing information
Organize and maintain digital files and documentation
They are committed to creating a positive and supportive workplace where motivated individuals can succeed and grow. They may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses.