Review and process medical, supplemental, or dental claims according to benefits, eligibility, and guidelines.
Validate accuracy of medical codes, assess eligibility, and evaluate authorizations in claim submissions.
Meet or exceed quality and productivity goals while working independently in a virtual environment.
The Cigna Group is a health services company dedicated to improving the health and vitality of those they serve. It is a large organization with a focus on innovation and employee well-being.
Provide effective and timely customer service for members, providers, and insurers regarding health care claims.
Ensure timely follow-up and organize health insurance paperwork and medical records.
Communicate status updates, negotiate with providers, and appeal claim denials on behalf of plan members.
Included Health is a healthcare company delivering integrated virtual care and navigation. They aim to raise the standard of healthcare for everyone, offering care guidance, advocacy, and personalized virtual and in-person care.
Ensure timely and accurate adjudication and payment of medical claims.
Process appeals and disputes by gathering and verifying claim information.
Work independently and as part of a team to meet daily processing quotas.
Sana is a health plan solution built for small and midsize businesses, designed around integrated primary care. Founded in 2017, Sana is remote-first with a fully distributed team across the U.S., valuing curiosity, ownership, and speed.
Maximize reimbursement by collecting outstanding balances from insurance companies through claim follow-up and appeals.
Resolve aged claims via payer portals and outbound calls, escalating for reconsideration and up to three levels of appeals.
Identify denial trends and collaborate cross-functionally to improve upstream processes and prevent future denials.
CareDx is a leading precision medicine diagnostics company advancing care in transplant, specialty oncology, and cell therapy. The company partners with healthcare providers and biopharma organizations to improve patient outcomes through molecular diagnostics and digital health solutions.
Develop and manage a large block of stop loss business, applying underwriting rules and best practices to ensure profitability and compliance.
Collaborate with sales team to formulate successful sales strategies and maintain strategic relationships with brokers and TPAs.
Utilize underwriting tools and pricing models to make sound Specific and Aggregate Stop Loss pricing recommendations.
Crum & Forster provides market leading property & casualty, accident & health, specialty and standard commercial lines insurance solutions. They have 3000 employees and are consistently recognized as a great place to work, earning multiple workplace and wellness awards.
Manage and investigate lost time workers' compensation claims, including coverage, liability, and exposure.
Evaluate claims for settlement and negotiate with claimants and attorneys to resolve files timely.
Maintain accurate reserves and document all claim files with appropriate payments and updates.
Acrisure is a global fintech leader that connects clients with customized solutions across insurance, reinsurance, payroll, benefits, cybersecurity, and mortgage services. With revenue of nearly $5 billion and over 19,000 colleagues in 20+ countries, the company emphasizes entrepreneurial spirit, leadership, accountability, and collaboration.
Investigate and analyze Motor Vehicle Accident accounts to coordinate insurance benefits and resolve outstanding balances for clients.
Conduct online medical research, review medical records, and manage claim life cycles using proprietary systems and tools.
Communicate with payers, attorneys, and clients to resolve claims, handle denials, and identify trends for prevention.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its E360 RCM intelligent automation platform. The company is a multi-year recipient of the Top Workplaces award, ranked #1 by Black Book in 2024, and has been on the Inc. 5000 fastest-growing companies list for eleven years, fostering a culture centered on professional growth and employee investment.
Research and follow up on unpaid insurance claims via mail and phone.
Review and appeal underpaid or rejected claims, coordinating with collection agencies as needed.
Respond to customer inquiries, resolve billing discrepancies, and maintain accurate records.
Accendra Health simplifies healthcare by delivering essential products and services beyond traditional settings, with a focus on home-based care. With over 6,000 teammates across 250 locations nationwide under the Apria and Byram Healthcare brands, we are dedicated to personalized care and accessible health solutions.
Serve as a trusted resource for clients throughout the claims process, coordinating with carriers and account teams.
Monitor claim activity and advocate for prompt, clear communication on behalf of clients.
Maintain accurate documentation and identify complex claims for escalation.
Risk Services of Louisiana, a Leavitt Group affiliate, provides insurance services and claims advocacy. The company is part of a larger network that values client service and professional growth.
Manage and investigate workers' compensation lost time claims to determine compensability and benefit eligibility.
Collaborate with injured workers, employers, and medical providers to facilitate timely return to work and cost-effective outcomes.
Oversee litigation, negotiate settlements, and ensure compliance with jurisdictional requirements.
Encova Insurance is a provider of insurance products and services, specializing in workers' compensation and property insurance. The company fosters a collaborative and inclusive culture, offering challenging opportunities and emphasizing continuous learning and growth.
Prepare mortgage insurance claims on assigned agency or investor-acquired properties.
Complete reconciliation of all advances to be included in the claim.
Validate all necessary supporting documents needed for the claim.
LoanCare is a leading full-service mortgage loan subservicer serving banks and credit unions. Backed by Fortune 500 company Fidelity National Financial, they subservice over 1.8 million loans and have a seasoned team.
Handle inbound and outbound member and provider inquiries via phone, email, and chat with professionalism and empathy.
Provide accurate information on benefits, eligibility, claims, prior authorization, billing, and provider portal support.
Collaborate with internal teams to resolve complex cases, identify process improvements, and meet performance goals.
XO Health is the first health plan designed by and for self-insured employers, delivering a unified health experience for members, providers, and payers. We are growing a multi-disciplinary team of diverse and digitally empowered employees committed to rebuilding trust in healthcare through transformation.
Verify patient insurance eligibility and benefits prior to services and document findings accurately.
Post insurance and patient payments, research variances, and follow up on outstanding claims.
Perform provider documentation and coding audits to ensure CPT, ICD-10-CM, and modifier accuracy.
Brightline is a premier national youth mental health provider delivering high quality virtual and in-person care to families. Founded in 2019, Brightline has delivered care to tens of thousands of families and is backed by investors including Google Ventures and KKR.
Verify patient eligibility and analyze Medicaid claim payments to ensure proper reimbursement.
Review UB-04 billing components and prepare initial Medicaid bill packets with supporting documentation.
Conduct timely follow-up with payers, manage authorizations, and appeal denials as needed.
EnableComp provides specialty revenue cycle management solutions for healthcare organizations, using intelligent automation to improve financial sustainability for hospitals and health systems. Recognized as a Top Workplaces recipient and among the Inc. 5000 fastest-growing private companies for eleven years, the company fosters a family-oriented culture focused on employee growth.
Manage accident benefit claims from investigation through resolution, ensuring compliance with legislation and delivering outstanding customer service.
Investigate and assess Minor Injury Guideline (MIG) claims to determine coverage eligibility and appropriate outcomes.
Coordinate claim activities with claimants, legal representatives, and healthcare providers to facilitate timely resolutions.
The partner company operates in the insurance industry, focusing on accident benefits claims. They maintain a fully remote, collaborative team culture that values integrity and customer service.
Serve as primary liaison with adjusters and carriers, opening insurance claims and ensuring treatment progression.
Request, track, and organize medical records, bills, and police reports, resolving liens and subrogation issues.
Maintain case timelines, oversee demand preparation, and negotiate with insurance carriers to finalize cases.
EvenUp uses technology and AI to close the justice gap, empowering personal injury lawyers and victims. Backed by top VCs, the company is a fast-growing vertical SaaS firm with a collaborative culture.
Enroll practitioners in health plans accurately and timely, monitoring progress and ensuring completion.
Validate and maintain provider enrollment forms, applications, and tracking systems.
Communicate with internal teams to meet enrollment goals and target start dates.
Pediatrix Medical Group is one of the nation's largest providers of prenatal, neonatal and pediatric services. With a focus on team approach, the company is home to a diverse group of business professionals dedicated to improving patient lives.
Provide technical guidance and operational support for LTD claims management.
Mentor and coach case managers to improve decision-making and service quality.
Monitor KPIs, conduct audits, and identify trends to drive continuous improvement.
They specialize in Long-Term Disability claims management, providing technical guidance and operational support. They are a US-based organization with a remote-first culture, emphasizing continuous improvement and employee development.