Responsible for timely billing and resolution of claims, with a focus on authorizations.
Manages the insurance approval process for hospice services, ensuring all levels of care are approved by payers to prevent denials.
Verify insurance eligibility and benefits for new and current patients including Medicare, Medicaid and private insurance at beginning of each month.
Ennoble Care is a mobile primary care, palliative care, and hospice service provider with patients in multiple states. They offer a variety of programs to ensure that their patients receive the highest quality of care by a team they know and trust.
Determine and verify insurance coverage and coordination of benefits.
Ensure proper, adequate, and timely billing for prompt payment.
Communicate with patients and practitioners regarding financial responsibility and insurance coverage issues.
UAB St. Vincent’s is a trusted healthcare provider that has been serving Alabama for over 125 years. They have five hospitals and numerous clinics, and their 4,800+ employees are committed to providing compassionate, personalized care and improving the health and lives of those they serve.
Perform outbound calls to obtain appropriate information and document accurately.
Answer in-bound calls and assist customers with pharmacy related services.
Contact insurance companies for benefit investigation and coverage eligibility.
IQVIA is a global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. They create connections that accelerate the development and commercialization of innovative medical treatments to improve healthcare and patient outcomes.
Develop collaborative relationships with insurance companies/payors to verify benefits and eligibility.
Enter and update patient demographics, guarantor, and insurance information in company systems.
Respond to inquiries from insurance companies and internal team members.
Equip is a virtual, evidence-based eating disorder treatment program ensuring everyone can access treatment. Founded in 2019, Equip has been fully virtual since its inception and is proud of their highly engaged team, with recognition from Time, Linkedin, and Lattice.
Acts as initial service ambassador to referral sources, physicians, patients, caregivers and other external customers providing the highest quality service.
Responsible for the initial entry, verification, and maintenance of information regarding new patients in all applicable software programs.
Processes private insurance verifications, verifies eligibility of Medicare, Medicaid and third party payers and any other duties as directed.
CommonSpirit Health at Home is a full-service health care organization that believes the best place for someone to get better is in their own home. As a faith-based organization, they are committed to finding new ways to improve the health of their patients and the health of the communities they serve.
Performs claims processing, insurance and charge verification, payment posting, account resolution, customer service and follow up.
Educates staff and physicians on CPT/HCPCS/ICD-10 codes and appropriate documentation requirements to reduce errors and remain compliant.
Works directly with staff when needed for insurance authorization assistance, IPA guidance and insurance optimization.
Community is committed to providing the highest standard of care. They value their diverse team members and offer various opportunities for growth and development.
Accountable for making decisions supported by policy based on confidential financial information to determine qualification for CICP, Charity programs, or payment arrangements.
Verify coverage and authorization for all scheduled procedures using scheduling and registration information; populate price estimate tool to decide patient portion.
Act as a liaison between patients, physicians, patient clinics, case management, centralized billing office, third party Medicaid eligibility vendor and community agencies.
CommonSpirit has over 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services and is accessible to nearly one out of every four U.S. residents. They are committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
Manage end-to-end case activities throughout the insurance verification and authorization process.
Serve as the single point of contact between the internal/external team, client, provider, payor, facility, and patient.
Provide support across multiple client programs, ensuring effective oversight, operational excellence, and consistent delivery of quality service.
PRO-spectus has created a culture that is supportive, dedicated, and teamwork driven. They celebrate each other’s joys in personal life and professional accomplishments, promoting meaningful relationships and friendships, with humility and compassion at our core.
Piedmont Healthcare serves as front line support for the Patient Connection Center. They focus on reviewing orders for outpatient hospital services to ensure completeness prior to scheduling and preparing for the patient visit by verifying patient insurance.
Enter patient referrals accurately and efficiently into the electronic referral portal in accordance with established workflows and timelines.
Review referral documentation for completeness and follow up with clinical staff to obtain missing information as needed.
Contact patients by phone or secure messaging to communicate referral status, appointment scheduling information, or follow-up instructions.
Ladder Health reimagines early childhood developmental care by delivering proactive, holistic, and family-centered support for children with or at risk of developmental delays. Built in collaboration with Boston Children’s Hospital, their virtual-first care model brings together expert clinicians, thoughtful technology, and a powerful belief: that every child deserves the chance to thrive.
Provide pre-service support and verify patient insurance benefits.
Contact insurance payers, confirm coverage details, and identify patient responsibilities.
Document all findings to facilitate accurate billing and address potential financial barriers.
CHI Health Clinic offers various healthcare services, including primary and specialty care, walk-in, and virtual services, with over 20 specialties and 100 convenient locations. They focus on providing better access to healthcare so individuals can prioritize their health.
Resolve claims rejections and denials in work queues as assigned.
Resolve outstanding claims based on an accounts receivable report.
Submit appeals to payors for non-payment of claims as needed.
Ennoble Care is a mobile primary care, palliative care, and hospice service provider with patients in multiple states. They offer a variety of programs designed to ensure patients receive the highest quality of care by a team they know and trust.
Contacts insurance companies to determine pre-authorization requirements.
Obtains pre-certification or pre-authorization before service.
Liaisons with physicians to obtain clinical information.
Piedmont Healthcare is a company focused on healthcare services. The job posting does not contain information about the company's size, employees, or culture.
Ensure coordination of provider invoice activities to support timely reimbursement.
Research and resolve claim denials that fail payer edits, preparing corrections and appeals.
Verify patient eligibility, benefits, and health‑plan information using payer databases.
CareCentrix supports value-based care by providing care management and transition of care services. They focus on improving patient outcomes and managing healthcare costs through a range of programs and services. The company values caring, doing the right things and striving for excellence.
Serve as a key point of contact for patients regarding billing questions, payment plans, and account resolution
Respond to inbound calls and proactively reach out to patients to collect past-due balances and arrange payments
Review and explain Explanation of Benefits (EOBs) to patients in a clear and supportive manner.
IVX Health is a national provider of infusion and injection therapy for individuals managing chronic conditions. They are transforming the way care is delivered with a focus on patient comfort and convenience, empowering their team to thrive while living their core values.
Handle Revenue Cycle department interactions via phone, email, voicemail, faxes, and patient portal.
Communicate with offices and patients to ensure current information.
Answer patient questions, inquiries, and concerns regarding their accounts and/or about centers.
LifeStance Health strives to help individuals, families, and communities with their mental health needs. They are the fastest growing mental health practice group in the country.
Collecting and verifying current demographic information
Contacting insurance companies when needed
Pediatrix Medical Group is a physician-led organization and one of the nation’s largest providers of prenatal, neonatal, and pediatric services. They focus on a team approach to improve the lives of patients everywhere, offering diverse opportunities and a commitment to clinical excellence.
Manage a steady, high volume of inbound calls and emails daily.
Act as a first-line troubleshooter for members facing technical hurdles.
Work closely with internal teams to resolve complex issues quickly.
Spring Health's mission is to eliminate every barrier to mental health by delivering the right care at the right time. They partner with over 450 companies and provide care for 10 million people, with clients including Microsoft, Target, and Delta Airlines.
Responding to high volume inquiries via email/phone
Assist with triaging case volumes
Providing resolution guidance/support to care center staff on complex claims/billing inquiries; claim holds, overrides, take backs, corrected claim workflows, coding assistance
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Submit bills compliant with all appropriate regulations and managed care contracts.
Collect money due by contacting third parties and providing explanations of charges.
Analyze accounts to determine coordination of benefits, refunds, and denials.
They are Oregon's only public academic health center, involved in patient care, research, and training healthcare professionals. As Portland's largest employer, they offer opportunities for learning and advancement in hospitals and clinics across Oregon and Southwest Washington.