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.
Process medical claims by reviewing, validating, and entering data accurately and in compliance with policies.
Identify discrepancies, flag unusual cases, and escalate issues while maintaining productivity and quality standards.
Collaborate with peers, participate in training, and uphold confidentiality and regulatory requirements like HIPAA.
Sidecar Health is redefining health insurance by making excellent healthcare affordable and accessible for everyone. The passionate team, with backgrounds as tech leaders, policy makers, and healthcare professionals, is driven to fix a broken system and create a more personalized, affordable, and transparent experience.
Research and resolve insurance claims to maximize cash collections and minimize denials.
Maintain worklists and assignments based on performance targets and quality scores.
Interface with payers and internal partners to conduct follow-up and escalate items promptly.
USACS is a clinician-centric provider of hospital-based emergency and inpatient medicine, serving 11 million patients annually in 400+ programs across 27 states. They are a large practice prioritizing personal and professional satisfaction with a culture of robust support.
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 data accuracy and input on the computer billing system, updating patient and insurance information.
Handle patient inquiries regarding insurance, credit, and billing issues; review and mail statements; file electronic claims.
Follow up on litigation cases, scan documents into electronic medical records, and coordinate with physicians for documentation.
Munson Healthcare is northern Michigan's largest healthcare system, with eight community hospitals serving over half a million residents. They prioritize a culture of excellence, teamness, and creativity, committed to exceptional experiences for patients and teammates.
Review healthcare claims and determine appropriate payment methodologies based on contractual terms and client requirements.
Analyze claim information and system data to ensure accurate repricing while meeting productivity and quality metrics.
Collaborate with internal audit and operational teams to support compliance, quality assurance, and process improvement initiatives.
The company provides healthcare claims review and repricing services. It operates remotely with a focus on compliance, accuracy, and continuous improvement.
Create a welcoming experience by authentically engaging every caller and providing a world-class experience.
Thoroughly and accurately answer questions about customers' healthcare accounts and provide appropriate solutions.
Handle 35-50+ inbound and outbound phone calls per day and work closely with claim staff to adjust claims.
Point C Health is a national third-party administrator that delivers customized self-funded benefit programs. They are a mission-driven company with a focus on partnership, innovation, and a supportive culture.
Handle inbound calls from patients, attorneys, and insurance providers to resolve billing-related issues.
Communicate revenue cycle processes and insurance information clearly to ensure positive customer experiences.
Apply knowledge of healthcare insurance terminology and payer requirements to support accurate responses.
The company is a healthcare services organization that provides patient support and revenue cycle management services. It fosters a patient-focused, remote work culture with an emphasis on empathy and professionalism.
Submit and follow up on dental insurance claims, post payments, and verify benefits for multiple dental practices nationwide.
Manage day-to-day client communication and relationships to ensure satisfaction and retention.
Prepare and deliver monthly ROI statistics and quarterly business reviews.
DentalXChange simplifies the business of dentistry by providing revenue cycle management for dental practices across the country. They have a team that values core values like Actively Care, Try Hard, Be Humble, and Feedback is a Gift, fostering a positive culture.
Manage and resolve claims rejections and denials, escalating trends as identified.
Verify patient eligibility and benefits, and coordinate with insurance payers.
Maintain compliance with HIPAA regulations and meet productivity standards.
Workit Health is an industry-leading provider of on-demand, evidence-based telemedicine care for addiction. They are a growing company with a dedicated team passionate about making judgment-free care accessible.
Oversee the processing of initial payer applications to ensure compliance with accreditation standards and regulations.
Maintain and manage payer credentialing databases with accuracy and audit readiness.
Supervise payer credentialing staff by coordinating workloads, providing training, and monitoring performance.
Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care. They serve facilities across the United States, offering multispecialty physician services, telemedicine, and remote patient monitoring.
Act as a subject matter expert on medical payment policy, analyzing client data and presenting new policy opportunities to health plans.
Collaborate with Client Medical Directors and internal teams to develop and advocate for adoption of medical policies that maximize value.
Prepare presentations, coordinate reviews, and inspire trust as a trusted advisor for the Health Plan's medical payment strategy.
Cotiviti is a healthcare analytics company that partners with health plans to optimize payment accuracy and medical policy through data-driven solutions. The company employs a global workforce and fosters a collaborative, client-focused culture.
Assess, identify, and resolve dental provider inquiries regarding claims, eligibility, and benefits via phone in a timely and professional manner.
Research and handle complex requests, manage personal inventory, and ensure effective follow-up to meet quality and business metrics.
Communicate clearly with providers, peers, and leadership, and contribute to divisional and corporate goals while fostering a team-based environment.
Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston, serving 2.8 million members for over 75 years. We are consistently ranked among the nation's best health plans and are dedicated to creating an inclusive, wellness-focused culture that promotes work-life balance.
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.
Contribute directly to improving Provider experience through timely credentialing and enrollment.
Collaborate with cross-functional teams to support new payer launches and share operational insights.
Help educate credentialing associates as new processes and payers are introduced.
Rula is a remote-first company that makes mental health care more accessible by streamlining provider onboarding. The team values diversity, equity, and inclusion, fostering a culture of belonging.
Processes referral requests and authorizations for patients, ensuring timely and accurate scheduling.
Communicates with physicians, employers, and payors to coordinate specialist referrals and obtain necessary information.
Maintains high standards of quality and patient experience while meeting production requirements.
Concentra operates over 500 medical centers and 130 onsite clinics nationwide, focusing on providing high-quality healthcare to improve the health of America's workforce. The company emphasizes a culture of outstanding patient experience and customer service.
Develop and maintain system pricing for health care claims.
Analyze contract financial performance and coordinate internal/external audits.
Provide routine and ad hoc reporting to support business decisions.
HCSC is a health insurance company dedicated to expanding access to high-quality, cost-effective health care. With over 80 years of experience, they foster a collaborative and inclusive culture that values employee development and diversity.
Conducts administrative and clinical intake of calls for clinical review.
Provides quality customer service and telephonic support to providers and office staff.
Maintains high confidentiality and documentation standards while performing data entry.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving over 700 clients across 10 industries. With 66,000+ employees across 13 countries, they combine deep domain expertise with AI platforms to drive business resilience and sustainable outcomes.