Create and maintain client profiles by accurately inputting information into the client's system
Work closely with clinical staff to retrieve necessary information required for processing patient claims
Verify the completeness and accuracy of client information, make necessary updates, and review and analyze claim documentation for compliance with established guidelines and requirements
Manage prior authorizations and related administrative paperwork.
Input patient information, medical records (CPT, ICD-10, HCPCS), and billing data into EMR/EHR systems.
Assist with processing insurance claims, verifying patient insurance information, and handling billing inquiries, concerns, and documentation.
Wing is redefining the future of work for companies worldwide. They aim to be a one-stop shop for companies looking to build world-class teams and place their operations on autopilot.
Support clinical staff by gathering data to complete the medical necessity review process.
Create and send letters to providers and/or members to communicate information.
Collaborate with care management teams and stakeholders to provide optimal service.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, and they’ve built their reputation on over 80 years’ worth of trust. They are motivated by the well-being of their members, putting them first and committing to sustainability and innovation.
Responsible for economic credentialing and provider enrollment with contracted managed care and governmental plans.
Communicating provider participation information to internal and external customers.
Ensures compliance with regulatory agencies and maintains a working knowledge of statues and laws.
The West Virginia University Health System is West Virginia’s largest health system and the state’s largest employer. They have more than 3,400 licensed beds, 4,600 providers, 35,000 employees, and $7 billion in total operating revenues.
Handle incoming calls, emails, and online inquiries from prospective personal injury clients in both English and Spanish.
Accurately enter and maintain client and case information in the firm’s case management system.
Proactively follow up with English- and Spanish-speaking leads to obtain missing information or documentation.
SnappyCX seeks detail-oriented and client-focused individuals. They support their client's legal team by managing client intake, lead screening, case documentation, and coordination between clients and attorneys.
Showcase customer service and data entry skills as part of the healthcare team.
Involved in claims adjudication and/or provider credentialing.
Support customers by phone, email and chat.
Sutherland helps customers globally achieve greater agility and transform automated customer experiences. As a digital transformation company they have been in business for over 35 years and are Great Place to Work certified with nearly 40,000 employees.
Act as the primary point of contact for new patients calling and emailing in.
Efficiently register and onboard a high volume of new patients.
Precisely verify patient insurance information to confirm active coverage and eligibility.
Form Health is a virtual obesity medicine clinic delivering multi-disciplinary evidence-based obesity treatment through telemedicine. Founded in 2019, Form Health is a venture-backed innovative startup with an experienced clinical and leadership team that values its employees.
Manage the insurance claims process and provide customer service to clients.
Analyze and approve claims and determine coverage based on medical necessity.
Resolve discrepancies, secure proper reimbursement, and follow regulations and guidelines.
CommuniCare Family of Companies delivers person-centered care as a national leader in post-acute care. They operate over 150 facilities, employing more than 19,000 employees across six states, and are dedicated to improving the lives of seniors.
Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
Assess payment determinations using clinical information and established guidelines.
Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
Broadway Ventures transforms challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), they empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth.
Prepare and submit credentialing and enrollment packets.
Maintain accurate provider files and track expirations.
Provide assistance to the billing team during staff absences.
Modena Health and Modena Allergy & Asthma are leading medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona and plans for national expansion. They are physician-led and technology-enabled, committed to transforming allergy care while advancing clinical research and expanding access to cutting-edge medicine.
Conduct timely and accurate eligibility checks and benefit investigations through payer portals and phone outreach to ensure claims are submitted correctly from the start
Enter and monitor DME claims across multiple platforms, troubleshoot billing issues, and proactively follow up to reduce denials and accelerate reimbursement
Analyze explanation of benefits (EOBs) for errors, missing payments, or misapplied patient responsibility, then determine and execute the correct resolution path
Babylist is the leading registry, e-commerce, and content platform for growing families helping parents feel confident, connected, and cared for at every step. It has over $1 billion in annual GMV, and more than $500 million in 2024 revenue and is reshaping the $320 billion baby product industry.
Manage provider enrollment & credentialing, leading the credentialing lifecycle for new and existing providers and practice locations.
Maintain provider data, ensuring CAQH profiles are complete, current, and accurately reflect provider credentials and practice information.
Optimize workflows, assessing current credentialing processes, identifying inefficiencies, and implementing improvements.
Sailor Health aims to solve the mental health crisis among older adults by connecting them, therapists, healthcare professionals, and insurance plans through their AI-native operating system. They are a growing company partnered with Medicare, offering affordable psychotherapy and striving to redefine aging with mental wellness.
Nurture & Grow: Take ownership of existing accounts and drive increased patient referral volume.
Success Management: Act as the primary point of contact for clinical partners, answering questions, providing updates.
Process Implementation: Work with clinics to refine their internal referral processes, making it easier for them to send patients to our platform.
Carda Health is building the world’s first patient-centered virtual heart and lung platform, starting with cardiac and pulmonary rehab. They are a team of clinicians, mathematicians, entrepreneurs, and engineers who believe technology and data, when applied ethically, can transform healthcare.
Manage all aspects of provider licensing, credentialing, and payer enrollment.
Coordinate end-to-end licensing workflows and maintain accurate records.
Act as a key liaison between clinicians, state boards, payers, and internal stakeholders.
They are committed to providing safe, discreet medication abortion treatment and offer a range of reproductive and sexual health care services. The in-house clinical care team composed of board-certified doctors, advanced practice clinicians, nurses, and patient care advocates, is just a text message away.
Serves as a lead to Clinical Business Operations Representatives and facilitates the prompt resolution of highly complex problems related to pre and post care that arise in daily clinical operations.
Performs administrative and receptionist functions, to include answering incoming calls, efficient management of patients, and the acquisition of necessary patient care and records.
Assists patients in a courteous, efficient, and professional manner and ensures adherence to divisional and departmental service standards.
The University of Miami and UHealth have become one of the nation’s top research universities and academic medical centers. With more than 17,000 faculty and staff, the University strives for excellence, and is driven by a powerful mission to transform and impact the lives of its students, patients, members of the community, and people across the globe.
Utilize active listening and written communication skills to interact with and support patients via phone, chat, and emails.
Manage all care coordination needs, including platform sign up, troubleshooting tech issues, and scheduling appointments.
Conduct a clinical needs assessment to develop a plan of action for each member and refer to an appropriate level of care.
Spring Health is on a mission to revolutionize mental healthcare by removing every barrier that prevents people from getting the help they need, when they need it. They partner with over 450 companies, from startups to multinational Fortune 500 corporations, providing care for 10 million people and are valued at $3.3 billion.
Consistently practices Patients First philosophy and adheres to high standards of customer service.
Correctly identifies and collects patient demographic information in accordance with organization standards.
Utilizes multiple online order retrieval systems to verify or print the patients order.
Northwestern Medicine strives to cultivate a positive workplace through its patient-first approach. They are a leader in the healthcare industry, providing competitive benefits such as tuition reimbursement, loan forgiveness, 401(k) matching, and lifecycle benefits.
Serve as the primary contact for inbound patient calls, answering questions regarding prescriptions, prior authorizations, and referrals.
Document all patient interactions and requests accurately in the EHR, routing clinical tasks to the appropriate teams according to escalation protocols.
Follow standardized workflows, adhering to HIPAA requirements and meeting service-level expectations for response time and accuracy.
Midi Health is on a mission to transform care for women in midlife. They aim to build a best-in-class team while working with smart, purpose-driven people.
Responsible for decision-making and coding reviews.
Facilitate, obtain, validate, and reconcile appropriate provider documentation.
Ensure accurate reflection of illness severity and patient care complexity.
Millennium Physician Group (MPG), formed in 2008, is the largest independent physician group in Florida and one of the largest in the United States. They provide employees with the tools to succeed, a team atmosphere, and opportunities for growth.
Provide customer service in a phone-based environment, processing prescription information accurately.
Perform claim adjudication and auditing duties, like prior authorizations and eligibility checks.
Maintain patient records with attention to detail and confidentiality, ensuring regulatory compliance.
AnewHealth is a pharmacy care management company specializing in caring for people with complex, chronic needs. With over 1,400 team members, they care for more than 100,000 people across all 50 states, enabling better outcomes for patients and healthcare organizations.