Oversee day-to-day operations of the Unresponded team, including offshore and onshore staff, to drive resolution of post-appeal payer responses.
Partner cross-functionally with Denials & Appeals, Technology, and operational leadership to reduce backlog and maintain SLA compliance.
Build and refine standard operating procedures and workflows to sustain SLA compliance as volume scales.
Natera is a global leader in cell-free DNA testing, dedicated to oncology, women’s health, and organ health. The company consists of highly dedicated professionals from world-class institutions who care deeply for their work.
Perform complete, accurate, and timely processing of reimbursement/payment audits in compliance with policies, payer contracts, and government fee schedules.
Collaborate with operations consultants, RCM AR staff, and management to address Care Center payment performance audits and maximize cash flow.
Identify, monitor, and manage denial management trends, and work closely with Revenue Cycle Teams and payer representatives.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The company is led by top industry talent and exceptional physician leadership, focusing on reducing healthcare costs and improving outcomes.
Manage complete and timely processing of claims, including reviewing daily correspondence and resolving issues through SalesForce.
Oversee accounts receivable functions such as worklists, zero pay, and denials to ensure timely resolution.
Serve as an escalation point and subject matter expert on internal sub-teams, driving toward daily and monthly KPIs.
Privia Health is a technology-driven physician enablement company that collaborates with medical groups and health systems to optimize practices and reduce costs. They are a national organization with top industry talent and a focus on high-value care.
Manage patient account activities to optimize reimbursement and reduce accounts receivable.
Perform billing, follow-up, collections, and denials resolution to improve financial outcomes.
Ensure accuracy of charge, claim, and payment data through reviews and targeted corrections.
The University of Kentucky is a public land-grant university dedicated to advancing education, research, and healthcare. It promotes a supportive culture that values employee well-being and professional growth.
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.
Apply deep clinical, coding, and reimbursement expertise to enhance AI-enabled claim selection tools.
Partner with data science teams to validate AI outputs and improve model performance.
Serve as a coding subject matter expert to support audit concept development and optimization.
Cotiviti is a healthcare analytics company specializing in payment integrity and data-driven solutions. The company fosters a collaborative culture and emphasizes innovation in healthcare audit and analytics.
Manage claim submission and resolution for governmental and commercial insurance accounts.
Analyze and correct accounts receivable problems, post payments, and resolve credit balances.
Research denials, initiate appeals, and maintain documentation for maximum reimbursement.
CCS is a healthcare company specializing in chronic care management, using AI-powered models to improve patient adherence and outcomes. It supports over 200,000 patients nationwide and is recognized as a Great Place to Work.
Own end-to-end claims and revenue-cycle operations, including claim submission, denials, appeals, and collections across Medicaid and commercial payers.
Build and optimize payer-specific billing workflows, including claim configuration, coding, and credentialing.
Drive cross-functional execution with Operations, Partner Success, and Finance to improve processes and achieve over $1M in monthly claims.
Jukebox Health partners with health plans to make homes safer and more accessible for older adults and high-needs populations, combining technology with networks of clinicians, suppliers, and installers. Founded by experienced entrepreneurs, Jukebox Health is a fast-growing healthcare services company backed by top venture capital firms like Valtruis and The Home Depot, with a high-trust, collaborative, remote-first culture.
Own the data work behind accurate client billing, reconciling across systems and building durable checks.
Partner with the Client Group to support timely billing and answer pressing data questions.
Develop reporting and dashboards that surface billing trends, risks, and anomalies.
Virta Health is transforming type 2 diabetes and weight-loss care through technology, personalized nutrition, and virtual care. They have raised over $350 million from top-tier investors and partner with health plans, employers, and government organizations.
Respond to patient billing and insurance inquiries via Zendesk, resolve financial questions, and manage payment arrangements with empathy.
Work Athena claim hold and denial queues, research claims in payer portals, and coordinate with clinical teams to resolve documentation gaps.
Serve as billing and insurance subject matter expert for the Patient Experience team, identify root causes of denials, and support process improvements.
Midi Health is a comprehensive virtual care clinic for women in midlife, focusing on perimenopause, menopause, and midlife health challenges. It is a fast-growing telehealth company with a collaborative, remote-first culture.
Review and resolve healthcare credit balance accounts through detailed analysis and accurate actions including refunds or adjustments.
Manage accounts receivable and communicate effectively with internal teams and providers to resolve overpayments.
Maintain high accuracy in a fast-paced, performance-driven environment while identifying and escalating complex issues.
Trend Health Partners is a tech-enabled payment integrity company that facilitates collaboration between payers and providers to reduce waste and improve healthcare access. It is a dynamic, growing organization that promotes a collaborative and innovative work environment.
Manage complex pre-bill functions and investigate claim rejections to ensure accurate resolution.
Partner with cross-functional teams to analyze trends and optimize revenue cycle workflows.
Provide guidance to offshore teams and monitor automated processes for operational efficiency.
Rula is a mental health company dedicated to treating the whole person and eliminating stigma. They are a remote-first organization with a growing team that values diversity, equity, and inclusion.
Drive cross-functional collaboration and track progress using project management tools to ensure on-time delivery of objectives.
Conduct audits of call and email communications to assess quality and accuracy, compiling feedback summaries for management.
Support patient-focused teams with quality improvement initiatives and maintain documentation such as SOPs and protocols.
Natera is a global leader in cell-free DNA testing for oncology, women's health, and organ health. The team consists of highly dedicated statisticians, geneticists, doctors, and other professionals from world-class institutions, fostering a culture of hard work and growth.