Analyze and process complex medical claims in accordance with program policies and procedures.
Apply critical thinking to adjudicate claims and resolve issues through collaboration with internal departments.
Maintain confidentiality of patient records and ensure thorough record-keeping in compliance with HIPAA regulations.
Broadway Ventures is an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business providing expert program management, technology, and consulting solutions. As a small business, they emphasize integrity, collaboration, and excellence in serving government and private sector clients.
Contact employers and insurers via phone, email, or fax to verify information and obtain claim documentation.
Manage inbound and outbound calls, compile billing packets, and file insurance claims.
Perform accurate data entry in several systems while handling confidential patient health information under HIPAA guidelines.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM platform. The company is a multi-year Top Workplaces award recipient and has been on the Inc. 5000 list for eleven years.
Analyze benefit plan documents to build benefit categories and adjudication rules for claims processing.
Review member accumulators and assist in loading benefit logic to member and group records.
Manage daily configuration inventory queues and support cross-functional teams during implementations and renewals.
Gravie creates health benefits that actually benefit small and midsize businesses and their employees. They are well capitalized, have top-tier investors, and a diverse, non-hierarchical, merit-driven culture that values authenticity and high performance.
Manage high-value medical claims, denials, and appeals to ensure accurate and timely reimbursement.
Analyze unpaid/underpaid claims, investigate billing errors, and communicate with insurance payors via portals, phone, and email.
Maintain detailed documentation, process updates, and collaborate with internal teams to resolve complex accounts receivable issues.
Our partner operates within the healthcare revenue cycle, ensuring accurate reimbursement for medical services. They are a collaborative team focused on improving financial outcomes and maintaining compliance with healthcare regulations.
Accurately capture Auto and Property claims, ensuring complete First Notice of Loss documentation and triaging exposures.
Provide consultative policy guidance and effortless customer experiences to help customers understand coverage and next steps.
Collaborate with teams and vendors to drive timely claim resolution and maintain accuracy and compliance.
Liberty Mutual is a Fortune 100 insurance company that helps people navigate life's uncertainties with coverage and claims services. They are a large employer with a focus on inclusion and employee well-being, offering comprehensive benefits and professional development.
Review, evaluate, appeal, and follow up on denied and underpaid claims using proprietary software.
Use payment documentation and contract information to ensure correct reimbursement.
Research and submit complex underpayment appeals to payers for timely claim resolution.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations using proprietary automation. The company has been recognized as a top workplace and among the fastest-growing private companies in the US for eleven years.
Prepares and submits hospital, physician, and clinic claims to third-party insurance carriers electronically or by hard copy.
Follows up with insurance carriers on unpaid claims and secures needed medical documentation.
Processes rejections by correcting billing errors and resubmitting claims to insurance carriers.
TruBridge provides innovative solutions that support the financial and clinical sides of healthcare delivery, connecting providers, patients, and communities. They foster a remote team culture that encourages pushing boundaries and thinking differently.
Own HIPAA-compliant source-of-truth artifacts governing Medicare claims business rules.
Validate changes internally and communicate updates to external CMS stakeholders.
Bridge product and engineering by translating policy needs into clear requirements.
Nava is a consultancy and public benefit corporation working to make government services simple and effective. Since 2015, they have helped federal, state, and local agencies solve technology modernization challenges, and they are a remote-first team with a collaborative culture.
Support quality assurance and audit planning for the WTC Health Program
Analyze claims data to identify trends and recommend improvements
Maintain health plan codebook and ensure accurate medical coding standards
Advanced Technologies & Laboratories International, Inc. (ATL) provides expertise in quality assurance, claims processing, medical coding, and audit activities for the WTC Health Program. The company offers a competitive total compensation package and invests in professional growth through tuition reimbursement and certification programs.
Manage document workflows, including processing, quality assurance, and adherence to internal procedures.
Conduct incoming claim reviews, assign statuses, organize data, ensure accuracy, and route files to auditors.
Collaborate with internal teams to maintain the import queue, reconcile balances, validate charges, correct errors, and manage claim routing.
Machinify is a leading healthcare intelligence company delivering value, transparency, and efficiency to health plan clients. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, they foster a collaborative culture focused on innovation and results.
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.
Manage the end-to-end medical billing and revenue cycle process for home healthcare services.
Process and submit medical claims, verify insurance eligibility, and resolve claim denials.
Coordinate with Massachusetts insurance carriers and maintain compliance with HIPAA standards.
SnappyCX is a growing medical billing startup focused on supporting home healthcare providers across Massachusetts. They are a small, remote-first team seeking experienced billing professionals to join their fast-paced startup environment.
Complete billing tasks daily and monitor assigned accounts to minimize write offs.
Submit clean claims to insurance companies electronically or by paper according to guidelines.
Research, correct, and resubmit rejected and denied claims, and prepare appeals.
Enhabit Home Health & Hospice provides home health and hospice services. It is a large corporate agency with a focus on employee growth and competitive benefits.
Process inbound claim contacts from dealers, repair facilities, sales agents, and contract holders.
Manage queue contacts via phone, email, and chat channels.
Correspond with vendors and assist with claim estimation and cost comparison.
Protective helps protect customers against life's uncertainties by providing insurance and claims services. The company offers comprehensive benefits and promotes work/life balance with a focus on employee wellbeing.
Process and resolve insurance claims, denials, and appeals accurately and timely using Epic and other systems.
Verify patient insurance eligibility, update demographics, and communicate with payors to ensure proper coverage.
Analyze and correct claim issues, perform write-offs, and contribute to workflow improvements for optimal AR outcomes.
Exact Sciences helps change how the world prevents, detects and guides treatment for cancer. The company offers an inclusive culture, purpose-driven careers, and robust benefits.
Oversee end-to-end health plan enrollment process and manage vendor performance.
Ensure accurate and timely processing of enrollment requests while maintaining compliance with SLAs.
Act as subject matter expert in payer enrollment requirements and resolve enrollment delays.
Medallion is a healthcare technology company that automates licensing, credentialing, and compliance monitoring for healthcare organizations. It is one of the fastest-growing healthcare technology companies, ranked #3 on Inc. Magazine's 2024 Fastest-Growing Private Companies in the Pacific Region and a Glassdoor Best Place to Work in 2024 & 2025.
Investigate multiple sources of health insurance data to identify potential accidents and physical injuries, determining recoverability of claims.
Communicate and negotiate with healthcare plan members, insurance adjusters, and attorneys to recover funds from at-fault parties.
Utilize computer systems for documentation, apply analytical skills to manage workflows, and create medical expense spreadsheets for payment processing.
Machinify is a leading healthcare intelligence company that uses an AI-powered platform to maximize financial outcomes and reduce healthcare costs for health plans. They are deployed by over 85 health plans and represent more than 270 million lives, fostering a culture of asking why, thinking big, and delivering results.
Identify, research, process, and resolve customer inquiries regarding health insurance benefits, claims, and eligibility.
Analyze medical records and apply medical necessity criteria to determine the appropriateness of benefit requests.
Maintain accurate records, meet quality and timeliness standards, and coordinate with internal departments and external organizations.
Blue Cross Blue Shield of Arizona provides health insurance products and services to individuals, families, and businesses, aiming to inspire health and make it easy. The company has been recognized as a Healthiest Employer and has transformed healthcare for over 80 years with teams in Phoenix, Tucson, Chandler, and Flagstaff.
Handle high-volume calls, emails, and chats for workers' compensation policy servicing, billing, and audits.
Process policies and maintain accurate documentation while ensuring regulatory compliance.
Support claims coordination and identify process improvements to enhance service quality.
FOCUS provides cloud-based core administration solutions and services for property and casualty insurance companies and managing general agents. As part of Team Focus Insurance Group with over 75 years of industry experience, the company fosters a collaborative culture where employees learn, laugh, and love their work.
Investigate and resolve auto physical damage and property damage claims in a timely manner.
Serve as primary customer contact, handling high volume calls and providing exceptional service.
Collaborate with team members and document claims activities accurately.
Mercury Insurance is a midsize insurance company dedicated to helping people reduce risk and overcome unexpected events. They have been recognized as one of America's Best Midsize Employers for 2025 and foster a collaborative, growth-oriented culture.