Deliver high-quality customer service in a healthcare environment, handling inbound and outbound calls to resolve claims, benefits, and coverage inquiries.
Research and document member and provider issues, escalate complex cases, and ensure timely follow-up across systems.
Maintain strict confidentiality of sensitive information while adapting communication for diverse audiences including members, clinics, and vendors.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies efficiently. It operates as a partner recruiting organization, facilitating applications and next steps for roles like this one.
Review and validate medical codes for accuracy and compliance with ICD-10, CPT, HCPCS, and other coding systems.
Provide expert coding guidance and support to clinicians and departments, serving as a resource for complex coding questions.
Conduct coding audits, generate productivity reports, and collaborate with IT and billing teams to resolve system issues.
Mission Healthcare is a home health and hospice company serving seven states, the largest of its kind in the western United States. They emphasize a culture of compassion, accountability, respect, excellence, and service (CARES) and are committed to diversity and inclusion.
Process assigned claims based on client-specified guidelines.
Meet productivity targets and procedural accuracy standards.
Mentor junior team members and collaborate on special projects.
UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. With a global presence and over 4000 employees, they are dedicated to simplicity, honesty, and leadership.
Manage insurance account workflows and ensure accurate resolution of billing and reimbursement issues.
Investigate, resolve, and appeal insurance denials while documenting actions in compliance with standards.
Monitor aged accounts receivable and prioritize workloads to optimize collections and reduce outstanding balances.
Our partner is a healthcare services organization focused on revenue cycle management. They offer a collaborative and mission-driven environment with a comprehensive benefits package.
Improve first-pass claim acceptance by ensuring correct coding, flagging inconsistencies, and reviewing EOBs and denial trends to identify recurring issues.
Work closely with billing teams and vendors to resolve complex claim issues, review clinical documentation, and support coding corrections and resubmissions.
Ensure compliance with CMS, state Medicaid, and managed-care guidelines while monitoring payer policy changes to optimize coding and billing practices.
ReKlame Health is a clinician-led, tech-enabled provider group providing culturally competent behavioral health and addiction care. As an early-stage organization focused on expanding access to care and health equity, they are building a purpose-driven team dedicated to making a positive impact.
Submit commercial insurance claims accurately and in a timely manner.
Monitor claim status and proactively resolve denials, rejections, and unpaid claims.
Verify insurance eligibility and benefits and post insurance payments.
LivWell Behavioral Health Services is a licensed outpatient behavioral health organization committed to improving the lives of youth and families through accessible, high-quality mental health care. They partner with schools and communities in the Chandler/Mesa, AZ area and continue expanding into additional states.
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.
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.
Process timely and accurate billing of medical claims in multiple states.
Monitor accounts daily to maximize reimbursement and identify potential billing compliance issues.
Utilize EHR and billing systems to manage claims, denials, and payer communications.
Indigenous Pact PBC, Inc. is a certified B-Corporation established in 2017 with a mission to create health equity for American Indians and Alaskan Natives. The dedicated team has decades of experience working in Indian Country, specializing in customized solutions for sustainable revenue and improved health outcomes.
Investigate and resolve insurance claim denials, handling 50 to 100 denials daily with speed and accuracy.
Partner with payers to secure timely reimbursement and interpret LCD/NCD requirements for CPT/HCPCS-related denials.
Provide top-tier phone support to patients, insurance companies, and internal teams while using payer portals and clearinghouses.
IVX Health is a national provider of infusion and injection therapy for individuals managing complex chronic conditions like rheumatoid arthritis, Crohn’s disease, and multiple sclerosis. We foster a culture of respect, empowerment, and shared purpose, with a team committed to patient-centered outcomes and values such as Be Kind and Do What’s Right.
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.
Manage the full Authorization process, from initial notification to determination and discharge, with detailed documentation in EMR and payer systems.
Verify patient eligibility and benefits, act as a liaison between hospital staff and health payers, and track pending authorizations for timely responses.
Maintain HIPAA compliance, escalate issues causing delays or denials, and manage workloads through accurate record keeping.
CorroHealth is a partner to healthcare providers, solving revenue cycle challenges through a mix of services, consulting, and technology. The company focuses on scalability and clinical expertise, building long-term careers by investing in employee development.
Conduct benefit investigations, insurance verification, and prior authorizations to secure timely patient access to therapies.
Manage patient case files, coordinate product ordering and shipment with pharmacies and prescribers.
Handle inbound inquiries, report adverse events, and educate stakeholders on program requirements.
Jobgether is a platform that uses AI-powered matching to connect candidates with hiring companies. They focus on efficient, objective candidate screening and share top-fitting shortlists with employers.
Responsible for initiating ERA and EFT setup with clearinghouses and payers.
Assist in vendor support for daily cash reconciliation and understand RCM Payment Posting Processing.
Maintain payer portal admin and employee registration; resolve unidentified payments.
Advantia Health provides unparalleled healthcare services to customers. The company employs highly qualified individuals and is an equal opportunity employer committed to diversity.
Provide medical coding, system configuration, and administrative support for medical policy functions.
Perform coding analyses and utilization reporting to recommend updates to medical policies and system configuration.
Participate in cross-functional meetings to align with enterprise strategic priorities and support team operations.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, built on over 80 years of trust. We prioritize member well-being over profits, with a focus on sustainability and innovation.
Manages full cycle accounts receivable including invoicing, payment posting, and reconciliation.
Communicates with patients, insurance carriers, and internal teams to resolve billing discrepancies.
Processes insurance claim denials, resubmits claims, and maintains timely follow-up on outstanding balances.
Oral Surgery Partners is a dental and oral surgery practice providing surgical care. The company offers a supportive team environment with benefits and opportunities for full-time employees.
Lead daily CDI operations, including staffing, workload balancing, and training for clinical documentation improvement.
Conduct real-time clinical reviews for complex cases and analyze data to ensure quality and accuracy.
Collaborate with physicians and staff to enhance documentation quality and compliance with coding guidelines.
Adventist HealthCare is a faith-based, not-for-profit healthcare organization providing comprehensive services including acute-care hospitals, rehabilitation, outpatient centers, and home care. With over 6,000 employees, they are the largest healthcare provider in Montgomery County, Maryland, focused on extending God's care through physical, mental, and spiritual healing.
Prepare and submit mortgage insurance claims according to regulatory requirements.
Conduct audits, resolve escalations, and collaborate with cross-functional teams.
Assist in training and process improvements to ensure data integrity.
The partner company specializes in mortgage servicing operations. It is an organization that values accuracy, quality, and efficiency in claims-related processes.
Review medical records and clinical documentation to ensure accurate, compliant coding per CMS, federal, state, and payer policies.
Conduct routine and focused coding audits, collaborate with clinical leadership and revenue cycle teams, and provide actionable recommendations.
Serve as a subject matter expert on pediatric, Medicaid, telehealth, and behavioral health coding, interpreting state-specific billing requirements.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual and in-home medical, behavioral, and social care, and are a remote-first, high-growth environment.
Responsible for accurate and timely assignment of ICD-10-CM/PCS and HCPCS/CPT codes for various record types.
Performs coding and abstracting to support billing, data quality, and severity-of-illness reporting.
Serves as a mentor to newer coders and works within service line structures as needed.
ChristianaCare is one of the largest health care providers in the Mid-Atlantic Region, operating hospitals in Delaware and Maryland. With over 1,100 beds and ANCC Magnet Recognition across its facilities, it is committed to delivering health through values of love and excellence.