Provide direct support to customers navigating healthcare reimbursement, claims, and insurance processes.
Assist with verifying benefits, reviewing claims documentation, and maintaining compliant records.
Collaborate with internal teams to resolve complex reimbursement issues and improve workflows.
This partner company provides customer reimbursement coordination services for healthcare. They operate remotely and offer a collaborative environment with opportunities for professional development.
Proactively educate healthcare providers on navigating access, reimbursement, and coverage pathways for company products. - Serve as a subject matter expert in preventing and addressing access and reimbursement issues through education and problem-solving. - Build and maintain access-related relationships with healthcare provider accounts and office staff to ensure timely patient access.
Acadia Pharmaceuticals Inc. is a biopharmaceutical company focused on developing and commercializing innovative therapies for central nervous system disorders. The company fosters a collaborative and inclusive culture, offering competitive benefits and a commitment to diversity and equity.
Make high-volume outbound calls to prospects and convert leads.
Educate beneficiaries on Medicare plans and close enrollments.
Maintain compliance, retain members, and cross-sell ancillary products.
Keystone is a fast-growing company in the Medicare sales industry. They seek top talent employees and offer a fun, friendly environment with perks like yoga, pickleball, and golf simulator.
Provide medication prior authorization support for assigned clinics using the Epic In Basket system.
Manage prior authorizations from clinic to pharmacy, including submission, tracking, and follow-up.
Communicate with clinics, pharmacies, and insurance payers to ensure timely approvals and patient access.
UnityPoint Health is a healthcare system delivering medical services across the Midwest. Recognized as a Top 150 Place to Work in Healthcare, it fosters a culture of belonging and supports team members with development and well-being.
Guide beneficiaries through health insurance options by listening to their needs, answering questions, and recommending suitable coverage solutions.
Conduct phone consultations to help customers understand plans and make informed purchasing decisions while meeting sales targets.
Maintain accurate customer information and documentation while navigating multiple systems and applications.
Amplify helps individuals make informed decisions about their health insurance coverage through personalized support and education. The company operates a remote call center environment with a focus on customer service and sales, offering paid training and career growth opportunities.
Make outbound and receive inbound calls to Medicare clients to retain business and resolve issues.
Cross-sell ancillary products and identify new business opportunities while delivering exceptional customer service.
Navigate multiple systems, complete case management in Salesforce, and meet department performance goals.
Spring Venture Group is a leader in Medicare health insurance distribution, guiding people through finding the right coverage. The company offers an incredible culture, competitive benefits, and a diverse, inclusive team environment.
Determine patient qualification for financial assistance programs and payment arrangements using confidential financial information.
Verify insurance coverage, obtain authorizations, and provide price estimates for scheduled procedures.
Serve as a liaison between patients, providers, and internal departments to coordinate benefits and collect patient portions.
CommonSpirit Health is a large healthcare system with over 700 care sites across the U.S., serving nearly one in four Americans. The culture emphasizes compassion, community health, and employee commitment to a greater cause.
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.
Conduct medical necessity reviews for inpatient admissions and post-acute services using evidence-based guidelines.
Lead peer-to-peer discussions with attending physicians to clarify clinical documentation and support appropriate care decisions.
Collaborate with utilization management and care management teams to ensure consistent, cost-effective care.
Our partner company provides utilization management services for Medicare Advantage members, focusing on evidence-based clinical decision-making. It operates with a collaborative, matrixed team and emphasizes regulatory compliance and patient-centered care.
Educates healthcare providers on patient access and reimbursement support for AbbVie's psychiatry portfolio.
Develops relationships with providers and coordinates with internal teams to enhance patient experience.
Identifies payer trends and improves processes to navigate local healthcare access barriers.
AbbVie discovers and delivers innovative medicines and solutions to address serious health issues in immunology, oncology, and neuroscience. They are a large global company with a strong culture of integrity and innovation serving communities.
Submit provider and organizational contract requests to commercial, Medicare, Medicaid, and managed care payers.
Monitor contract application status and maintain detailed tracking of all submissions and negotiations.
Coordinate with internal teams to facilitate successful implementation of newly executed agreements.
Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services. Since 2019, we have served thousands of clients and maintain a fully remote culture focused on collaboration and personal connection.
Serve as a primary contact for medication inquiries, triaging calls and portal messages with empathy and urgency.
Facilitate prior authorizations and coordinate follow-up appointments to ensure continuity of care.
Document all interactions using SBAR standards and educate patients on refill policies and adherence.
Mindpath Health is redefining how mental health care is delivered, operating in more than 100 locations across six states with in-person and telehealth services. The team is deeply committed to compassionate, collaborative care and values diversity and inclusion.
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.
Verify insurance eligibility, benefits, and network status, and create pre-service liability estimates.
Secure prior authorizations for outpatient imaging and office services, following up on delayed or denied requests.
Act as a liaison between payers and clinic schedulers, ensuring accurate documentation and issue resolution.
University of Utah Health enhances health and well-being through patient care, research, and education. With five hospitals and eleven clinics, it is nationally ranked and fosters a culture of collaboration, excellence, leadership, and respect.
Manage insurance authorization workflows from initial request through final approval.
Verify insurance eligibility, benefits, and authorization requirements.
Collaborate with clinical and billing teams to ensure timely processing.
The company is a healthcare operations organization focused on managing insurance authorization processes to support patient care. They offer a collaborative remote work environment with cross-functional teams.
Handle inbound and outbound calls with prospective DSNP Medicare members, focused on sales, education, and enrollment.
Guide individuals through Dual Special Needs Plan options, helping them understand Medicare and Medicaid benefits and eligibility.
Meet performance expectations around sales goals, call quality, conversion metrics, and schedule adherence.
Connexion Point, an Integrity Marketing company, specializes in customized contact center services connecting healthcare consumers to their providers. They are one of the fastest-growing companies in the US, headquartered in Sandy, Utah, and emphasize a supportive, family-like culture.
Manage patient billing episodes, prior authorizations, and claim submissions.
Review and resolve claims issues, appeals, and eligibility with payors.
Ensure timely follow-up on outstanding accounts and document activities.
Acadia Healthcare's Comprehensive Treatment Centers (CTC) division operates 170+ CARF-accredited outpatient opioid treatment programs (OTPs) nationwide, serving more than 74,000 patients daily. As the leading provider of medication-assisted treatment in the nation, our team is at the forefront of the battle against the opioid epidemic.
Act as a trusted liaison between patients and healthcare providers, providing expert guidance on pharmacy benefits.
Own patient cases end-to-end, resolving coverage, prior authorization, and appeals issues.
Collaborate with stakeholders to ensure members navigate the healthcare system with confidence.
AffirmedRx is a pharmacy benefit management company on a mission to improve healthcare outcomes by bringing clarity, integrity, and trust to the industry. They are a mission-driven organization committed to patient-centered care and ethical practices.
Eligibility Review: Review patient records and clinical documentation to determine eligibility for Form Health.
Record Collection: Manage requesting, faxing, and tracking medical records from external providers while ensuring HIPAA compliance.
File Communication: Maintain clear communication with patients and colleagues to keep them updated throughout the eligibility process.
Form Health is a virtual obesity medicine clinic that provides multi-disciplinary evidence-based obesity treatment through telemedicine. Founded in 2019, it is a venture-backed startup with an experienced clinical and leadership team, committed to a culture of inclusion and patient-first values.
Provide initial training on central business office duties to new staff.
Develop into higher-level roles with two years of acceptable performance.
Piedmont Healthcare Corporate is a healthcare organization focused on revenue cycle management and central business office operations. It is a large corporate entity with a culture centered on accuracy and development.