Manage billing and collections to support timely reimbursement.
Investigate claim denials and implement solutions.
Collaborate with payers and internal teams to resolve discrepancies.
Evernorth is a health services company specializing in home infusion and specialty pharmacy. They foster a collaborative, performance-driven culture focused on continuous improvement.
Research denied claims and complete portal inquiries or outbound calls to insurance reps to identify root causes.
Resubmit corrected claims using CMS 1500 knowledge and draft appeals in line with medical policies.
Prioritize denials using the internal Claim Prio Model and flag system improvements to reduce denial inflow.
Grow Therapy is a mental health care platform operating a three-sided marketplace that connects providers, insurance payors, and patients to expand access to quality care. Backed by over $328M in funding and a $3B valuation, the company fosters an ambitious, ownership-driven culture.
Manage accounts receivable, including analysis of aged AR and identification of root cause issues.
Investigate, resolve, and appeal insurance claim denials, contacting payer representatives as needed.
Collaborate with internal teams and care center staff to drive optimal revenue cycle performance.
Privia Health is a technology-driven physician enablement company that partners with medical groups and health systems to optimize practices and improve patient experiences. It is led by top industry talent and physician leadership with a focus on scalable operations and cloud-based technology.
Review referred accounts to validate underpayments and analyze reimbursement variance reports.
Request additional payment from insurance companies and perform timely follow-up on all assigned accounts.
Escalate unresolved appeals, prepare monthly denial logs, and collaborate to recover underpayments.
Lucile Packard Children's Hospital Stanford provides world-renowned pediatric care, combining advanced technologies and breakthrough discoveries with family-centered care. We support our caregivers with continuing education and state-of-the-art facilities, fostering a caring and committed team culture.
Monitor and manage post payment queues, conducting outreach and negotiation calls to providers.
Communicate with providers to verify understanding of NSA claims payments and regulations.
Maintain HIPAA compliance and document all conversations, payment rates, and counter offers.
Reliant Health Partners is an innovative medical claims repricing service provider that helps employers achieve maximum health plan savings. The company tailors services to each client’s needs and values a diverse, inclusive workplace.
Manage end-to-end case activities for insurance verification, authorization, and reimbursement.
Serve as the single point of contact among patients, providers, payors, and internal teams.
Prioritize competing demands to ensure timely patient access to therapy.
PRO-Spectus supports patient services programs by navigating patient access from benefit verification through claims and reimbursement resolution. The company fosters a supportive, teamwork-driven culture focused on improving patients' lives.
Coordinate denial and appeal follow-up activities to ensure timely resolution of insurance denials and appeals.
Investigate payment issues with insurance carriers, maintain tracking systems, and document follow-up actions.
Analyze performance data and collaborate with revenue integrity teams to improve billing accuracy and recovery.
This healthcare organization specializes in pediatric care and research, focusing on operational excellence. The team fosters a collaborative culture centered on quality, accountability, and continuous improvement.
Research and analyze credit balances on patient accounts to determine if overpayments have been made.
Prepare and process refund requests, payment corrections, and transfers of patient payments to resolve outstanding balances.
Ensure compliance with credit balance review processes and maintain accurate documentation in EPIC.
Clinical Health Network for Transformation (CHN) is a collaboration between Planned Parenthood affiliates across the United States, aiming to bring high-quality, affordable care to communities. CHN is committed to advancing health equity and racial justice, and fosters a culture of accountability and inclusivity.
Contact insurance companies to check claim status and appeal submissions via payer portals and phone calls.
Manage administrative tasks such as gathering medical records, processing mail, and maintaining filing systems.
Build foundational knowledge of healthcare claims, ERISA regulations, and Commercial and Managed Care insurance policies.
Ternium specializes in resolving complex healthcare insurance claim denials and delays, helping hospitals and health systems optimize their revenue cycles. We are a growing, mission-driven team focused on professional development, inclusion, and improving healthcare outcomes.
Coordinates patient, client, and insurance billings for a medical facility, ensuring accurate and complete financial records.
Processes insurance payments, obtains prior authorizations, and investigates denials to maximize reimbursement.
Communicates with providers and patients to resolve billing inquiries and maintain compliant billing operations.
HNL Lab Medicine is a medical laboratory providing testing and related services to physician offices, hospitals, long-term care facilities, employers, and industrial accounts. With more than 2,000 professionals, including board-certified pathologists and certified laboratory scientists, the company emphasizes patient-focused care and operational excellence.
Serve as a subject matter expert in claim denials, payment posting, and remittance reconciliation, independently managing complex queues.
Analyze Explanation of Benefits (EOBs) and remittance advice to identify root causes of denials and payment discrepancies.
Collaborate with team members to optimize workflow, resolve billing issues, and mentor junior staff.
Lyra Health is a leading provider of evidence-based mental health care, serving more than 20 million people globally through employer and health plan partnerships. The company has delivered over 15 million sessions of care and fosters a culture focused on innovation, collaboration, and high-quality outcomes.
Own relationships with commercial and government health plans, serving as primary escalation contact.
Support contract negotiations and renewals with financial analysis, tracking deadlines and rate changes.
Partner with revenue cycle to resolve denials and underpayments, and report payer performance to leadership.
Adaptive Home Health is fixing US healthcare with an AI-native physical care platform, starting with home health. It pairs one of the best AI teams in the world with healthcare veterans, valuing innovation and problem-solving in a fast-growing environment.
Process and transmit electronic and paper claims to insurance companies, patients, and other responsible parties.
Follow up on unpaid claims, review rejections, and resolve payment questions with insurance providers.
Verify insurance benefits, analyze charges and payments, and support coordination of benefits for patient accounts.
Munson Healthcare is northern Michigan's largest healthcare system, operating eight award-winning community hospitals across 29 counties. The organization values excellence, teamness, positivity, and creativity, and is committed to creating exceptional experiences for patients and staff.
Review unpaid accounts and take action to ensure timely and accurate reimbursement of aged accounts receivable.
Work closely with auto insurance carriers and attorneys to manage Motor Vehicle Accident (MVA) and litigation claims.
Meet productivity benchmarks, document actions, and identify trends while assisting internal and external customers.
Upstream Rehabilitation is the largest dedicated provider of outpatient physical and occupational therapy services in the U.S. With 1,200+ locations and 8,000+ employees, it fosters an inclusive workplace and uses data and technology to drive operational excellence.
Manage end-to-end denials and appeals to maximize reimbursement recovery.
Analyze payer policies and medical documentation to develop appeal strategies.
Collaborate with clinical and financial teams to improve revenue cycle performance.
Our partner organization focuses on improving patient outcomes and supporting cancer care. They are a collaborative remote team blending clinical, financial, and administrative expertise.
Investigate claim denials, navigate evolving payer requirements, and ensure complex claims are prioritized and resolved accurately.
Partner with cross-functional teams to identify operational and denial trends, optimizing workflows and claim outcomes.
Act as the pod’s go-to expert for payer workflows, claim resolutions, and best practices, supporting new-hire onboarding and team performance.
Rula is a mental healthcare company dedicated to providing quality, evidence-based care and reducing stigma around mental health. It is a remote-first company with a focus on inclusion, employee well-being, and making mental healthcare work for everyone.
Post payments, adjustments, and denials from ERAs, EOBs, and lockbox files into customer PM systems.
Balance daily batches, reconcile to bank deposits, and resolve missing or mismatched ERAs.
Flag underpayments and denials, resolve unapplied cash, credit balances, refunds, and transfer balances.
Amperos is healthcare's first AI-native denial management and revenue recovery platform, using agentic AI to resolve claims end-to-end. Backed by a $16M Series A, it remains a small, early-stage team tackling a $260B+ problem with a mission-driven culture.
Manage pre-service authorization denials and coordinate reconsiderations, appeals, peer-to-peer reviews, and payer exception requests within applicable timeframes.
Interpret payer policies, medical necessity criteria, and coverage requirements to determine appropriate resolution pathways and obtain supporting documentation.
Collaborate with providers, payers, and internal teams to resolve complex cases, identify denial trends, and support process improvement.
IVX Health is a national provider of infusion and injection therapy for patients managing complex chronic conditions. They are a growing healthcare organization with a culture built on collaboration, innovation, and purpose, offering professional development and meaningful work.
Make high-volume outbound calls to investigate, bill, and maximize payments on medical claims to insurance companies. - Research auto accident details to determine responsible payers and submit bills and documentation. - Follow up on denied or incorrect payments and support team with reports, audits, and overall assistance.
Revecore helps hospitals recover earned revenue so they can continue serving patients and communities. Trusted by over 1,300 hospitals across 48 states, the company offers a supportive, innovative culture where employees are trusted to do their best work.