Serve as the primary point of contact for providers and Medicare contractors, responding to inquiries via phone, written, and electronic channels.
Maintain knowledge of contract requirements, develop professional relationships, and educate providers on proper protocols and appeal rights.
Perform research, due diligence, and data entry to resolve complex issues, while notifying management of escalated concerns.
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, the company combines an AI-powered platform with best-in-class expertise.
Responsible for timely and accurate submission of data calls and statistical data to regulatory bodies.
Review and interpret regulatory reporting requirements and analyze their impact.
Reconcile submissions to data sources and resolve variances to ensure accuracy.
Sutton National Group is a rapidly growing national property and casualty insurance carrier group. The company fosters a fast-paced, highly collaborative environment and seeks proactive, experienced problem solvers.
Audits claims, customer service inquiries, member and group enrollment activities to validate Plan performance.
Supports internal audit and special investigations as needed.
Analyzes performance guarantee accounts and participates in external client audit requests.
Capital Blue Cross is a health insurance company providing coverage and services. They have been voted one of the 'Best Places to Work in PA' and foster a flexible, supportive culture with emphasis on employee well-being.
Respond to member and staff inquiries via the centralized ticketing system with timely, accurate support.
Process a variety of membership, childcare, and program transactions across YMCA operating systems.
Complete audits of account data and escalate issues to ensure data integrity and SLA adherence.
YMCA of the USA is a nonprofit organization that strengthens communities through youth development, healthy living, and social responsibility. It operates remotely with a culture centered on caring, honesty, respect, and responsibility, and serves a wide network of YMCA associations nationwide.
Handle customer enquiries and emergency situations over the phone with professionalism.
Meet service delivery targets by resolving queries in a timely and consistent manner.
Use multiple systems to accurately record interactions and build customer trust.
Capita is an outsourcer that helps clients across the public and private sectors run complex business processes more efficiently, creating better consumer experiences. Operating across 8 countries, we support primarily UK and European clients with people-based services underpinned by market-leading technology.
Schedule, confirm, and manage appointments for benefit counselors, coordinating daily schedules to maximize efficiency and accommodate client needs.
Provide outstanding customer service by assisting clients with scheduling questions and general benefit enrollment information, maintaining accurate records.
Support the benefit team with administrative tasks including data entry, report preparation, and rescheduling appointments as needed.
Hilb Group is a Top 25 middle-market independent insurance broker offering expertise in property & casualty, employee benefits, HR consulting, and retirement services nationwide. The firm provides the resources of a big broker with the personal service of a small agency, driven by values of trust, passion, integrity, and growth.
Guide employees through voluntary benefits education and enrollment via in-person, phone, and web platforms.
Complete benefit applications with focus on accuracy, compliance, and confidentiality.
Deliver high-quality customer service while managing high-volume enrollment during peak periods.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. As a service provider, it facilitates recruitment by processing applications and sharing shortlists with employers.
Process energy incentive applications, reviewing for eligibility.
Provide inbound and outbound support to applicants and program participants via phone and online chat.
Perform back-office processing in support of utility clients and their customers.
AdNet is a staffing and recruitment agency that connects talent with companies in various industries. They emphasize a culture of acceptance and belonging, and are committed to inclusive practices.
Manage patient collections and financial arrangements via calls and account review.
Inform patients of coverage options including Government programs and Financial CARE.
Perform skip tracing and resolve accounts with uninsured or residual balances.
Air Methods provides air medical transport services. The company is an EEO/AA employer with a focus on patient billing and collections, and maintains a culture of compliance and compassion.
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.
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.
Serve as the vital link between members and their dental care by answering 40-60 inbound calls daily, addressing inquiries with compassion and expertise.
Capture member information accurately, investigate unresolved issues, and collaborate with internal teams to ensure timely resolutions.
Maintain flexibility and compliance with HIPAA, while navigating multiple software systems in a high-volume call center environment.
Avēsis has been providing essential ancillary benefit solutions since 1978, developing and administering programs covering over 8.5 million members. They strive for excellence in member satisfaction and client retention, fostering a culture of inclusivity and diversity.
Accurately enter and update clinical and operational data into internal systems, ensuring data integrity.
Review data for completeness and accuracy, identifying and resolving discrepancies.
Collaborate with cross-functional teams to support data validation and quality control processes.
Sarah Cannon Research Institute (SCRI) is one of the world's leading oncology research organizations conducting community-based clinical trials. Founded over 30 years ago, SCRI's research network includes more than 1,300 physicians and over 200 locations across 20+ states in the U.S., and is a subsidiary of McKesson.
Conducts administrative and clinical intake of calls for clinical review.
Provides quality customer service and telephonic support to providers and office staff.
Maintains high confidentiality and documentation standards while performing data entry.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving over 700 clients across 10 industries. With 66,000+ employees across 13 countries, they combine deep domain expertise with AI platforms to drive business resilience and sustainable outcomes.
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.
Answer inbound calls and make outbound calls to participants enrolled in the Condition Management Program.
Assist participants via email and online messaging, and accurately document all participant communications.
Work independently and in a team environment with strong customer service skills; no experience required as training is provided.
Cottingham and Butler's Health and Wellness division focuses on reducing medical costs while increasing employee engagement and productivity through onsite screenings, technology, and condition management programs. They value an open-door culture where team opinions are appreciated.
Act as a primary point of contact for client inquiries via email and phone, handling professional correspondence with speed and clarity.
Manage daily account intake processes, including data validation and strict accuracy checks to ensure compliance.
Support front-line collections by handling settlement offers, account instructions, and maintaining data integrity across systems.
Sentry Credit, a wholly owned subsidiary of TrueAccord, combines machine learning with a human-based approach to transform debt resolution and financial health. With over 30 years of legacy and a world-class team, they serve millions of consumers annually.
Handle incoming customer requests via phone, email, and website with urgency and attention to detail.
Process, monitor, and manage critical customer shipments using the proprietary logistics management platform.
Communicate with customers and agents professionally and courteously while meeting team metrics.
Marken is a clinical and advanced therapy logistics provider within UPS Healthcare. As part of UPS, which employs over 500,000 people globally, it offers a rewarding culture and opportunities for growth.
Process medical claims by reviewing, validating, and entering data accurately and in compliance with policies.
Identify discrepancies, flag unusual cases, and escalate issues while maintaining productivity and quality standards.
Collaborate with peers, participate in training, and uphold confidentiality and regulatory requirements like HIPAA.
Sidecar Health is redefining health insurance by making excellent healthcare affordable and accessible for everyone. The passionate team, with backgrounds as tech leaders, policy makers, and healthcare professionals, is driven to fix a broken system and create a more personalized, affordable, and transparent experience.