Evaluate Medicare regulatory requirements and CMS guidance to assess compliance risks for government contracts.
Serve as a subject matter expert to ensure regulatory requirements are implemented accurately and timely across operations and partners.
Collaborate with stakeholders to develop and monitor mitigation strategies for compliance risks and issues.
HCSC expands access to high-quality, cost-effective health care and equips members with tools for better decisions. As an industry leader, they have over 80 years of experience and offer compelling careers in a collaborative, innovative environment.
Manage the collection and organization of medical records for billing and coding support
Review documentation for completeness and accuracy, ensuring HIPAA compliance
Collaborate with internal teams to track and route records for claims and appeals
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. They focus on accuracy and efficiency in revenue cycle management, with a supportive remote work environment.
Lead complex hospital and professional billing compliance audits and investigations to identify risks and ensure regulatory alignment.
Analyze billing, coding, and operational data to uncover systemic issues and provide actionable recommendations to leadership.
Serve as a billing compliance subject matter expert, advising cross-functional teams and developing training and policies.
The company is a healthcare organization focused on billing compliance and risk management, providing auditing and advisory services. It offers a remote-first collaborative environment with opportunities to influence policies and work with senior leaders.
Provide real-time documentation support to healthcare providers before and after patient encounters.
Evaluate chart review performance and assist physicians in improving coding and documentation best practices.
Ensure compliance with federal and state laws related to coding and documentation guidelines for risk adjustment.
Interwell Health is a kidney care management company that partners with physicians to reimagine healthcare. They are mission-driven and value diversity, equity, and inclusion.
Initiate and manage compliance onboarding for healthcare contractors, including credentialing verification.
Collaborate with staffing agencies and internal stakeholders to meet compliance deadlines.
Monitor credential expirations and maintain accurate records in the Vendor Management System.
Trio Workforce Solutions helps healthcare organizations manage workforce challenges through technology and services. The company is a mission-driven organization with a collaborative culture and growth opportunities nationwide.
Support the Chief Compliance Officer in developing and monitoring the Compliance Work Plan, including auditing and monitoring activities.
Manage intake, tracking, review, and response to governmental revenue cycle investigations and serve as the compliance resource for revenue cycle and operational leaders.
Develop and deliver role-based compliance training, translate regulatory changes into actionable policies, and monitor audit results to create corrective action plans.
UnityPoint Health is a healthcare organization providing comprehensive services across multiple states. Recognized as a Top 150 Place to Work in Healthcare, they are committed to team members and foster a culture of belonging.
Perform daily audits of RCM accounts to ensure accuracy and compliance with policies.
Review documentation, billing records, and account activity to identify errors and process gaps.
Communicate quality issues and provide constructive feedback to staff and department leaders.
Our partner focuses on revenue cycle management services for healthcare organizations. They foster a remote culture centered on accuracy, accountability, and continuous improvement, with a team dedicated to quality and compliance.
Serve as primary escalation point for compliance representatives, researching and resolving escalated matters.
Develop and maintain compliance SOPs, training materials, and provide ongoing coaching to team members.
Assist with compliance reporting, monitoring, and ensure policies are followed consistently.
PeopleFinders.com is an online service for locating, contacting, and verifying people and businesses. Over the past couple of decades, it has become one of the largest owners of public records data in the country.
Own the compliance strategy and risk assessment for the business, including regulatory, corporate, and clinical compliance.
Build government programs compliance capability, including Medicare marketing and member communication requirements.
Partner with clinical, product, operations, data, and payer teams to embed compliance into new workflows, AI tools, and market expansions.
Chamber is rebuilding the system for cardiology by partnering with independent cardiologists to improve outcomes through technology, data, and operational tools. As an early-stage company, they value low ego, empathy, courage, ownership, and grit, fostering a culture of innovation and human-centered care.
Oversee all day-to-day accounting operations and ensure accurate financial reporting in accordance with GAAP.
Manage income and sales tax compliance, coordinate external audits, and serve as primary point of contact for auditors.
Partner with senior leadership to provide financial insights and support strategic decisions.
Compliancy Group is a platform for healthcare compliance programs, consolidating every element of a complete program into one connected system. They are a growing SaaS company with a collaborative, mission-driven culture.
Manage governance forums, agendas, decision logs, and action tracking.
Support execution of strategic compliance priorities and monitor cross-functional dependencies.
Coordinate departmental KPIs and executive dashboarding.
HealthEdge is a healthcare technology company that provides software solutions for health plans and payers. The company fosters a culture of accountability, transparency, and compliance, operating remotely across the US.
Serves as a subject matter expert in clinical documentation quality, risk adjustment, and HCC coding integrity.
Performs prospective reviews of medical records to validate chronic conditions and ensure documentation accuracy.
Utilizes Epic and OurPractice Advisories to support accurate coding, HCC capture, and compliance.
UASI is a clinical documentation improvement consulting firm dedicated to improving the quality and accuracy of clinical documentation. They offer a collaborative, mission-driven environment with opportunities for professional growth.
Oversee content compliance review for marketing, educational, and communications materials, ensuring alignment with pharmacy regulations and FDA/FTC guidelines.
Collaborate cross-functionally with Compliance, Clinical, Marketing, and Legal teams to provide risk-based guidance and streamline content approval workflows.
Develop training resources, manage review queues in Asana, and maintain auditable documentation to support compliance and process improvement.
Strive Pharmacy is a personalized compounding pharmacy focused on individualized care, creating medications tailored to each patient's needs. The company is growing and fosters a culture of community and professional development, with team events and a commitment to employee growth.
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.
Lead portions of regulatory assessments, external audits, and accreditation processes for Commercial, Medicare, Medicaid, and Marketplace departments.
Act as primary point of contact for internal and external partners on regulatory activity, quality efforts, SOP development, and client delegation agreements.
Maintain regulatory gap status reporting, track work streams, and lead change management related to regulatory requirements.
Prime Therapeutics is a pharmacy benefit manager (PBM) with a purpose beyond profits, reimagining pharmacy solutions to connect care for those they serve. The company is a large, purpose-driven organization focused on simplifying healthcare and fostering a collaborative culture.
Oversee day-to-day operations across billing, coding, claims, and accounts receivable functions.
Coordinate workloads and monitor performance metrics to ensure client requirements are met.
Resolve escalated operational issues and improve workflows to maintain service quality.
Raventra Health is a medical services company that provides outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company emphasizes operational excellence and client service, with a focus on accuracy and efficiency.
Lead privacy and security impact assessments for partner-facing business applications.
Design and improve the Partner Data Privacy & Security Impact Assessment process.
Evaluate risks throughout the data lifecycle and recommend mitigation strategies.
Del Oro Consulting is a staffing and consulting firm that connects professionals with contract opportunities. They are a mid-sized organization focused on delivering specialized talent solutions in a collaborative environment.
Manage end-to-end credentialing and payer enrollment activities with minimal supervision.
Ensure provider readiness, accurate records, and compliant documentation across multiple systems.
Serve as a knowledgeable resource for less experienced team members and support cross-functional processes.
Our partner is a healthcare organization focused on credentialing and provider network management. They offer a mission-driven, inclusive environment with a focus on collaboration and continuous learning.
Post insurance payments, patient payments, adjustments, and contractual write-offs accurately.
Review electronic and paper remittance information to ensure payments are applied to correct accounts.
Reconcile posted payments against remittance advice and identify discrepancies.
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. They focus on accuracy and efficiency in revenue cycle management, operating with a fully remote team.
Serve as the go-to compliance resource for HSA, FSA, and HRA products, ensuring compliance with regulatory requirements.
Lead compliance risk assessments for new product features and platform developments, including AI-powered tools.
Monitor regulatory developments and produce actionable impact assessments for affected teams.
Lively set out to raise the bar on benefit solutions, offering a modern HSA and a full suite of benefits. It is a remote-first company with employees across the US, focused on user-centric design and innovation.