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• Ensure the organization's medical coding and billing practices comply with regulations and guidelines.
• Perform independent audits and provide training for medical staff.
• Act as a subject matter expert on coding and documentation standards.

Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care.

• Conduct thorough audits of medical records and coding practices.
• Develop and deliver educational programs on coding best practices.
• Collaborate with billing, clinical, and revenue cycle teams.

Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching.

• Oversee the end-to-end billing process.
• Maintain comprehensive billing records, monitor and report key performance indicators related to claims submission, denial resolution, and payment posting.
• Serve as the primary point of contact for internal teams and external payers.

Apollo Behavior is the premier provider of ABA therapy in metro Atlanta, and the largest ABA provider based in Georgia.

• Perform auditing of claims, ensuring processing, payment, and financial accuracy.
• Complete reporting of audits finalized with decision methodology for procedural and monetary errors.
• Communicate corrections and adjustments to Examiners as identified on pre-payment audits.

Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their bills.

Acts as key point of contact for the processing of enrollment applications for all providers. Works with System Credentialing and local medical staff contacts. Responsible for completing the ongoing review and attestation of all Munson Healthcare provider enrollment records.

Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents.

Review and accurately post insurance and patient payments. Resolve auto-posted ERA errors on a daily basis. Research and follow up on outstanding insurance claims.

Prompt is revolutionizing healthcare by delivering highly automated and modern software to rehab therapy businesses, their teams, and the patients they serve.

• Meet with billing teams to train them on billing best practices and assist in their transition over to Prompt.
• Assist in teaching submission, posting, invoicing, AR, etc best practices on Prompt.
• Understand unique team needs to help configure and develop workflows with their new EMR/PM system

Prompt is revolutionizing healthcare by delivering highly automated and modern software to rehab therapy businesses, the teams within, and the patients they serve. As the fastest growing company in the therapy EMR space and the new standard in healthcare technology, they are looking for someone scrappy, willing to bring new ideas, take on big challenges, and is into doubling down on what works.

• Lead the preparation and submission of comprehensive provider rosters to Managed Medicare, Medicaid, and commercial payers.
• Audit internal provider data against database records to ensure 100% accuracy before submission.
• Serve as the primary point of contact for health plans to resolve roster discrepancies, rejections, or paneling delays.

Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs.

• Conduct comprehensive coding reviews to ensure accuracy in code assignment and reimbursement.
• Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications.
• Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations.

Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. The Coherenauts who succeed here are empathetic and believe diverse, inclusive teams make the most impactful work.

Perform pre-call analysis and check the status by calling the payer or using IVR or web portal services. Maintain adequate documentation on the client software to send the necessary documentation to insurance companies. Comply with all reimbursement and billing procedures for regulatory, third party, and insurance compliance norms.

You’ll help connect providers, patients and communities with innovative solutions that create real value by supporting both the financial and clinical sides.

• Assists with medical record documentation requests and leverages medical management system to initiate case and/or authorization to support clinical processes.
• Conducts fax and telephonic outreach; and written communications to members and/or providers to communicate status of UM/CM processes.
• Actively participates in supporting department compliance and performance through administrative activities such as report monitoring/distribution, and other tasks as assigned by leadership.

Capital Blue Cross promises to go the extra mile for their team and community. Employees consistently vote it one of the “Best Places to Work in PA”.

• Multi-task position covering main functions of the Central Business Office.
• Accurately handle at least one unit function of the Central Business Office.
• Monitor billing errors and claim/line item rejections.

Piedmont Healthcare is a company in the healthcare sector, though further details are not given in the job description.

• Provide strategic leadership and expert oversight for payer relations and contracting.
• Manage a team responsible for negotiating and monitoring contracts with payers.
• Analyze contract terms and financial performance to influence strategic pricing strategies.

CommonSpirit Health is building a healthier future for all through its integrated health services as one of the nation’s largest nonprofit Catholic healthcare organizations.

• Responsible for accurate and timely processing of designated claims.
• Resolve claim issues, answer incoming SalesForce cases and management of issues that escalate to the RCM team.
• Management of accounts receivable, including analysis of aged AR, and investigating denial sources.

Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems.

In this position, you will be responsible for handling a variety of tasks to ensure payment collection activity is resolved, disputed, or sent to Legal. Conduct collection activity on appealed claims by contacting government agencies, third party payers via phone, email, or online. Communicate with insurance plans and researching health plans for benefits and types of coverage.

Sutherland is a digital transformation company helping customers globally achieve greater agility and transform automated customer experiences for over 35 years.

• Provides support in the functional areas of the Revenue Cycle, including Billing, Reimbursement, and Insurance Recovery.
• Ensures adherence to company policies, procedures, and related government regulations.
• Prepares and submits claims to various insurance companies electronically or on paper.

At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being.

• Provide high-level customer service to patients and fellow employees.
• Review and update billing, codes, and account information.
• Ensure accurate billing for all services provided, adhering to compliance.

Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products. With 160 years of clinical excellence, Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value.

• Perform coding audits and reviews on a variety of professional fee record types.
• Perform necessary research in order to provide the client with supportive regulatory and coding guideline documentation.
• Assist in the design and presentation of educational seminars to clients and staff.

UASI has over 40 years of experience and enduring partnerships with our valued clients, and is proud of the stability they’ve built and the long-term success of their dedicated team.

The Payment Corrections Coordinator will research, process, and resolve payment discrepancies, ensuring smooth billing workflows. You will collaborate closely with accounts receivable teams and managers, assist with special projects, and perform compliance audits. This position provides the opportunity to contribute to process improvements, reduce errors, and help optimize financial operations.

Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching.

The Provider Enrollment Specialist is responsible for timely and effectively enrolling practitioners in health plans. The Specialist will monitor progress, ensure timeliness of enrollment completion, and provide updates. The Specialist will maintain accurate provider profiles in IntelliCred and CAQH.

Pediatrix Medical Group is one of the nation’s leading providers of specialized health care for women, babies and children since 1979.