Act as a liaison between patients, providers, and insurance companies to ensure accurate data collection and compliance.
Verify insurance benefits, eligibility, and prior authorization requirements for scheduled patients.
Notify patients of estimated liability and act as a financial counselor regarding insurance and payment options.
Vail Health is the world's most advanced mountain healthcare system, providing exceptional care through a 56-bed hospital and various outpatient services. It is a nonprofit organization committed to patient-centered care and community well-being.
Verify patient insurance eligibility, benefits, authorization requirements, and referral needs prior to services.
Obtain referrals from primary care providers and ensure all referral requirements are met before scheduling.
Communicate insurance coverage, financial responsibility, and estimated costs to patients in a clear and empathetic manner.
Oshi Health is a virtual digestive health practice on a mission to transform GI care. As a startup, they offer a remote-first, mission-driven environment with a focus on improving patient lives.
Work with ABA/behavioral health providers to collect patient information and communicate authorization decisions
Verify patient eligibility and benefits with insurers and complete prior authorizations via portals or calls
Manage multiple authorizations and collaborate with product team to automate parts of the process
Silna Health is obsessed with optimizing the broken healthcare system by automating prior authorizations and eligibility checks. Backed by Accel and Bain Capital Ventures, they are a fast-growing company working across behavioral health, physical health, ambulatory care, and post-acute care.
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.
Submit and track prior authorization requests across multiple insurance payers
Gather and review clinical documentation required to support authorization requests
Follow up with payers on pending requests and monitor authorization status through resolution
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company operates with a fully remote workforce and emphasizes a detail-oriented, collaborative culture.
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 complete and timely processing of claims, including reviewing daily correspondence and resolving issues through SalesForce.
Oversee accounts receivable functions such as worklists, zero pay, and denials to ensure timely resolution.
Serve as an escalation point and subject matter expert on internal sub-teams, driving toward daily and monthly KPIs.
Privia Health is a technology-driven physician enablement company that collaborates with medical groups and health systems to optimize practices and reduce costs. They are a national organization with top industry talent and a focus on high-value care.
Reviews insurance eligibility and coverage issues for patient appointments across practice sites.
Serves as the primary escalation contact for scheduling and practice teams on pre-visit and day-of-visit insurance questions.
Follows up post-visit to resolve PCP assignment and Coordination of Benefits discrepancies.
Bluebird Kids Health provides underserved communities with value-based pediatric primary care, aiming to help every child thrive through comprehensive services and around-the-clock support. The organization is a dynamic team focused on exceptional health outcomes and a rewarding environment for clinicians and staff.
Supervise and develop Patient Connection Center staff handling imaging order accuracy, insurance verification, and authorizations.
Monitor performance, coach employees, and ensure high-quality patient access and scheduling processes.
Collaborate with leadership to meet revenue cycle goals and maintain compliance with healthcare reimbursement standards.
Piedmont Healthcare is a not-for-profit health system that provides comprehensive medical services across Georgia. With a focus on patient-centered care, the organization operates multiple hospitals and employs a large, dedicated workforce.
Lead and coach a team of Patient Access Case Managers to achieve departmental KPIs and service levels.
Oversee daily operations, coordinate with vendors and internal teams, and ensure compliance with reimbursement workflows.
Drive process improvements, develop training materials, and foster a patient-focused culture.
Noctrix Health develops clinically validated therapeutic wearables for chronic neurological disorders. Their team combines medical device specialists, neuroscientists, and engineers to deliver prescription-grade, drug-free therapy.
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.
Own end-to-end claims and revenue-cycle operations, including claim submission, denials, appeals, and collections across Medicaid and commercial payers.
Build and optimize payer-specific billing workflows, including claim configuration, coding, and credentialing.
Drive cross-functional execution with Operations, Partner Success, and Finance to improve processes and achieve over $1M in monthly claims.
Jukebox Health partners with health plans to make homes safer and more accessible for older adults and high-needs populations, combining technology with networks of clinicians, suppliers, and installers. Founded by experienced entrepreneurs, Jukebox Health is a fast-growing healthcare services company backed by top venture capital firms like Valtruis and The Home Depot, with a high-trust, collaborative, remote-first culture.
Own RCM end to end for Medicaid and Medicare, from eligibility through claims, denials, and collections.
Lead strategy, team building, KPI reporting, and cross-functional collaboration with operations, product, and engineering.
Analyze claims data to improve collection rate, manage payer relationships, and ensure billing compliance.
Pair Team is an AI-enabled medical group for Medicaid and Medicare, delivering whole-person care through community-based organizations. It is California's largest complex care provider and is building an AI platform to scale across the safety net.
Own and execute U.S. market access and reimbursement strategy across product lines from coding through payment.
Serve as subject-matter expert on CMS/Medicare, including LCD/NCD processes and diagnostic pricing pathways.
Partner cross-functionally with Medical Affairs, Clinical, and Commercial to align evidence with payer requirements.
We develop next-generation blood-based tests for early cancer detection using fragmentomics and machine learning. We are a small, collaborative team with a culture of science, pragmatism, and inclusivity, with offices in Palo Alto and Baltimore.
Prepare and file stop loss claim submissions, assessing eligibility against policy terms and gathering required documents.
Build and maintain claimant files, ensuring accurate and audit-ready records throughout the claim lifecycle.
Track and recover outstanding reimbursements, monitoring requests and following up with carriers to drive resolution.
Personify Health created the first and only personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. The company serves employers, health plans, and health systems with data-driven solutions and is on a mission to empower people to lead healthier lives.
Ensure accurate verification of patient insurance benefits and authorizations.
Meet quantity and quality benchmarks for production and denial rates.
Utilize knowledge of medical terminology and insurance processes.
Gastro Health is one of the largest gastroenterology multi-specialty groups in the US with over 130 locations. They have a collaborative team and offer a great work/life balance.
Code across specialties, translating clinical documentation into ICD-10-CM, CPT, and HCPCS codes with heavy dermatology and orthopedic focus.
Own documentation quality by validating provider notes against E/M guidelines and directly communicating with practice managers and physicians.
Resolve denials by researching complex coding-related denials, understanding why claims were denied, and using AI tools to draft appeals.
Clarity RCM is a rapidly growing revenue cycle management company on the Inc. 5000 list. They manage billing, credentialing, and account management for private dermatology practices nationwide, expanding into orthopedics.
Investigate and analyze Motor Vehicle Accident accounts to coordinate insurance benefits and resolve outstanding balances for clients.
Conduct online medical research, review medical records, and manage claim life cycles using proprietary systems and tools.
Communicate with payers, attorneys, and clients to resolve claims, handle denials, and identify trends for prevention.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its E360 RCM intelligent automation platform. The company is a multi-year recipient of the Top Workplaces award, ranked #1 by Black Book in 2024, and has been on the Inc. 5000 fastest-growing companies list for eleven years, fostering a culture centered on professional growth and employee investment.
Manage insurance authorizations for clients in PHP and IOP programs, including pre-certifications and concurrent reviews.
Verify benefits, obtain Single Case Agreements, and build medical necessity cases using ASAM, LOCUS, and CALOCUS criteria.
Maintain accurate authorization, denial, and SCA records and prepare appeals on denied authorizations.
AWA and PRC are dual behavioral health organizations operating PHP and IOP programs across South Florida. They exist to serve clients and families at their most critical moments.