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.
Serve as the primary non-clinical contact for members, providing timely and empathetic assistance via phone, email, and other channels.
Explain healthcare benefits and programs, coordinate appointments, and manage cases from intake through resolution.
Collaborate with clinical teams and providers to remove barriers to care and ensure a seamless healthcare journey.
The company provides healthcare navigation and member support services, helping members access essential healthcare services. The culture emphasizes customer service, remote work, and professional development in a technology-driven healthcare environment.
Process referrals and prior authorizations, ensuring accurate and timely documentation.
Collaborate with clinical teams, physician offices, and insurance companies to resolve authorization issues.
Monitor denial reports, manage referral tracking, and communicate decisions to providers, staff, and patients.
Baystate Health is an integrated healthcare system serving western Massachusetts. With 12,000 employees and a community-focused culture, it includes five hospitals and offers career growth.
Coordinates utilization review and prior authorization requests, ensuring accurate entry into the UM platform.
Provides customer service to providers and members, confirming benefits and answering authorization questions.
Facilitates communication between reviewers, hospitals, and physicians to ensure timely decisions.
University of Utah Health Plans is a patient-focused organization that enhances health through patient care, research, and education. It is part of a nationally ranked academic medical center with five hospitals and eleven clinics, fostering a culture of collaboration and excellence.
Review clinical documentation and ensure accurate charge entry in the billing system.
Submit insurance claims, monitor status, and resolve denials to maintain a clean billing cycle.
Support families with billing questions and assist with accounts receivable monitoring.
InStride Health delivers specialty anxiety and OCD care for kids, teens, young adults, and families through evidence-based clinical care and technology. The company is a mission-driven startup focused on expanding access to insurance-based care, with a collaborative culture grounded in values like heart, humility, and community.
Respond to patient inquiries through chat, email, and internal messaging with clarity, warmth, and professionalism.
Break down complex topics (billing, CPT codes, coverage, device returns) into simple, patient-friendly explanations.
Document all interactions clearly and accurately, ensuring consistent follow-up until issues are fully resolved.
Salvo Health takes a new approach to help millions of Americans facing chronic health conditions, centered on chronic gut health and metabolic conditions. Backed by leading health care investors, Salvo's team includes board-certified physicians, dietitians, nurses, and therapists who provide evidence-based, continuous care.
Counsel patients on healthcare payment responsibilities, insurance benefits, and financial assistance options.
Contact insurers, resolve registration, billing, authorization, and claims issues to advocate for patients.
Maintain accurate documentation and provide compassionate, clear communication on sensitive financial matters.
A healthcare organization helping patients navigate medical costs, insurance benefits, and financial assistance. It operates as a large, patient-centered environment focused on caregiver well-being and professional development.
Take inbound calls from patients, providers, and members, handling everything from routine questions to emergent situations.
Support members with insurance needs, including changing primary care physicians, locating urgent care clinics, and getting prescription authorizations.
Provide 24/7 Triage Support and assign priority for a Registered Nurse to deliver health advice.
Carenet Health pioneers advancements across the healthcare consumer journey, interacting with 1 in 3 Americans daily to deliver positive healthcare experiences and improve outcomes. For over 30 years, the company has combined clinical expertise with data-driven technology, fostering a collaborative and innovative culture that empowers growth through trust, opportunity, and accountability.
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.
Serve as the first point of contact for patients in person and by phone, delivering excellent customer service.
Process new orders, verify insurance, obtain authorizations, and gather documentation for accurate billing.
Perform data entry, collect payments, and make outbound satisfaction calls to patients and referrals.
Accendra Health makes essential healthcare products and services accessible outside traditional settings. With over 6,000 teammates in 250+ locations under Apria and Byram Healthcare, it offers meaningful work focused on personalized, long-term care.
Receive medical claims from healthcare providers or patients and verify supporting documentation to ensure completeness.
Interpret Explanation of Benefits (EOB) and CMS-1500 forms, then evaluate claims against program-specific business rules for approval or rejection.
Provide support to customer inquiries via phone, email, or fax while maintaining HIPAA compliance and meeting daily productivity goals.
IQVIA is a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. With operations in over 100 countries, they cultivate a diverse, collaborative culture focused on improving patient outcomes.
Monitor clearinghouse portals and resolve rejected medical claims daily.
Investigate rejection causes including coding errors and eligibility issues.
Correct claim information and resubmit to insurance payers for reimbursement.
Our partner is a healthcare revenue cycle management company focused on optimizing medical claims processing for providers. They offer a collaborative, inclusive work culture with opportunities for professional growth in a remote environment.
Coordinate insurance clearance for inpatient and outpatient services, verifying eligibility and benefits.
Review scheduled appointments, obtain authorizations, and document progress in EPIC.
Assist patients with payment options and refer uninsured patients for Medicaid or charity screening.
UW Medicine is Washington's only health system that includes a top-rated medical school and an internationally recognized research center. Nearly 29,000 healthcare professionals, researchers, and educators work within its family of organizations, fostering a collaborative and compassionate environment.
Serve as the first point of contact, greeting patients and handling inbound calls.
Verify insurance, update demographics, and register patients in EMR (EPIC).
Document patient concerns, triage messages, and escalate emergent issues promptly.
U.S. Urology Partners provides urology and specialty services, including surgery and cancer treatment. It has over 50 offices across the East Coast and Midwest, with values of compassion, collaboration, respect, and accountability.
Verify insurance, obtain benefits, calculate estimates, and secure prior authorizations for outpatient services.
Act as liaison between payers and clinic staff; follow up on denied or delayed authorizations.
Maintain detailed documentation and resolve issues with physicians, nurses, and financial advocates.
University of Utah Health is a patient-focused organization enhancing health through care, research, and education. It operates five hospitals and eleven clinics with a culture of collaboration, excellence, leadership, and respect.
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.
Manage the full lifecycle of PIP and Medical Payments claims, from coverage verification and investigation to settlement or denial.
Apply medical cost-containment strategies, coordinate experts, and identify subrogation opportunities while meeting compliance standards.
Work remotely within the US, maintaining accurate claim files and communicating professionally with claimants and stakeholders.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. The partner company is seeking a remote Associate PIP Claims Rep to handle Personal Injury Protection claims across multiple states in a structured, compliance-focused environment.
Obtain managed care authorizations and verify patient insurance benefits prior to services.
Review office schedules daily and update EHR systems with authorization and insurance details.
Coordinate with staff and providers on denials, peer-to-peer reviews, and monthly re-verification of coverage.
Surgery Partners operates a network of surgical facilities and provides healthcare services across the United States. The company fosters a diverse and inclusive workplace, offering comprehensive benefits and professional development opportunities.