Review and evaluate denied claims using proprietary software to determine correct reimbursement.
Research and acquire medical records and supporting documentation for submission to payers.
Conduct telephone follow-up with payers to ensure prompt reimbursement.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations using an intelligent automation platform. The company has over 24 years of industry expertise, is a multi-year Top Workplaces award recipient, and has been on the Inc. 5000 list for eleven years.
Coordinates financial clearance activities including pre-registration, insurance verification, and authorizations to ensure timely access to care.
Maintains knowledge of payer requirements and works collaboratively with patients, providers, and insurance representatives to resolve issues.
Adheres to quality and productivity standards to support revenue cycle performance and patient access.
Boston Medical Center is a leading academic medical center dedicated to providing exceptional and equitable care to all. As a large health system, it fosters a strong sense of teamwork and support, and has been recognized as a top employer and best place to work.
Review and analyze Medicare claims sampled by the Department of Justice to determine correct coding and payment based on coverage and utilization.
Conduct in-depth claims analysis to detect fraudulent or abusive billing practices using ICD-10, CPT-4, and CMS guidelines.
Complete summary reports and communicate findings internally while maintaining confidentiality and compliance with DOJ and CMS regulations.
Empower AI provides AI-powered solutions for federal government agencies, helping them transform their workforce and operations. Headquartered in Reston, Va., the company has three decades of experience in Health, Defense, and Civilian missions and is recognized as a 2024 Military Friendly Employer.
Contact insurance companies to collect outstanding accounts receivable and follow up on appeals.
Process and refile claims, audit adjustments, and resolve manual tasks assigned for follow-up.
Maintain an accuracy rating of 97% or greater and identify trends to leadership.
US Anesthesia Partners is a healthcare organization that provides anesthesia services and manages related billing and accounts receivable. The company emphasizes professionalism, accuracy, and teamwork in a remote work environment.
Coordinate with providers, insurance companies, and hospital staff to secure pre-authorizations and address denials.
Review daily schedules, obtain authorizations via phone/fax/portals, and verify CPT/ICD-10 code alignment.
Communicate with patients about approvals, reschedules, or cancellations while maintaining HIPAA compliance.
Cardiac Study Center is a dedicated team at the forefront of cardiovascular medicine, empowering patients with the knowledge and treatment they need to lead heart-healthy lives. As a growing organization with deep roots in the Pacific Northwest, we foster continuous learning and collaboration among passionate professionals.
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.
Supervise and advise claims examiners in all phases of the adjudication process and ensure compliance with regulations and departmental standards.
Manage workflow, caseload challenges, and team performance to meet production goals and quality standards.
Act as subject matter expert for complex claims, provide coaching and training, and participate in hiring and performance evaluations.
Protective helps protect customers against life's uncertainties by providing insurance and peace of mind. The company is focused on employee wellbeing and offers a broad benefits package including health, financial, and paid time away.
Manage end-to-end credentialing and payer enrollment for behavioral health providers and facilities.
Serve as subject matter expert on credentialing requirements, ensuring timely and compliant files.
Coordinate with HR, Talent Acquisition, and leadership to facilitate provider onboarding and resolve issues.
We are a leading provider of immediate-access behavioral health crisis care. We are physician-led and data-driven, with over 15 years of crisis care expertise, recognized as a national best practice.
Convert raw medical claims (837 EDI, UB-04, CMS-1500) into canonical models applying healthcare coding standards.
Perform data quality audits and write SQL/Spark SQL queries to validate pipeline output and detect overpayment patterns.
Act as SME on claims coding, adjudication rules, and payer policy, mentoring analysts and collaborating with cross-functional teams.
Machinify is a healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients across the US. Deployed by over 85 health plans and representing more than 270 million lives, the company combines an AI-powered platform with industry expertise to maximize financial outcomes and reduce healthcare costs.
Support front-end and back-end billing operations for a fully virtual care delivery model.
Ensure accurate charge entry, claims submission, and denial resolution.
Serve as a billing point of contact for families, explaining insurance processes with empathy.
InStride Health delivers specialty anxiety and OCD care for children, teens, and young adults through a combination of research-backed clinical care and innovative technology. The team is mission-driven, focused on expanding access to insurance-based care, and values heart, smart work, humility, and community.
We are seeking detail-oriented candidates for medical billing and coding positions. - Experienced professionals in claims, insurance verification, and accounts receivable are encouraged to apply. - Entry-level candidates will receive training as needed to succeed in the field.
Sydiera Healthcare Staffing connects motivated individuals with opportunities in medical billing and healthcare administration. They welcome both experienced professionals and entry-level candidates interested in building a career in the healthcare revenue cycle.
Review, process, and troubleshoot incoming Prior Authorization requests for various medications.
Accurately process requests according to regulatory and client-specific guidelines while meeting departmental performance metrics.
Work with clinical teams and handle requests via phone, fax, and web submission.
Navitus is a pharmacy benefit manager (PBM) alternative focused on reducing drug costs to make medications more affordable. The company offers a diverse and creative work environment with numerous employee benefits and growth opportunities.
Review appeals of adverse benefit determinations within federal and state regulatory timeframes.
Apply medical policy, coding guidelines, and contractual requirements to assess coverage decisions.
Collaborate with medical divisions and respond to state insurance department inquiries regarding benefit complaints.
Arkansas Blue Cross and Blue Shield is a health insurance provider serving Arkansas. It is consistently ranked as one of the best places to work in Central Arkansas, with an inclusive culture and an average employee tenure of 10 years.
Reviews inpatient and outpatient medical records for documentation, abstracting, and assigning codes to the highest level of specificity.
Assigns procedural and diagnosis codes following ICD-10-CM, CPT, HCPCS guidelines, and payer regulations.
Collaborates with Clinical Auditors to improve coding quality and resolves coding-related denials per payer policies.
UnityPoint Health is a healthcare system providing patient services and medical care. It is recognized as a Top 150 Place to Work in Healthcare, with a culture that champions belonging and offers competitive benefits.
Manages claim strategies and resolutions while advocating for optimal client outcomes.
Communicates claim information to internal and external clients and maintains strong relationships.
Develops expertise in multiple coverage lines and participates in presentations and new business pitches.
IMA Financial Group is an independent insurance brokerage providing risk management, employee benefits, and wealth management solutions. With a focus on associate ownership and team-based culture, the company has been recognized as a best place to work by multiple publications and operates nationally.
Perform thorough review of medical records for identification of relevant diagnoses and procedures.
Assign appropriate ICD-CM and ICD-10 PCS codes to ensure accurate MS-DRG and APR-DRG assignment.
Abstract required data elements and adhere to compliant provider query practices and coding guidelines.
University of Utah Health is a patient-focused organization that enhances health through patient care, research, and education. It is a Level 1 Trauma Center with five hospitals and eleven clinics, nationally ranked for academic research and quality standards, and values collaboration, excellence, and integrity.
Respond to service requests from internal and external customers accurately and on time.
Maintain case documentation with precision to keep records audit-ready.
Compile and distribute monthly reports and data summaries for leadership.
Personify Health offers a personalized health platform combining health plan administration, wellbeing solutions, and care navigation. The company serves employers and health plans with data-driven solutions, fostering a mission-driven culture focused on improving health outcomes.
Assigns appropriate ICD-10-CM and CPT-4 codes to outpatient visit types with high accuracy.
Reviews medical records thoroughly and interprets documentation to select diagnoses and procedures.
Meets established coding productivity and quality standards (90% productivity, 95% accuracy).
Northwestern Medicine is a healthcare system focused on a patient-first approach to deliver better healthcare. They are a large organization that values employee well-being and offers competitive benefits like tuition reimbursement and 401(k) matching.
Manage billing, receivables auditing, and collections for services provided to patients in assigned facilities.
Achieve monthly cash collection goals and minimize the impact of bad debt.
Interact with insurance companies via telephone and written correspondence to resolve unpaid claims.
CommuniCare Family of Companies is a national leader in post-acute care, providing person-centered services for individuals with chronic or complex conditions. With over 19,000 employees across six states, the family-owned company is dedicated to serving with pride and fostering an environment where employees thrive.
Serves as the primary point of contact for members and providers, managing inbound and outbound calls and emails with professionalism.
Researches and resolves inquiries on benefits, eligibility, claims, and billing to ensure first-contact resolution and meet department metrics.
Supports escalation intake, collaborates with internal teams, and assists members with portal navigation to promote digital self-sufficiency.
Evry Health is on a mission to bring humanity to health insurance with high-technology health plans. It is the major medical division of Globe Life, which has 16.8 million policies in force, over 3,000 corporate employees, and an A (Excellent) rating from A.M. Best for 45+ years.