Verify insurance eligibility and benefits for all new Boulder Care commercial enrollments.
Answer incoming questions from patients about balances due and non-covered charges.
Serve as subject matter expert for internal insurance training and identify billing errors.
Boulder Care is an award-winning digital clinic for addiction medicine, recognized for innovation and high quality of patient care. Named by Fortune as one of the Best Workplaces in Healthcare, Boulder fosters a culture of kindness, respect, and meaningful work.
Conduct benefit investigations, insurance verification, and prior authorizations to secure timely patient access to therapies.
Manage patient case files, coordinate product ordering and shipment with pharmacies and prescribers.
Handle inbound inquiries, report adverse events, and educate stakeholders on program requirements.
Jobgether is a platform that uses AI-powered matching to connect candidates with hiring companies. They focus on efficient, objective candidate screening and share top-fitting shortlists with employers.
Deliver high-quality customer service in a healthcare environment, handling inbound and outbound calls to resolve claims, benefits, and coverage inquiries.
Research and document member and provider issues, escalate complex cases, and ensure timely follow-up across systems.
Maintain strict confidentiality of sensitive information while adapting communication for diverse audiences including members, clinics, and vendors.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies efficiently. It operates as a partner recruiting organization, facilitating applications and next steps for roles like this one.
Provide outstanding customer service to families over the phone, educating them about evaluation, treatment, and insurance processes.
Accurately enter patient registration information and schedule appointments, identifying potential conflicts.
Coordinate information between referring physicians, insurance companies, and treatment clinics, handling 40-70 calls daily.
Cranial Technologies is the only company globally dedicated to researching and treating plagiocephaly (flat head syndrome) and providing non-invasive ear shape correction. With over 300,000 babies successfully treated, they are a leader in pediatric cranial shaping and foster a compassionate, family-oriented culture.
Completes telephonic outreach to engage and schedule patients for health assessments.
Maintains call targets and metrics to ensure program success and volume goals are met.
Provides patient education and coordinates appointments and resources as needed.
Lumeris empowers value-based care, making healthcare safer, more affordable and personalized for providers, patients, and payers. The company is an EEO/AA employer with a focus on growth and employee engagement in a fast-paced environment.
Provide member-centered support by answering inbound calls and chats with empathy and clarity.
Resolve core member issues including benefits coverage, cost-sharing concepts, and network provider searches.
Own issues end-to-end using established workflows and document interactions accurately.
Included Health is a healthcare company delivering integrated virtual care and navigation. They are remote-first and focus on raising the standard of healthcare for everyone.
Serve as a primary point of contact for clients, managing inbound and outbound communications to resolve inquiries.
Connect with customers via phone, email, chat, or social media to de-escalate issues and track call data.
Upsell when required and escalate interactions as necessary.
TP is a leading global provider of digital business services, partnering with prominent brands to optimize operations through technology and sustainability. With a workforce of 500,000 across 300 languages, they foster a culture of inclusion and diversity.
Handle inbound and outbound calls to ensure patient satisfaction, troubleshoot concerns, and explain insurance coverage.
Obtain and process authorizations for reorders, resolve patient issues, and ensure accurate reorder processing via phone and document processing.
Maintain patient documentation, insurance requirements, and company procedures with high confidentiality.
CCS is a strategic partner addressing America's healthcare challenges through intelligent chronic care management, focusing on diabetes and chronic conditions. Recognized as a Great Place to Work®, they support over 200,000 people nationwide with home-delivered medical supplies and pharmaceuticals.
Facilitate client calls related to contracting and payer enrollments.
Run and analyze client KPIs, providing regular reports.
Manage the full contracting and payer enrollment process.
Experity transforms on-demand healthcare across the U.S. by empowering urgent care clinics with industry-leading software. The company fosters a team-first culture with opportunities for flexible work and career development.
Provide friendly, accurate, and timely service to customers through inbound and outbound interactions across multiple channels, resolving issues and educating on healthcare benefits.
Conduct outbound outreach for program enrollment and clinical quality calls, using consultative listening to overcome objections and guide customers.
Document all interactions thoroughly, adhere to HIPAA and regulations, and meet or exceed performance goals for customer satisfaction and quality.
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence, making healthcare affordable, and improving patient health. It is a physician-led, growing organization with a collaborative, agile culture emphasizing cross-training and ongoing development.
Perform clinical reviews for medical necessity, level of care, and authorization-related denials.
Apply payer-specific guidelines and internal policies to support clear, defensible clinical narratives.
Meet assigned turnaround times and document findings accurately in designated systems.
CorroHealth helps clients exceed their financial health goals through scalable reimbursement solutions and clinical expertise, leveraging technology and analytics. The company builds long-term careers by investing in professional development and personal growth, fostering a culture of accountability and success.
Conducts utilization review to determine medical necessity of admission and continued stay using established criteria.
Communicates with payers to secure authorization and negotiate medical necessity decisions.
Educates providers on documentation requirements and participates in strategies to reduce length of stay and readmissions.
OHSU is Oregon’s only public academic health center, providing patient care and conducting groundbreaking research while training health care professionals. As Portland’s largest employer, it offers a diverse and inclusive culture with opportunities for growth across Oregon and Southwest Washington.
Monitor and interpret CMS guidance for Medicare, Medicaid, and other healthcare programs.
Partner with internal teams to ensure compliance with regulations and contract obligations.
Maintain regulatory tracking documentation and support development of training materials.
HealthEdge provides healthcare software and services to payers and providers. It is a growing company with a focus on compliance and innovation, fostering a collaborative and remote-friendly culture.
Obtain and manage insurance authorizations for residents receiving skilled nursing and rehabilitation services.
Monitor authorization status, track expiration dates, and submit timely extension requests to prevent coverage gaps.
Collaborate with clinical, admissions, and payer representatives to ensure timely approvals and accurate documentation.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic and growing healthcare facilities. Leveraging a global network, they connect clients with qualified professionals and offer tailored services to meet unique business needs.
Serve as the vital link between members and their dental care by answering 40-60 inbound calls daily, addressing inquiries with compassion and expertise.
Capture member information accurately, investigate unresolved issues, and collaborate with internal teams to ensure timely resolutions.
Maintain flexibility and compliance with HIPAA, while navigating multiple software systems in a high-volume call center environment.
Avēsis has been providing essential ancillary benefit solutions since 1978, developing and administering programs covering over 8.5 million members. They strive for excellence in member satisfaction and client retention, fostering a culture of inclusivity and diversity.
Efficiently triage incoming calls and resolve member and pharmacy issues with professional phone etiquette.
Identify, document, and escalate concerns to appropriate internal teams to ensure quality care and safety standards.
Support fraud, waste, and abuse programs by reviewing pharmacy claims and communicating findings to internal staff.
Judi Health is a health technology company providing comprehensive health benefit management solutions for employers and health plans. They are rebuilding trust in healthcare with a platform that consolidates claim administration workflows.
Monitor a specific group of patients and support them in achieving short and long term health goals.
Coordinate with providers to ensure patients' needs are met through remote monitoring technology.
Manage patient onboarding, device setup, data management, and quality assurance for remote monitoring programs.
Optima Medical is an Arizona-based medical group consisting of 30 locations and over 130 medical providers, caring for more than 200,000 patients statewide. Their mission is to help communities 'Live Better, Live Longer' through personalized healthcare, with a focus on preventing leading causes of death.
Provide clinical review and correspondence for utilization management, including medical necessity reviews and member communications.
Collaborate with Medical Directors to ensure evidence-based decisions that meet NCQA and CMS standards.
Maintain productivity and quality while working 100% remotely in a fast-paced environment.
Cohere Health’s clinical intelligence platform and agentic AI-powered solutions connect health plans’ strategic goals and providers’ needs, optimizing the speed, cost, and quality of care. With over 250 employees, the company fosters a supportive, growth-oriented environment and has been named to the Inc. 5000 list and a Top 5 LinkedIn Startup.
Collaborate with a multidisciplinary care team to ensure quality, member-centered care and assist members with navigating and applying for entitlement benefits.
Become an expert on available insurance and social service resources within assigned region, and provide cross-state coverage support as needed.
Maintain timely documentation in electronic health records and participate in ongoing continuing education.
Groups provides assistance to members in accessing Medicaid, Marketplace, and Medicare insurance and other entitlement benefits. The company values member-centered care and harm-reduction practices, with a team-oriented and entrepreneurial culture.
Conduct medical claim reviews using clinical information and established criteria to determine medical necessity and appropriate reimbursement.
Educate internal and external staff on medical reviews, coding procedures, and coverage determinations.
Participate in quality control activities and provide guidance to LPN team members.
Palmetto GBA is a healthcare service administrator and one of the nation's largest providers of high-volume medical claims and transaction processing. The company offers a diverse workforce, training programs for leadership, tuition assistance, and financial incentives.