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 and maintain a clear audit trail for future reference.
Record after-call actions and perform post-call analysis for the claim follow-up.
TruBridge connects providers, patients, and communities with innovative solutions that create real value by supporting both the financial and clinical sides of healthcare delivery. They are a remote team that encourages their employees to push boundaries and look at things differently.
Responsible for complete, accurate and timely processing of all designated claims.
Investigating denial sources, resolving and appealing denials which may include contacting payer representatives.
Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership.
Receive and resolve patient correspondence regarding insurance billing.
Answer all correspondence relating to billing questions.
Verify insurance status, eligibility and general account information.
MANA Administration provides support services for 27 physician-owned medical practices in Northwest Arkansas. Their Administrative team are independent and work together, to help their physicians and clinics provide compassionate, comprehensive, quality health care while maintaining a healthy work-life balance.
Process medical claims, resolve issues, and provide billing assistance.
Respond to inquiries promptly and coach physicians on OHIP billing.
Work individually and as a team to deliver a positive experience.
RBCx empowers tech trailblazers to compete harder and grow faster by leveraging RBC's experience, network, and capital. With four pillars – Banking, Capital, Platform, and Ventures – they aim to be the go-to backer of Canadian innovation and were named one of the 100 Best Workplaces for Innovators by Fast Company in 2020.
Provides billing support for the Sandstone Care billing team.
Responsible for verification of benefits, billing data, claims submission, claim corrections, claim re-submissions, claim follow up and appeals.
Generates revenue by making payment arrangements, collecting accounts, monitoring and pursuing delinquent accounts.
Sandstone Care is committed to providing accessible, affordable, and high-quality mental health and addiction treatment services. They strive to create a diverse and inclusive workplace where all employees feel valued, respected, and empowered.
Investigates and analyzes Motor Vehicle Accident accounts.
Identifies and coordinates insurance benefits, resolving outstanding balances.
Acts as a liaison between clients, attorneys, and insurance companies.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations. They leverage expertise and a unified intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers nationwide.
Ensure accurate Accounts Receivable positions via collections, credit, research & analysis.
Establish appropriate credit limits by analyzing DSO and external credit risk management tools.
Ensure prompt payment of assigned accounts through telephone, email, and written communication.
FUJIFILM Healthcare Americas Corporation innovates for a healthier world with cutting-edge healthcare solutions, including diagnostic imaging and in-vitro diagnostics. They have over 70,000 employees across healthcare, electronics, business innovation, and imaging, guided by their Group Purpose of “giving our world more smiles.”
Responsible for the accurate and timely resolution of patient accounts.
Work assigned accounts through the collections system, analyzing them for appropriate action.
Follow all third-party payer guidelines and procedures for collection; keep current on policy changes.
UChicago Medicine has been at the forefront of medicine since 1899. They provide superior healthcare, mindful that each patient is an individual, advancing medical innovation, serving the health needs of the community, and moving collective knowledge forward.
Exercises a high degree of control over confidential medical information.
Keeps current with changing billing requirements and shares pertinent information with billing team members.
Analyzes and initiates corrective action for patient claims.
Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents across 29 counties. They value excellence, teamness, positivity, creativity, and a commitment to creating exceptional experiences for patients and each other.
Research and interpret payer policies in accordance with healthcare coding and regulatory requirements.
Identify common error areas that can be made into automated software logics that prevent overpayments.
Develop claims editing logics that promote payment accuracy and transparency across lines of business.
Rialtic is an enterprise software platform empowering health insurers and healthcare providers to run their most critical business functions. Founded in 2020 and backed by leading investors, they are tackling a $1 trillion problem to reduce costs, increase efficiency and improve quality of care.
Develop and implement policies and procedures for collections to minimize bad debt.
Acumatica is a leading innovator in cloud ERP (Enterprise Resource Planning) solutions with growing businesses worldwide. Our industry-specific business management solution is engineered to address real-world needs—featuring intelligent workflows and market-leading usability. Acumatica's culture is collaborative and high-energy.
Auditing to ensure new provider and care center information is accurate.
Conducting Care Center audits based on the number of providers.
Identifying, monitoring, and managing denial management trends.
Privia Health is a technology-driven, national physician enablement company. They collaborate with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. Their platform is led by industry talent and cloud-based technology.
Supporting collections efforts to optimize cash flow.
Carrot is a global fertility and family care platform that supports members and their families through life's moments. They are trusted by multinational employers, health plans, and health systems, offering localized support in over 170 countries and 25 languages.
Review encounter documentation to confirm reported services.
Resolve pre-bill edits to confirm correct coding (modifier, diagnosis, CPT, and HCPCS review).
Educate providers on correct coding and documentation guidelines.
Northwestern Medicine is committed to prioritizing every patient interaction to cultivate a positive workplace. Because of its patient-first approach, the company stands as a leader in the healthcare industry with competitive benefits that take care of its employees.
Manage multiple channel interactions professionally and efficiently.
Effectively present products/services to providers with integrity, understanding, and accuracy.
Focus on provider retention through first call resolution and maintain positive relationships.
Capital Blue Cross promises to go the extra mile for its team and community. Employees consistently vote it one of the “Best Places to Work in PA”, valuing professional/personal growth by investing heavily in training and continuing education.
Responsible for timely responses to internal and external customers.
Works as part of a multi-departmental team to provide answers to billing inquiries.
Provides a variety of revenue cycle support services in connection to day-to-day operations.
Athletico empowers people, inspires hope, and transforms lives. They accomplish this by providing exceptional, progressive, and cost-effective fitness, performance and rehabilitative services through personalized care. They have a unique culture built on teamwork, understanding, recognition, people-focus, accountability, innovation, trust, and integrity.
Handle customer inquiries and analyze payment history.
Communicate account statuses and recommend solutions.
Maintain accurate records of customer interactions.
Sutherland is a digital transformation company that helps customers globally achieve greater agility and transform automated customer experiences. As a Great Place to Work certified company, they have been in business for over 35 years and work with well-known brands.
Build rapport with families, healthcare providers, and insurance companies in a compassionate manner.
Educate potential families about evaluation, treatment, and insurance processes.
Provide excellent customer service and expedite the process for families.
Cranial Technologies researches and treats plagiocephaly (commonly called flat head syndrome). They have treated over 300,000 babies with the DOC Band® and are the leader in pediatric cranial shaping orthoses. They also provide treatment with EarWell® to correct infant ear shapes without surgery, with 600,000+ successful outcomes.
Perform comprehensive review and oversight of medical records for Risk Adjustment compliance keeping with CMS and departmental guidelines with a 95%+ accuracy rate
Collaborates with a variety of internal and external clients, including health care executives, physicians, provider office personnel, and payer representatives from various health plans to streamline and optimize accurate diagnosis code capture.
Reviews medical records and billing history to determine if specific disease conditions were correctly billed and documented.
Capital Blue Cross promises to go the extra mile for their team and community. Employees consistently vote them one of the “Best Places to Work in PA” and they recognize that work is a part of life, not separate from it, and foster a flexible environment.
Monitor incoming faxes for authorization requests, enter UM authorizations review requests, and verify eligibility and claims history.
Ensure all necessary documentation is submitted, contact providers for required medical records, and generate correspondence for notifications.
Initiate appeal cases, meet deadlines, assist UM Nurses, and handle inquiries from call centers and other sources.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly and fairly. While the company size is not mentioned, they seem to have a modern approach by utilizing AI tools in the hiring process to identify top-fitting candidates for their client companies.