Lead and manage a team of revenue cycle and/or eligibility specialists.
Serve as the primary subject matter expert for insurance eligibility verification and billing requirements.
Oversee day-to-day revenue cycle operations, including patient billing support and claim resolution.
Midi Health is focused on scaling billing operations. They have a fast-paced, growth-focused environment that supports teamwork and continuous improvement.
Manage day-to-day operations of the Revenue Integrity department.
Lead project planning sessions and ensure timely and accurate delivery of outcomes.
Cultivate relationships within the healthcare community and manage client interactions.
They are a company working with partner companies. They use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements.
Collect, analyze, and interpret clinical, operational, and financial data to assess payer performance and trends.
Maintain SOPs, payer playbooks, internal how-to guides, and reference materials.
Translate front-line payer knowledge into scalable process improvements.
Spring Health is on a mission to revolutionize mental healthcare by removing every barrier that prevents people from getting the help they need, when they need it. They partner with over 450 companies and provide care for 10 million people.
Investigate and resolve insurance claim denials with speed and accuracy.
Partner with payers to resolve issues and secure timely reimbursement.
Provide top-tier phone support to patients, insurance companies, and internal teams.
IVX Health is a national provider of infusion and injection therapy for individuals managing complex chronic conditions like rheumatoid arthritis, Crohn’s disease, and multiple sclerosis. They foster a culture of respect, empowerment, and shared purpose, living out their values every day.
Utilizing healthcare experience to perform audit recovery procedures.
Identifying and validating incorrect claim payments.
Researching reimbursement regulations for claim payment compliance reviews and documentation to support current audit findings.
Cotiviti Healthcare is the payment accuracy expert, working with healthcare organizations to recover money, improve processes, strengthen relationships, and maximize their value. They are a well-established company with competitive pay, opportunities to develop professionally, and excellent benefits.
Conduct in-depth analysis of claim payments, identifying trends and patterns for cost avoidance through internal and external collaboration.
Ensure medical claims comply with guidelines, contracts, and standards while detecting billing inefficiencies and recommending corrective actions.
Provide data-driven recommendations to management on payment-affecting issues, supporting necessary system and policy updates and provider education.
BCBSRI is dedicated to serving Rhode Islanders by providing access to high-quality, affordable, and equitable care. They actively support associate well-being and work/life balance, fostering a culture of belonging where diverse perspectives are valued and employees are equipped for success.
Researches overdue account balances and follows up on delinquent payments.
Reviews unpaid and underpaid claims, resubmitting or appealing as necessary.
Responds to customer inquiries, resolves discrepancies, and prepares adjustments.
Accendra Health helps deliver care beyond traditional settings, making essential products and services more accessible through every stage of life. They have a presence in communities nationwide through their Apria and Byram Healthcare brands.
Manage and develop a team of Billing Specialists responsible for end-to-end claims processing.
Monitor workflows and systems to ensure timely, accurate submission of claims.
Analyze and address rejection trends, leading root cause resolution and implementing scalable solutions.
Spring Health aims to eliminate every barrier to mental health by providing the right care at the right time through their technology, Precision Mental Healthcare. They partner with over 450 companies and serve 10 million people, with a valuation of $3.3 billion.
CommonSpirit Health has 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services, making them accessible to nearly one out of every four U.S. residents. They are committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
Responsible for submitting medical billing claims and appealing denied claims.
Obtain referrals and verify healthcare service eligibility.
Follow up on missed payments and resolve financial discrepancies.
CRMS by DocGo leads the proactive healthcare revolution with an innovative care delivery platform. They disrupt the traditional healthcare system by providing high quality, affordable care with a team of over 5,000 certified health professionals.
Resolves delinquent payment issues of complex accounts.
Investigates patient account information, medical records and bills, billing and reimbursement regulations.
Analyzes each account to optimize reimbursement and remove barriers to processing claims.
Legacy Health is dedicated to good health for its people, patients, communities, and the world, emphasizing doing the right thing. They foster an inclusive environment where everyone can grow and succeed, committed to equal opportunity.
Oversee and execute patient collection initiatives.
Monitor outbound patient outreach campaigns to resolve outstanding balances.
Collaborate across billing, AR, and customer support teams to resolve discrepancies.
Spring Health aims to revolutionize mental healthcare by removing barriers to access. They partner with over 450 companies and serve 10 million people, offering tailored care and generating positive ROI for employers.
Ensure correct insurance information for claim submission.
Communicate with patients about balance, billing concerns, and insurance.
Work in computer systems to obtain and organize billing information.
CardioOne partners with independent cardiologists to provide innovative solutions that improve patient outcomes and reduce costs. In February 2024, they partnered with WindRose Health Investors as well as top physician services and payor executives to grow their team and invest in their next phase of growth.
Support implementation teams with deployment of Experian's ClaimSource revenue cycle management system.
Analyze internal processes and recommend improvements to enhance efficiency, automation, and effectiveness.
Build strong relationships with clients and implementation/service teams; participate in regular client calls.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. We operate across a range of markets and have a team of 23,300 people across 32 countries, investing in people and new advanced technologies to unlock the power of data and to innovate.
Serve as the primary point of contact for assigned clients, building strong relationships and addressing inquiries.
Oversee the entire billing process, ensuring accurate and timely claim submission and denial resolution.
Monitor claim submissions, payment posting, and aging AR to ensure targets are met and identify remediation efforts.
Motivity provides revenue cycle management services. They focus on helping ABA providers improve their financial success with billing and claims management. The company culture emphasizes strong partnerships, trust, and transparency.
Participate in end-to-end implementation activities.
Develop an understanding of Experian Health's product suite and apply best‑practice workflows.
Facilitate requirements gathering, workflow mapping, configuration reviews, and user acceptance testing.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. A FTSE 100 Index company listed on the London Stock Exchange, they have a team of 23,300 people across 32 countries and corporate headquarters in Dublin, Ireland.
Manage medical claims for telehealth services, ensuring compliance with coding guidelines.
Support patients in understanding financial responsibility and payment options.
Communicate with payers and vendors to resolve billing issues and appeal denials.
Midi Health provides virtual healthcare for women 40+, focusing on perimenopause, menopause, and other common health needs. They are a pioneering company aiming to bring compassionate, high-quality healthcare to women in midlife, though the company size is not specified in this job posting.
Provides accurate payment posting to accounts and analyzes accounts.
Identifies issues with payments and reconciles accounts for credits.
Monitors accounts receivable and communicates payment denials.
Gen4 is committed to providing an incredible patient experience. They foster a doctor-centric organization with a focus on culture, high performance, and growth, and seek individuals excited to be part of their growing company.
Source, interpret, and scope new payment integrity policies.
Prioritize policy updates based on savings potential and client impact.
Quantify and communicate policy value through data-driven analysis.
Rialtic, Inc. focuses on healthcare payment expertise, client strategy, and product innovation. They seem to have a culture that values collaboration and impact, although the job post doesn't specify size/employees.