Provides supervision, guidance and direction to the all functional area of responsibilities.
Accountable leader for the implementation of processes for receiving and processing additions and updates to the aIDX application.
Provides leadership and direction for a comprehensive managed care claims adjudication system, and claims examination and processing team for delegated health plans.
Identify, implement, and evaluate information systems and operational processes.
Collaborate with diverse stakeholders to elicit, analyze, communicate, and validate requirements.
Determine resource needs and ensure efficient and effective use of resources to support the EMR.
CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually. CommonSpirit has more than 157,000 employees and contributes more than $4.2 billion annually in charity care.
Own the full revenue cycle end-to-end: charge capture, claim submission, denial management, payment posting, and patient collections.
Drive RCM internalization — evaluate current vendor relationships, build the business case for what to bring in-house, and execute the transition without disrupting cash flow.
Partner with the contracting team to translate newly negotiated payor terms into billing workflows.
Dreem Health is America’s leading digital sleep clinic, powered by Sunrise’s technology. They make sleep care simple by replacing long waits and in-lab sleep studies with home-based testing, expert telehealth visits, and personalized treatment plans. They have 100+ clinicians, engineers, and operators across the U.S. and Europe.
Assist Revenue Cycle Consultant and Technical Consultant teams in the implementation of Experian's Claim Source revenue cycle management system.
Review internal process, recommend and develop changes to improve systems efficiency, automation, and effectiveness.
Document complex solutions to internal and external clients.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. They operate across a range of markets, from financial services to healthcare, automotive, agrifinance, insurance, and many more industry segments, with corporate headquarters in Dublin, Ireland, and a team of 23,300 people across 32 countries.
Responsible for the direct supervision of the centralized managed care activities.
Leads the team by recruiting, training, mentoring, and managing the work queues of direct reports.
Serves as the first line of communication with the practices/departments to answer questions and trouble shoot issues.
OHSU is Oregon's only public academic health center. In addition to caring for patients, they lead groundbreaking research and train the next generation of health care professionals. As Portland's largest employer, OHSU provides opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington.
Develop and implement Freenome’s enterprise-wide revenue cycle strategy.
Build, coach, and develop a high-performing team and foster a culture of accountability.
Establish and oversee all processes related to coding, claims submission, reimbursement, and accounts receivable management.
Freenome is an equal-opportunity employer that values diversity. They are committed to building a career with their company and offer future opportunities via email alerts.
Lead and manage end-to-end revenue cycle operations.
Develop strategic initiatives and performance metrics.
Collaborate with executive leadership and cross-functional teams.
Advantia Health is dedicated to providing unparalleled healthcare to our customers by employing the most highly-qualified individuals. It is a place where good people want to work, and customers want to continue to engage.
Responding to high volume inquiries via email/phone
Assist with triaging case volumes
Providing resolution guidance/support to care center staff on complex claims/billing inquiries; claim holds, overrides, take backs, corrected claim workflows, coding assistance
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 consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Own the full implementation lifecycle for assigned US accounts.
Partner with clinical stakeholders to define screening workflows.
Develop and deliver training programs for clinical staff.
Aegis Ventures partners with entrepreneurs and industry leaders to launch and scale transformative companies in digital health and artificial intelligence. Our platform brings together market-shaping ideas, growth capital, and ambitious individuals to solve major societal problems.
Partner with RCM leadership to monitor performance trends and identify revenue cycle opportunities.
Support payer contracting activities, including onboarding clinical network agreements.
Act as program manager for strategic payer partnership initiatives and drive implementation.
Headspace provides access to lifelong mental health support. They combine content, clinical care, and technology to help millions of members around the world get support. Their culture is collaborative, inclusive, and grounded in their values.
Responsible for managing and overseeing activities for multiple value streams within the revenue cycle.
Provide ongoing input in the strategic planning of business requirements and corporate objectives for the Revenue Cycle.
Ensure compliance with all federal, state, and local statutes and regulations, as well as all third-party payer policies.
Virginia Mason Franciscan Health brings together two award-winning health systems in Washington state - CHI Franciscan and Virginia Mason. As one integrated health system, our team includes 18,000 staff and nearly 5,000 employed physicians and affiliated providers at 11 hospitals and nearly 300 sites throughout the greater Puget Sound region.
Own the full implementation lifecycle for assigned US accounts.
Partner with clinical stakeholders to define screening workflows that integrate Optain’s platform with existing clinical operations and EHR systems.
Develop and deliver training programs for clinical staff on camera operation, image capture, and platform workflow—both in-person and virtual
Optain is a revolutionary healthcare company that uses groundbreaking clinicians, software, and hardware technology to rethink care, using the eye as a window to the body to improve the way we screen, manage, and treat eye and systemic conditions. Optain's Series A was done with the expectations of rapid commercial growth.
Performs claims processing, insurance and charge verification, payment posting, account resolution, customer service and follow up.
Educates staff and physicians on CPT/HCPCS/ICD-10 codes and appropriate documentation requirements to reduce errors and remain compliant.
Works directly with staff when needed for insurance authorization assistance, IPA guidance and insurance optimization.
Community is committed to providing the highest standard of care. They value their diverse team members and offer various opportunities for growth and development.
Responsible for complete, accurate, and timely processing of all designated claims.
Investigates denial sources, resolves and appeals denials, which may include contacting payer representatives.
Works with internal teams and care center staff to ensure optimal revenue cycle functionality.
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. Their platform consists of scalable operations and cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Own end-to-end revenue cycle performance across claims submission, denial management, and A/R follow-up
Manage and hold external billing vendors accountable to defined KPIs and service expectations
Monitor first-pass resolution rates, denial trends, and aging buckets to proactively mitigate revenue risk
Thirty Madison is a healthcare company that builds specialized healthcare brands that focuses on specific ongoing conditions, and thoughtfully designed to support the unique needs of its community with personalized treatments and care. They have built a number of brands and are continuing to grow rapidly.
Analyze and improve UM business workflows, including clinical assessments, rules, and documents.
Validate Health Services programs against business requirements and acceptance criteria.
Partner with medical directors and cross‑functional teams to review, evolve, and update InterQual and custom clinical criteria.
Wellmark is a mutual insurance company owned by its policy holders across Iowa and South Dakota, and it has built its reputation on over 80 years of trust. They are motivated by the well-being of their members and committed to sustainability and innovation.
Responsible for managing and growing client relationships through hands on partnership.
Delivering exceptional service, aligning client expectations with internal capabilities.
Driving satisfaction and retention through consistent, proactive communication.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations. They leverage industry expertise and a unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals and surgery centers. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024. They are also among the top one percent of companies to make the Inc. 5000 list for the last eleven years.
Support and advance the organization’s Infor Lawson and Infor CloudSuite applications.
Integrate new entities, modernize systems, and ensure seamless transitions that support patient care and business continuity.
Help ensure data integrity, lead and coordinate testing efforts, configure system functionality, develop reports, and analyze workflows.
Prime Healthcare is an award-winning health system headquartered in Ontario, California. It operates 54 hospitals and has more than 360 outpatient locations in 15 states, employing over 60,000 employees and physicians, and is known for saving and transforming hospitals.
Provides strategic oversight of Laboratory Information Systems (LIS) activities across CommonSpirit.
Collaborates with the other members of the System Lab Service Line to deliver the system's laboratory services strategy.
Manages LIS operations, functions, projects, and initiatives.
CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, they deliver more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings.
Analyze benefit plan documents to accurately build benefit categories and adjudication rules.
Be a leader on the configuration team by supporting training, process development, and peer review / QA.
Support cross-functional teams during implementations/renewals and develop solutions for plan variations.
Gravie aims to improve healthcare access through consumer-centric health benefit solutions. They foster a diverse and authentic work environment where individuals can contribute uniquely to industry-changing products and services.
Leads regional IT operations plans and data analysis programs.
Leads the implementation of regional level IT systems and infrastructure projects.
Provides oversight and direction to application standards and workflow adoption.
CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations.