Maintains the practice management system by entering accurate data, verifying and updating insurance and claims information, handles carrier correspondence, manages EOBs, and keys payments received into the system.
Prepares, reviews, submits, and follows up with clean claims to various companies/individuals.
Collects, posts, and manages patient account payments.
US Anesthesia Partners provides comprehensive anesthesia care. They are committed to clinical excellence and outstanding patient experience.
Accurately review denied claims to identify root causes.
Communicate directly with insurance representatives to negotiate settlements.
Monitor denial trends and provide actionable feedback to billing and clinical teams.
Mindoula is a healthcare organization. They are seeking an Account Receivable Representative and value candidates with strong communication and problem-solving skills.
Partner with Clinical, Claims, and Payment Integrity peers to review claims for DRG related issues.
Proactively identify overpayments to ensure accurate claims payments on inpatient services.
Participate in collaborative discussions with MDs to verify the clinical rationale behind billed procedures.
They are reinventing health insurance by combining data with human empathy to keep members healthier. Clover Health believes the healthcare system is broken, so they've created custom software and analytics to empower their clinical staff to intervene and provide personalized care to the people who need it most. They are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
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.
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.
Reviewing and resolving missed or miscoded charges.
Ensuring coding and billing practices comply with guidelines.
Following Medicare/Medicaid and other payer requirements.
Marshfield Clinic Health System enriches lives through accessible, affordable, and compassionate healthcare, prioritizing patients' needs. They value connection with colleagues and community recognition, offering affordable living and leisure opportunities.
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.
Follow VitalCaring billing Standard Operating Procedures and regulatory billing guidelines
Collaborate with your supervisor and the billing team to address payor and billing concerns
Ensure documentation accuracy and submit claims in accordance with Medicare and other payor requirements
VitalCaring is a leading provider of home health and hospice services. Founded in 2021, VitalCaring has grown into a leading provider of home health and hospice services, with over 65 locations across the country. They foster a culture of support, growth, and excellence.
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.
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.
Performs daily billing functions for assigned Accounts Receivable claims to ensure claims resolutions within set deadlines.
Sends out daily appeals to insurance companies for denied claims to maintain consistent cash flow of assigned A/R.
Resolves incoming correspondence or telephone inquiries in a timely manner in accordance with payer deadlines.
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, employing over 157,000 employees across 24 states.
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.
Responsible for accurate and timely submission of billing claims.
Responsible for the timely follow-up of unpaid inpatient, outpatient and clinic claims.
Provides appropriate medical documentation to the insurance carrier.
Plumas District Hospital provides essential health care services to the residents of Quincy and the surrounding area. They are located in Quincy, California, nestled against the Western slope of the Sierra Nevada mountain range.
Researches and analyzes data to answer questions and find trends.
Reviews carrier websites, regulations, and policies related to coding and reimbursement.
Prepares and presents quality reports, reviews, and analysis.
OSU Physicians provides exceptional patient care while fostering a collaborative work environment. They include more than 1,800 nurses, medical assistants, physicians, advanced practice providers, administrative support staff, IT specialists, financial specialists and leaders.
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.
Serve as the first point of contact for incoming calls from patients and internal teams.
Deliver clear explanations of insurance benefits, out-of-pocket costs, and payment options.
Review patient accounts and resolve billing-related concerns with professionalism and urgency.
Metro Vein Centers specializes in state-of-the-art vein treatments, with a mission to improve patients' quality of life. With over 60 clinics across 7 states, they deliver compassionate, results-driven care in a modern, patient-first environment and maintain a high patient satisfaction score.
Performs Current Procedural Terminology (CPT) and International Classification of Diseases, volume 10 (ICD10) coding through abstraction of the medical record.
Trains physicians and other staff regarding documentation, billing and coding, and performs various administrative and clerical duties to support the roles core function.
Acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service.
At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. As an integral part of their team, you'll have the opportunity to join their quest for better health care, no matter where you work within the Northwestern Medicine system.
Coordinate and support the hospital’s Utilization Review and Case Management program.
Review patient charts and clinical documentation to verify medical necessity.
Monitor patient progress and coordinate care management strategies.
NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. With hospitals in Indiana, Michigan, Texas, and Arizona, they’re expanding access to their unique model of care across the United States.
Plays a vital role in supporting the financial integrity of hospice operations.
Ensures accurate and timely billing in compliance with regulations.
Supports clinical and operational teams by safeguarding revenue.
VitalCaring is a leading provider of home health and hospice services. With over 100 locations across the country, they are committed to fostering a culture of support, growth, and excellence for their team, ensuring exceptional patient care.
The Hospital Contract Definition Analyst plays a critical role in the implementation and maintenance of hospital payer contracts within Experian Health's Contract Manager system.
You will ensure accurate modeling of reimbursement methodologies to support valuation of hospital claims and patient estimates and collaborate with senior team members to process new client implementations.
Independently manages routine maintenance cases, ensuring compliance with enterprise standards and client expectations.
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 (EXPN), they have a team of 23,300 people across 32 countries where their corporate headquarters are in Dublin, Ireland.