Manage day-to-day credentialing workflows and lead data analysis projects for payer enrollment.
Conduct routine audits of task boards and triage inquiries to improve process efficiency.
Develop and distribute reporting on credentialing status for cross-functional stakeholders.
Natera is a global leader in cell-free DNA testing, dedicated to oncology, women's health, and organ health. The company comprises highly dedicated professionals from world-class institutions, who care deeply for their work and each other, fostering a culture that values hard work and growth.
Analyze federal plain language and communications policy and guidelines.
Conduct research to support plain-language content development and health literacy initiatives.
Prepare written reports, analyses, briefings, and technical documentation.
FWI supports the Department of Health and Human Services Office of Minority Health, helping make health information accessible to limited English proficiency communities. The company is expanding rapidly and has been recognized as a Top Workplace for 2024, 2025, and 2026, offering excellent growth opportunities in a collaborative environment.
Analyze high-value and complex claims, ensuring alignment with carrier guidelines and regulatory requirements.
Oversee delegated claims operations and third-party administrators, monitoring compliance and quality.
Provide subject matter expertise and process improvements to strengthen claims governance and outcomes.
They are an insurance organization focused on claims governance, compliance, and operational performance. They are a growing company that prioritizes accountability, service quality, and effective risk management.
Analyze and support compensation programs to ensure market competitiveness and internal equity.
Collaborate with HR and business leaders on salary benchmarking and job evaluations.
Maintain compensation databases and ensure data accuracy and compliance.
Alcanza Clinical Research is a national, collaborative network of clinical research sites dedicated to accelerating the development of new therapies by reducing barriers to participation. With a focus on culturally competent care, the company employs a team that values inclusivity, impact, compassion, and determination.
Analyze and automate standard reporting requests for clients, working with implementation and account teams.
Build reports in Excel, Genesys, Calabrio, and Empower, and handle data discrepancy analysis.
Collaborate cross-functionally and innovate processes to improve reporting performance.
Personify Health created the first and only personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one place. They serve employers, health plans, and health systems with data-driven solutions that reduce costs while improving health outcomes, and their team is mission-driven and diverse.
You'll be the first intake for payor eligibility inquiries, handle CS tickets and calls, and pull claims data to root-cause issues.
You'll run the ineligible claims review, determine which flags are truly ineligible or product defaults to correct, and communicate outcomes.
You'll fix problems at the source by documenting recurring patterns, building CS-facing materials, and owning eligibility-risk dashboards.
Pivotal Health is a technology platform that helps healthcare providers get paid fairly in a complex reimbursement landscape by simplifying IDR workflows with AI-driven software, data, and service. The team is collaborative and low-ego, building solutions for reimbursement clarity, with a mission to make healthcare reimbursement fairer for providers.
Perform on-site or remote pre-study, initiation, interim, and close-out monitoring visits to ensure adequate facilities and staff.
Identify investigators and verify qualifications, resources, and staff for conducting clinical studies.
Train investigational site staff and support regulatory submissions as applicable.
Ergomed is a specialist clinical research organization focused on rare disease and oncology trials. With a collaborative international team across North America, South America, Europe, Asia, and Australia, the company values teamwork, flexibility, and work-life balance.
Lead external customer audits and utilization management oversight activities as a subject matter expert.
Analyze complex UM data, investigate findings, and prepare evidence-based responses for regulators and accreditation organizations.
Collaborate with operational, technical, and client-facing teams to drive compliance and process improvements.
This company is a healthcare organization specializing in utilization management and regulatory compliance. It operates with a remote team across the United States, fostering a collaborative and improvement-driven culture.
Drive rapid decision-making within Tier 1 of the Tiered Resolution Pathway.
Facilitate and document meetings for VHA EHRM Tier 1 SME Teams and stakeholders.
Support project management, strategic communications, and change management efforts.
Aptive partners with federal agencies to improve performance, streamline operations, and enhance service delivery. Based in Alexandria, VA, we support more than a dozen agencies and have 300+ employees nationwide.
Provide administrative support to the Claims Coverage Counsel team, including review of referrals and preparing documents for attorney use.
Proofread, format, and finalize coverage opinions and letters, ensuring accuracy and supporting the internal review process.
Maintain diaries, spreadsheets, trackers, and archives, while assisting with research, training materials, and special projects.
EMC is an insurance company with more than 105 years of financial strength, committed to working together to make an impact. The culture empowers team members with outstanding benefits, recognition, and opportunities for growth.
Manage accident-related accounts from intake to resolution, coordinating no-fault and liability benefits.
Submit claims to carriers, maintain accurate records in AcciClaim, and monitor insurance portals.
Work independently, set priorities, and communicate professionally with patients and adjusters.
Revecore helps hospitals recover revenue they've earned so they can continue serving patients and communities. Trusted by more than 1,300 hospitals across 48 states, the company combines specialized expertise with proprietary technology and fosters a supportive, innovative workplace.
Investigate potential payment inaccuracies using Medicare Advantage claims and reimbursement knowledge to interpret data and explain payment outcomes.
Review claims populations identified through SQL analysis, distinguishing supported discrepancies from exceptions and correctly adjudicated claims.
Document validated findings clearly and support downstream recovery, Compliance/Legal review, and recurring audits.
Clover Health provides healthcare plans for seniors, using data and technology to improve care and lower costs. The company is a remote-first, mission-driven organization focused on diversity and inclusion.
Review appeals of adverse benefit determinations within federal and state regulatory timeframes.
Apply medical policy, coding guidelines, and contractual requirements to assess coverage decisions.
Collaborate with medical divisions and respond to state insurance department inquiries regarding benefit complaints.
Arkansas Blue Cross and Blue Shield is a health insurance provider serving Arkansas. It is consistently ranked as one of the best places to work in Central Arkansas, with an inclusive culture and an average employee tenure of 10 years.
Analyze, research, and resolve issues related to the creation and submission of paper and electronic claims.
Monitor claim errors, identify opportunities for new edits, and collaborate with the Business Systems Department to implement clearinghouse edits.
Validate daily imports, balance hash totals, and report system issues to IS to ensure timely resolution.
Pediatrix Medical Group is one of the nation’s largest providers of prenatal, neonatal and pediatric services, led by physicians. They offer a diverse range of opportunities, competitive salaries, and a commitment to clinical excellence, focusing on a team approach to improve patient lives.
Perform billing and collection accounting, including account reconciliation, invoicing, and letters of credit.
Interact with internal departments, attorneys, and customers to resolve disputes and collect outstanding balances.
Analyze account activity and identify cash flow opportunities while providing prompt, professional service.
Liberty Mutual is a global insurance company offering a wide range of insurance products and services. The company values inclusion, employee well-being, and professional development, fostering a supportive culture for its workforce.
Verify insurance eligibility, benefits, and patient liability to ensure accurate financial clearance.
Collaborate with providers, authorization teams, and payers to resolve coverage questions.
Maintain accurate records and communicate financial expectations to patients.
Jobgether is a platform that uses AI-powered matching to connect candidates with job opportunities. They partner with companies to manage applications and provide a collaborative hiring process.
Support annual pay administration and provide key insights and analysis for compensation programs.
Conduct market pricing and compensation surveys to ensure competitiveness and internal equity.
Administer benefits programs including health, welfare, COBRA, leave of absence, and retirement plans.
WellBe Senior Medical provides home-based medical visits for patients with chronic conditions to improve their well-being and independence. Named a Best Place to Work from Modern Healthcare, the company builds a team of capable and compassionate individuals.
Review and configure executed provider contracts and amendments for completeness and accuracy.
Coordinate with cross-functional teams to resolve issues and manage downstream dependencies.
Manage an assigned caseload while maintaining service delivery, productivity, and quality standards.
Oscar is a health insurance company built on a full-stack technology platform, focused on serving its members. The company values collaboration and innovation, with a team dedicated to transforming healthcare.
Create, maintain, and audit Budget to Actual documentation for client accounts.
Run routine audits of CSM workflows and administrative tasks to ensure consistency.
Support reporting, dashboards, and operational scorecards for Client Success.
RainFocus provides an event software platform for in-person, virtual, and hybrid events, serving Fortune 500 clients like Adobe and Cisco. The rapidly-growing, well-funded company values employees and builds a disruptive product in a challenging, fun environment.
Support program planning, tracking, and reporting for VA clinical informatics programs, keeping schedules, metrics, risks, and deliverables organized.
Maintain integrated schedules, track deliverables against due dates, and prepare biweekly sprint reports and status updates in Jira.
Manage risk and issue logs, support EHR issue management, patient safety monitoring, and informatics workforce program tracking.
Aptive is a professional services firm supporting federal health care programs, including the Department of Veterans Affairs' Office of Clinical Informatics. The company works within Scaled Agile Framework to help delivery teams stay focused and keep program operations running smoothly.