Review and evaluate denied claims using proprietary software to determine correct reimbursement.
Research and acquire medical records and supporting documentation for submission to payers.
Conduct telephone follow-up with payers to ensure prompt reimbursement.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations using an intelligent automation platform. The company has over 24 years of industry expertise, is a multi-year Top Workplaces award recipient, and has been on the Inc. 5000 list for eleven years.
Investigate and research health insurance claims to ensure maximum payment for hospitals and medical providers.
Follow up on unresolved commercial, Medicare, and Medicaid claims to facilitate payment.
Support the team with denial reports, audits, and overall tasks in a fast-paced environment.
Revecore helps hospitals recover earned revenue so they can continue serving patients and communities. Trusted by 1,300+ hospitals across 48 states, it combines specialized expertise with proprietary technology and fosters a supportive, innovative culture.
Respond to client and team information requests in a timely, professional manner.
Communicate with insurance carriers to resolve claim issues and improve cash flow.
Contribute to training materials and maintain proactive communication with clients.
Ternium RCM specializes in resolving complex healthcare insurance claim denials and delays, empowering hospitals to focus on patient care. They are a growing team of dedicated professionals committed to optimizing revenue cycles and improving healthcare outcomes.
Manage DRG-related payer denials to protect reimbursement and minimize revenue loss.
Leverage clinical and coding expertise to produce compliant appeal outcomes.
Identify documentation and coding risks pre-claim to strengthen revenue integrity.
Rochester Regional Health is an integrated health services organization serving Western New York and beyond, with nine hospitals and numerous care facilities. It is a large health system focused on leading the evolution of healthcare.
Oversee insurance verification, prior authorizations, and MOHS claims processing to ensure accuracy and reduce denials.
Serve as the operational lead and subject matter expert, providing daily guidance and escalation support across revenue cycle workflows.
Partner with providers and teams to ensure seamless coordination of eligibility, benefits, referrals, and claims for dermatology and MOHS services.
Optima Dermatology is on a mission to revolutionize skin care with a world-class, mission-driven team. They are growing rapidly and foster a collaborative, fun, and hardworking environment.
Build and maintain client eligibility and accumulator files ensuring accurate claims adjudication.
Develop coding automations and manage SFTP connections for secure file transmission.
Apply deep PBM claims adjudication expertise to resolve discrepancies and support data operations.
AffirmedRx brings clarity, integrity, and trust to pharmacy benefit management, aiming to improve healthcare outcomes. A small, collaborative team focused on using clinical approaches and state-of-the-art technology.
Manage charge entry, claim submission, and payment posting for assigned clients
Work first-pass denials and resubmit or appeal claims as appropriate
Monitor and report on denial rates and billing performance for your assigned accounts
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company is an equal opportunity employer committed to diversity and inclusion.
Serve as the operational lead and subject matter expert for enterprise client accounts, overseeing accounts receivable and revenue cycle performance.
Drive root cause analysis of denied claims, payment variances, and workflow breakdowns to implement corrective actions.
Mentor team members, assign workloads, and facilitate training to ensure high-quality client support and operational consistency.
Prompt provides software for outpatient rehab organizations, helping them treat more patients and deliver better care while reducing environmental waste. It is a team of talented individuals committed to solving complex healthcare problems, fostering a culture of smart work and positive impact.
Perform daily charge audits and coding reviews for accurate CPT, ICD-10, and HCPCS code assignment.
Submit clean claims daily through Apero and the clearinghouse.
Monitor and resolve claim system rejections to avoid timely-filing issues.
Dreem Health is a digital sleep clinic that provides home-based testing and telehealth visits. They are part of an international team that values trust, collaboration, and compassion.
Investigate and analyze Motor Vehicle Accident accounts to coordinate insurance benefits and resolve outstanding balances for clients.
Conduct online medical research, review medical records, and manage claim life cycles using proprietary systems and tools.
Communicate with payers, attorneys, and clients to resolve claims, handle denials, and identify trends for prevention.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its E360 RCM intelligent automation platform. The company is a multi-year recipient of the Top Workplaces award, ranked #1 by Black Book in 2024, and has been on the Inc. 5000 fastest-growing companies list for eleven years, fostering a culture centered on professional growth and employee investment.
Review and process healthcare claims in accordance with payer requirements and established procedures
Verify claim information for accuracy, completeness, and consistency before submission
Work with billing and coding teams to investigate and resolve claim-related issues
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. They foster a remote work environment and value accuracy, teamwork, and continuous improvement.
Assess current denials processes and analyze denial trends to identify root causes and financial risks.
Develop and implement strategies to reduce preventable denials and improve revenue cycle performance.
Lead denials-related projects from planning through implementation, coordinating with stakeholders and tracking KPIs.
The Wilshire Group is a boutique healthcare consulting firm specializing in revenue cycle, Epic, and healthcare technology solutions. We are a small team of experienced professionals dedicated to improving financial performance for healthcare organizations.
Serves as the primary analytical resource for the Unresponded team, tracking post-appeal payer response activity.
Monitors key performance metrics including backlog aging, SLA adherence, and resolution trends.
Partners with the Manager to translate operational findings into actionable workflow recommendations.
Natera is a global leader in cell-free DNA testing, dedicated to oncology, women's health, and organ health. The team consists of highly dedicated professionals from world-class institutions who care deeply for their work and each other.
Own end-to-end claims and revenue-cycle operations, including claim submission, denials, appeals, and collections across Medicaid and commercial payers.
Build and optimize payer-specific billing workflows, including claim configuration, coding, and credentialing.
Drive cross-functional execution with Operations, Partner Success, and Finance to improve processes and achieve over $1M in monthly claims.
Jukebox Health partners with health plans to make homes safer and more accessible for older adults and high-needs populations, combining technology with networks of clinicians, suppliers, and installers. Founded by experienced entrepreneurs, Jukebox Health is a fast-growing healthcare services company backed by top venture capital firms like Valtruis and The Home Depot, with a high-trust, collaborative, remote-first culture.
Manage an assigned book of insurance accounts receivable, working claims from submission through final resolution to keep aging balances down.
Follow up with payers on outstanding claims, underpayments, and payment discrepancies, and drive them to close.
Investigate and resolve claim denials and rejections — corrected claims, appeals, and reconsiderations with the documentation payers require.
SimpliFed gives parents the tools they need to navigate baby feeding questions, concerns, and obstacles, starting in pregnancy and through the feeding journey. We're a Series A company growing fast, and our operational and revenue infrastructure needs to grow with us.
Investigate, analyze, and resolve highly complex provider disputes involving reimbursement methodologies, contractual interpretation, and regulatory requirements.
Serve as a subject matter expert providing technical guidance to Provider Dispute Resolution Analysts.
Identify trends, prepare reports, and make recommendations for process improvements and corrective actions.
Gold Coast Health Plan is a health plan focused on disrupting the healthcare industry with innovative solutions to meet the whole person's needs. They seek collaborators and innovators who are passionate about addressing society's healthcare challenges.
Manage complete and timely processing of claims, including reviewing daily correspondence and resolving issues through SalesForce.
Oversee accounts receivable functions such as worklists, zero pay, and denials to ensure timely resolution.
Serve as an escalation point and subject matter expert on internal sub-teams, driving toward daily and monthly KPIs.
Privia Health is a technology-driven physician enablement company that collaborates with medical groups and health systems to optimize practices and reduce costs. They are a national organization with top industry talent and a focus on high-value care.
Own RCM end to end for Medicaid and Medicare, from eligibility through claims, denials, and collections.
Lead strategy, team building, KPI reporting, and cross-functional collaboration with operations, product, and engineering.
Analyze claims data to improve collection rate, manage payer relationships, and ensure billing compliance.
Pair Team is an AI-enabled medical group for Medicaid and Medicare, delivering whole-person care through community-based organizations. It is California's largest complex care provider and is building an AI platform to scale across the safety net.
Maximize reimbursement by collecting outstanding balances from insurance companies through claim follow-up and appeals.
Resolve aged claims via payer portals and outbound calls, escalating for reconsideration and up to three levels of appeals.
Identify denial trends and collaborate cross-functionally to improve upstream processes and prevent future denials.
CareDx is a leading precision medicine diagnostics company advancing care in transplant, specialty oncology, and cell therapy. The company partners with healthcare providers and biopharma organizations to improve patient outcomes through molecular diagnostics and digital health solutions.
Ensure timely and accurate adjudication and payment of medical claims.
Process appeals and disputes by gathering and verifying claim information.
Work independently and as part of a team to meet daily processing quotas.
Sana is a health plan solution built for small and midsize businesses, designed around integrated primary care. Founded in 2017, Sana is remote-first with a fully distributed team across the U.S., valuing curiosity, ownership, and speed.