Resolves medical claims that are not automatically adjudicated, ensuring timely and accurate processing.
Investigates and communicates to obtain needed information, and interprets contract benefits.
Works from home within Arkansas, Washington, Oregon, Utah, Idaho, North Dakota, or Minnesota.
Arkansas Blue Cross and Blue Shield is a health insurance provider that resolves medical claims and supports member health and wellness. The company is consistently ranked as a best place to work in Central Arkansas, with an average tenure of 10 years and an inclusive culture.
Make high-volume outbound calls to investigate, bill, and maximize payments on medical claims to insurance companies. - Research auto accident details to determine responsible payers and submit bills and documentation. - Follow up on denied or incorrect payments and support team with reports, audits, and overall assistance.
Revecore helps hospitals recover earned revenue so they can continue serving patients and communities. Trusted by over 1,300 hospitals across 48 states, the company offers a supportive, innovative culture where employees are trusted to do their best work.
Adjudicate healthcare claims based on client-specified guidelines and determine appropriate payment for services.
Meet productivity, financial accuracy, and procedural standards while mentoring junior team members.
Collaborate on special projects including process documentation, training, quality audits, and surge activity.
HealthEdge provides AI-powered operational infrastructure for health insurance companies, helping them modernize operations and compete effectively. The company is expanding and investing in its people, fostering a collaborative and growth-oriented culture.
Evaluate, negotiate, and settle low to high complexity bodily injury claims to prevent unnecessary exposure.
Investigate and analyze medical records, law enforcement reports, and witness statements to determine liability and damages.
Coordinate settlement, mediation, and arbitration with attorneys, ensuring compliance with state laws and regulations.
Mercury Insurance helps people reduce risk and overcome unexpected events, providing insurance products and claims services for more than 60 years. They emphasize a collaborative, inclusive culture where team members are encouraged to grow, have fun, and make a meaningful impact.
Investigate claim denials, navigate evolving payer requirements, and ensure complex claims are prioritized and resolved accurately.
Partner with cross-functional teams to identify operational and denial trends, optimizing workflows and claim outcomes.
Act as the pod’s go-to expert for payer workflows, claim resolutions, and best practices, supporting new-hire onboarding and team performance.
Rula is a mental healthcare company dedicated to providing quality, evidence-based care and reducing stigma around mental health. It is a remote-first company with a focus on inclusion, employee well-being, and making mental healthcare work for everyone.
Process medical claims and appeals accurately and timely, following health plan policies and procedures.
Maintain detailed notes, research claim issues, and communicate outcomes with claimants and teams.
Support customer success teams, escalate operational issues, and help improve claims processes.
Sana is a health plan solution built for small and midsize businesses, with integrated primary care services to make healthcare easy. Founded in 2017, the company is remote-first with a fully distributed team across the U.S., and values curiosity, ownership, and speed.
Collaborate with claimants, attorneys, medical providers, and insured businesses to ensure accurate, fair, and efficient claim outcomes.
This company provides workers' compensation claims management services, handling lost-time claims across multiple jurisdictions. The role is fully remote, emphasizing independent work, sound judgment, and high-quality service.
Review and verify credentialing documents, licenses, and background reports against client-specific standards.
Collaborate with onboarding teams to ensure files are accurate, complete, and ready for approval.
Monitor document trends and support continuous improvement to reduce errors and enhance efficiency.
This company provides healthcare staffing services with a focus on clinician credentialing and onboarding. While the company size is not specified, it fosters a collaborative, service-oriented culture emphasizing accuracy and compliance.
Serve as primary point of contact for clients, managing inbound and outbound communications with professional excellence.
Utilize web-based tools to efficiently resolve inquiries and ensure a seamless, positive customer experience.
De-escalate issues, escalate when necessary, and track call information for auditing and reporting purposes.
TP is a leading global provider of digital business services, partnering with prominent brands to optimize operations through advanced technology and sustainable practices. With a global workforce of 500,000 across 300 languages, they prioritize inclusion, diversity, and career growth.
Reviews claim notices, policies, and state requirements to determine coverage and compensability.
Conducts timely claim investigations and coordinates return-to-work efforts with involved parties.
Manages claim documentation, settlement evaluations, and collaboration with internal teams and attorneys.
EMC Insurance is a property and casualty insurer providing workers' compensation and other insurance solutions, with over 105 years of financial strength. The company fosters a collaborative culture that empowers team members, and has been recognized as a top workplace.
Handle inbound and outbound customer inquiries related to third-party liability and subrogation matters.
Conduct professional interviews to collect, verify, and document insurance and claims information.
Navigate multiple computer systems while maintaining accurate records and meeting productivity targets.
This company focuses on improving healthcare payment accuracy and helping individuals navigate complex insurance-related inquiries. It operates with a customer-focused team in a fast-paced, technology-driven 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.
Adjudicate high-end General Liability claims involving serious injuries, complex coverage scenarios, and legal disputes.
Develop case strategies for satisfactory resolution, coordinating with local counsel, clients, and medical or legal experts.
Work in a remote, flexible environment with opportunities for career growth and comprehensive benefits.
Sedgwick is the world's leading risk and claims administration partner, helping clients navigate the unexpected with expertise and AI-enabled technology. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides a caring culture, professional development, and work-life balance.
Serve as first point of contact for patient and customer inquiries, resolve issues.
Schedule appointments, verify insurance, and maintain records.
Coordinate with clinical teams, route urgent calls, and support navigation.
A patient-focused healthcare organization dedicated to simplifying access to care. The team provides comprehensive training and development in a supportive, fast-paced culture.
Provides exceptional customer service and engagement via telephone.
Identifies customer needs and assists them with healthcare related issues through outreach programs.
Researches, identifies, and solves problems while verifying eligibility and placing call backs as required.
Carenet Health is a healthcare services company that provides customer engagement and support solutions for health plans and members. The company fosters a collaborative, innovative culture focused on empowering team growth through trust, opportunity, and accountability.
Resolve denied claims by reviewing supporting documentation, calculating benefits due, and composing appeal letters.
Analyze claims to determine validity of denial/recovery options and draft convincing correspondence to effect reimbursement.
Build relationships with insurance carriers, patients, attorneys, and employers while documenting all actions to resolution.
Xsolis is an AI-driven technology company reducing administrative waste in healthcare by enabling smarter collaboration between providers and payers. Recognized on the Inc. 5000 and Deloitte Technology Fast 500 lists, it is one of the fastest-growing privately-held companies in North America with a passionate, fast-moving culture.
Conduct quality audits and monitor compliance with standards and contractual requirements.
Analyze operational data to identify trends and performance gaps.
Collaborate with teams to implement corrective actions and drive continuous improvement.
We are a partner company providing security and IT services, focused on operational performance, compliance, and continuous improvement. We operate as a fully remote team, fostering a culture of accountability and continuous improvement.
Help members navigate US health insurance, including billing questions, denied claims, and appeals.
Coordinate with providers, insurers, and members to resolve coverage issues and prior authorizations.
Translate complex insurance benefits into clear guidance and identify trends to improve the member experience.
This company provides a global safety net for remote workers, offering health, income, and travel coverage. It operates as a remote-first organization with a culture of empathy, integrity, and a mission to improve access to healthcare worldwide.
Analyze and evaluate worker's compensation claim payments using proprietary software and tools.
Research and acquire medical records and submit claims with supporting documentation to insurance companies.
Conduct telephone follow-up with payers to ensure claims are received and facilitate prompt reimbursement.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging a unified platform to improve financial sustainability. The company is a multi-year Top Workplaces award recipient and has been among the fastest-growing private companies in the US for eleven years.
Serve as the first point of contact for patients in person and by phone, delivering excellent customer service.
Process new orders, verify insurance, obtain authorizations, and gather documentation for accurate billing.
Perform data entry, collect payments, and make outbound satisfaction calls to patients and referrals.
Accendra Health makes essential healthcare products and services accessible outside traditional settings. With over 6,000 teammates in 250+ locations under Apria and Byram Healthcare, it offers meaningful work focused on personalized, long-term care.