Resolve aged claims and appeals via payer portals & outbound phone calls.
Identify non-payment trends and escalate groups of claims to the Dispute Resolution teams.
Propose solutions and collaborate cross-functionally with the Denials Management Steering Committee.
CareDx, Inc. is a precision medicine solutions company focused on healthcare solutions for transplant patients. They offer products, testing services, and digital healthcare solutions. They are the leading provider of genomics-based information for transplant patients.
Conducting collection activity on appealed claims by contacting government agencies and third party payers.
Requesting additional information from Patients, Medical Records, and others as needed.
Reviewing contracts and identifying billing or coding issues and requesting re-bills, secondary billing, or corrected bills as needed.
Sutherland helps strengthen brands by improving customer experiences. They're a global company with nearly 40,000 employees across over 100 countries, focusing on customer care and delivering extraordinary service.
Manages medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted.
Utilizes clinical background to address the clinical denials, as well as write sound, compelling factual arguments for appealing denials.
Responsible for maintaining a detailed knowledge of Third Party Payors and Governmental Payors clinical/medical necessity criteria, as well as filing compliant appeals.
Shriners Children’s respects, supports, and values each other. They are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact and were named as the 2025 best mid-sized employer by Forbes.
Review patient documentation for accuracy and qualification.
Create claim and/or invoice by confirming sales order.
Monitor Patient billing module and update information as needed.
Cala Health is dedicated to freeing people from the burden of chronic disease by creating non-invasive prescription therapies. They currently have thousands of employees and strive to empower people to get back to their lives with confidence and ease.
Manage collections process for customer accounts, including proactive outreach on past-due balances.
Monitor aging reports and work to reduce outstanding accounts receivable through timely follow-up and account analysis.
Partner with Billing, Sales, Customer Success, and Finance teams to resolve customer concerns and billing discrepancies.
WorkWave provides innovative software and fintech solutions for service professionals. With over 8,000 customers globally, their platform supports various business operations from customer acquisition to payments.
Monitor assigned accounts for irregularities, non-payments, and delayed payments.
Contact Sponsors/CROs to follow up on unpaid invoices and ensure timely payments.
Investigate and resolve sponsor, patient and customer disputes, maintaining strong business relationships.
Sarah Cannon Research Institute (SCRI), a subsidiary of McKesson, is one of the largest community-based cancer programs advancing oncology treatments and improving outcomes for cancer patients across the globe. SCRI's research network brings together more than 1,300 physicians who are enrolling patients into clinical trials at more than 200 locations in 20+ states across the U.S.
Collect information, assemble, and create accurate monthly client invoices, verifying data in the accounting system.
Research and resolve billing errors, issue debit/credit memos, and follow up with customers to collect revenue.
Process vendor invoices, manage 1099 vendor onboarding and compliance, and provide general administrative support to the accounting team.
Concentric is a risk consultancy specializing in delivering strategic security and intelligence services for private clients and corporations globally. The organization, powered by professionals from military, government, and intelligence backgrounds, fosters a culture of integrity, collaboration, and excellence.
Complete billing tasks daily; ensure minimal write off of reimbursement dollars.
Submit clean claims timely and appropriately to various insurance companies; complete submissions electronically or by paper according to payor guidelines.
Research, correct, and resubmit rejected and denied claims.
Enhabit Home Health & Hospice provides in-home healthcare services. They are an equal opportunity employer committed to a collaborative and respectful work environment that supports, encourages, and motivates all individuals.
Take incoming requests for appeals ensuring customer service and maximizing productivity.
Work with appeals team for multiple lines of business ensuring appeal submission for review.
Maintain quality standards, remain current on updated processes, and follow SOPs and HIPAA guidelines.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They have full-service health benefit management solutions to employers, TPAs, and health plans.
Lead the resolution of complex financial and benefits billing escalations to ensure accurate member financial tracking.
Perform root-cause analysis on multi-system issues, coordinate corrective actions, and reconcile claims data across platforms.
Act as the primary bridge between internal and external teams to clarify issues and expedite resolutions while communicating clearly with members.
Maven Clinic is the world's largest virtual clinic for women and families, providing clinical, emotional, and financial support through its digital platform across fertility, maternity, parenting, and menopause care. It is an award-winning, mission-driven company trusted by over 2,000 employers and health plans, with a culture recognized for innovation and as a great place to work.
Make outgoing calls for messages received regarding new claims
Enter new claim information into the client website
ClaimsPro LP is an international programs group that handles a variety of claims including auto physical damage and property damage. They are Canada's largest privately owned provider of insurance services empowering employees with the tools and technology to provide clients with the highest quality of service.
Reviews accounts in assigned queue to determine next course of action required to resolve the delinquent account.
Utilize various skip tracing techniques and collection strategies to locate right parties
Negotiate payment terms and methods, often requiring probing questions of the consumer in order to better understand potential objections to payment.
Velera is the nation’s premier payments credit union service organization (CUSO) and an integrated fintech solutions provider. The company serves more than 4,000 financial institutions throughout North America, operating with velocity to help our clients keep pace with the rapid momentum of change and fuel growth in the new era of financial services.
Performing portfolio collections outreach, exceeding goals, and meeting KPIs.
Researching and reconciling misapplied cash and documenting efforts in Netsuite.
Reviewing customer financial position and engaging in policy updates.
Basis is a company that empowers agencies and brands with software automating digital media operations. They have a culture where individuals drive change, with flexible work options across the U.S. and Canada.
Submit clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers.
Review provider documentation and assign accurate codes per ICD-10-CM, CPT, and HEDIS/quality reporting guidelines.
Maintain and contribute to the internal billing rules matrix (payer, state, provider type, modifiers).
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group that reimagines care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care. They enhance existing care teams with compassion, creativity, and an unwavering commitment to children with medical complexity.
Collaborate with Sales to resolve billing discrepancies and ensure accurate account reconciliation.
Maintain the integrity and accuracy of customer master data within ERP and CRM systems.
Conduct approximately 25–30 outbound collection calls daily to follow up on outstanding balances.
Netrix Global provides the people, processes, and technology needed to run and scale modern, data-driven businesses that are always on and always secure. They work with clients of all sizes and specialize in solutions for healthcare, manufacturing, government, education, financial services, and legal industries.
Assist team on a smooth end-to-end billing process
Investigate, document, and follow up on denials and underpayments
Complete recurring work queues on a monthly basis
Omada Health is reverse engineering healthcare delivery, focusing on the space between doctor visits. They offer virtual-first models with human-led care teams, connected devices, and AI to support chronic conditions and have served over two million members across 2,000+ organizations.
Monitor customer accounts daily and contact customers to secure timely payments for aged receivables.
Handle inbound AR-related calls, billing inquiries, and research/resolve service and parts billing issues.
Maintain accurate records and reports while responding to internal and external inquiries within service-level timelines.
Lithia & Driveway is the largest automotive retailer in North America, operating hundreds of store locations while providing vehicle purchase, financing, and online sales services. As a Fortune 500 company listed on the NYSE, they emphasize entrepreneurial leadership and a customer-centric culture focused on delivering 'Auto Done Easy' experiences.