Evaluate dispute eligibility and documentation to ensure cases meet federal IDR or state-specific requirements before submission.
Research and interpret state regulatory requirements, translating them into clear workflows for the team.
Monitor arbitration timelines, track correspondence, and maintain accurate case records to support operational improvements.
Pivotal Health is a technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. We are a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers.
Track open payer issues end-to-end, ensuring clear ownership and accountability across teams.
Drive measurable business outcomes by improving RCM efficiency and revenue performance.
Partner with BD and operations teams to align stakeholders and move issues to resolution.
Alma simplifies access to mental health care by helping therapists accept insurance and offer in-network care. With over 20,000 therapists across all 50 states, Alma has raised $220.5M and been named an Inc. Best Workplace.
Lead and develop a team of Collections Specialists while managing a portion of the Tier 3 AR portfolio.
Serve as escalation point for complex denials and payer disputes, tracking team-level AR aging and denial trends.
Ensure operational consistency through productivity scorecards, standardized follow-up templates, and auditable documentation practices.
Virta Health is on a mission to reverse metabolic disease in one billion people. They have raised over $350 million from top-tier investors and are a remote-first company with office hubs in Denver and San Francisco.
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.
Provide remarkable service by answering inbound calls and emails from clients, agents, and brokers.
Process administrative tasks including account maintenance, data entry, and interdepartmental coordination.
Communicate with Treasury to resolve credit card disputes, refunds, and perform daily payment reporting.
HealthEquity empowers healthcare consumers by providing HSAs and consumer-directed benefits. The company fosters an inclusive culture and is committed to saving and improving lives.
Lead managers and supervisors responsible for member enrollment and billing operations.
Drive achievement of client SLAs, quality metrics, productivity, and financial targets.
Partner with clients and internal stakeholders to identify operational improvements and foster a culture of accountability.
Sutherland leverages artificial intelligence, automation, and cloud engineering to drive digital transformation for iconic brands. With over 200 patents and a focus on human-machine collaboration, the company delivers measurable results through a seamless 'as a service' model.