Source Job

The Insurance Reimbursement Specialist maximizes reimbursement by collecting outstanding balances from insurance companies. The Specialist follows up on unresolved claims and escalates claims for reconsiderations. The Specialist works with CareDx Payer Dispute Resolution/Market Access teams ensuring proper reimbursement from payers.

CareDx, Inc. is focused on the discovery, development, and commercialization of clinically differentiated, high-value healthcare solutions for transplant patients.

• Conduct timely and accurate eligibility checks and benefit investigations through payer portals and phone outreach to ensure claims are submitted correctly from the start
• Enter and monitor DME claims across multiple platforms, troubleshoot billing issues, and proactively follow up to reduce denials and accelerate reimbursement
• Analyze explanation of benefits (EOBs) for errors, missing payments, or misapplied patient responsibility, then determine and execute the correct resolution path

Babylist is the leading registry, e-commerce, and content platform for growing families helping parents feel confident, connected, and cared for at every step. It has over $1 billion in annual GMV, and more than $500 million in 2024 revenue and is reshaping the $320 billion baby product industry.

• Responsible for submitting medical billing claims and appealing denied claims.
• Obtain referrals and verify healthcare service eligibility.
• Follow up on missed payments and resolve financial discrepancies.

CRMS by DocGo leads the proactive healthcare revolution with an innovative care delivery platform. They disrupt the traditional healthcare system by providing high quality, affordable care with a team of over 5,000 certified health professionals.

• Review list of completed services/cycles to ensure completion.
• Maintain financial records for proper billing
• Reconcile all commercial insurance claims for cycles and single services

Spring Fertility is composed of physicians and scientists who trained at research hospitals and fertility centers. They are building the fastest-growing fertility group grounded in clinical excellence and innovation, delivering deeply patient-centric and compassionate care. They value collaboration, positivity, and enjoyment.

• Address the needs of patients with a focus on customer support, coordination of logistics, and problem solving.
• Schedule and coordinate the flow of work within or between departments to expedite project efficiencies and resolution to escalations.
• Address and resolve assigned inquiries with a sense of urgency; Ensure timely closure of escalation cases using email, phone, or salesforce.com

Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other.

• Prepare, review, and submit clean medical claims to commercial payers.
• Manage denial resolution: research root cause, correct and resubmit, or prepare appeals.
• Conduct proactive follow-up on outstanding A/R and aging claims.

Tava Health aims to make mental healthcare accessible and stigma-free. They are a fast-growing team using technology to provide accessible, high-quality mental health care.

• Responsible for collections and appeals from various Federal, State, & Third Party (HMO, PPO, IPA, TPA Indemnity) payers.
• Optimize payment reimbursements by reviewing accounts for billing accuracy and health plan coverage.
• Process an appeal, resubmit/rebill, or forward claims for adjudication as necessary.

BillionToOne is a next-generation molecular diagnostics company on a mission to make powerful, accurate diagnostic tests accessible to everyone. Forbes recently named them one of America's Best Startup Employers for 2025, and they were awarded Great Place to Work certification in 2024.

• Evaluate denied Medicare primary insurance claims efficiently.
• Appeal denied claims through Redetermination, Reconsideration, or Administrative Law Judge processes, following laws.
• Proactively investigate patient charts by reading documents and conduct computer-based research.

Solventum is a new healthcare company with a history of tackling major challenges to improve lives and support healthcare professionals. They focus on innovative solutions at the intersection of health, material, and data science and are guided by empathy and clinical intelligence.

• Process transactions on insurance accounts and interact with insurance companies.
• Communicate with staff and third-party customers to ensure accurate processing.
• Prioritize accounts to maximize aged AR resolution, and research documentation.

Oregon Health & Science University values a diverse and culturally competent workforce. They are proud of their commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status.

• Ensure correct insurance information for claim submission.
• Communicate with patients about balance, billing concerns, and insurance.
• Work in computer systems to obtain and organize billing information.

CardioOne partners with independent cardiologists to provide innovative solutions that improve patient outcomes and reduce costs. In February 2024, they partnered with WindRose Health Investors as well as top physician services and payor executives to grow their team and invest in their next phase of growth.

• Ensure timely and accurate payment of medical claims, following health plan policies and procedures.
• Maintain accurate and up-to-date notes of all claims processed.
• Process appeals and disputes by gathering and verifying claim information and communicating outcomes.

Sana Benefits aims to create an easy healthcare experience. They focus on providing seamless care and affordable benefits to small businesses.

• Resolves delinquent payment issues of complex accounts.
• Investigates patient account information, medical records and bills, billing and reimbursement regulations.
• Analyzes each account to optimize reimbursement and remove barriers to processing claims.

Legacy Health is dedicated to good health for its people, patients, communities, and the world, emphasizing doing the right thing. They foster an inclusive environment where everyone can grow and succeed, committed to equal opportunity.

• Provide support across our full customer base via various channels, addressing complex product and technical inquiries with accuracy and efficiency.
• Guide customers on best practices for revenue cycle management, claims submission, payment processing, collections, and denial management within our platform.
• Meet or exceed established performance metrics, including customer satisfaction, resolution time, and quality benchmarks; handle a high volume of inbound calls daily, ensuring timely and accurate responses to customer inquiries.

Tebra is the digital backbone for practice well-being, formed by the merging of Kareo and PatientPop. They aim to unlock better healthcare by helping independent practices bring modernized care to patients everywhere, serving over 100,000 providers.

Responsible for daily accounts receivable collections and billing. Assist with increasing collections, reducing accounts receivable days, and reducing bad debt. Partners with the field to ensure appropriate and timely revenue and collections.

• Reviews refund requests daily for completeness.
• Prepares Refund Request Forms and supporting documentation regarding overpayment calculations.
• Performs follow-up on checks that have not cleared the bank, and research’s checks that are returned for insufficient address.

US Anesthesia Partners validates and tracks credits due to insurance companies, patients and other payers. At this time, US Anesthesia Partners does not hire candidates residing in California, Hawaii, or Alaska and provides equal employment opportunities to all employees and applicants for employment.

Discuss insurance coverage with patients and explain financial obligations. Identify and enroll eligible patients in financial aid programs. Coordinate payment arrangements pre- and post-treatment and accurately document communications.

IVX Health is a national provider of infusion and injection therapy for individuals managing chronic conditions like Rheumatoid Arthritis, Crohn's Disease, and Multiple Sclerosis.