Perform clinical medical record review and abstraction to support healthcare quality and compliance.
Apply established review criteria consistently and document findings clearly and objectively.
Work independently to complete accurate reviews within project deadlines while managing multiple priorities.
Health Services Advisory Group (HSAG) is transforming the delivery of healthcare in the United States. They are a growing team dedicated to improving healthcare quality, with a focus on community and collaboration.
Submit and manage prior authorization requests for surgical and procedural services
Review patient charts and clinical documentation to ensure medical necessity requirements are met
Work directly within payer portals including Availity to process and track authorization requests
Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments. With over 70 clinics across 8 states and a Net Promoter Score of 93, we are building the future of vein care.
Review medical records to develop concise clinical reviews supporting authorization and reimbursement.
Facilitate communication with payors to ensure appropriate utilization management decisions.
Collaborate with interdisciplinary team to prevent denials and optimize patient care.
West Virginia University Health System is West Virginia’s largest health system, providing comprehensive healthcare services. With over 35,000 employees and 25 hospitals, it is the state's largest employer and offers a collaborative, patient-centered culture.
Conduct medical necessity reviews for inpatient admissions and post-acute services using evidence-based guidelines.
Lead peer-to-peer discussions with attending physicians to clarify clinical documentation and support appropriate care decisions.
Collaborate with utilization management and care management teams to ensure consistent, cost-effective care.
Our partner company provides utilization management services for Medicare Advantage members, focusing on evidence-based clinical decision-making. It operates with a collaborative, matrixed team and emphasizes regulatory compliance and patient-centered care.
Perform clinical reviews for medical necessity, level of care, and authorization compliance.
Prepare and submit high-quality appeals related to DRG downgrades and clinical validation denials.
Apply payer-specific guidelines and document review findings accurately in designated systems.
CorroHealth helps clients exceed their financial health goals through scalable revenue cycle solutions and clinical expertise. The company builds long-term careers by investing in team members' professional development and personal growth.
Drive forward movement within the post-trial pipeline by proactively removing barriers and ensuring timely progression.
Obtain medical records and prescriptions from prescribers while maintaining accurate client records in CRM.
Communicate consistently with speech language pathologists, clients, and care providers to complete sales and secure funding.
Lingraphica is a mission-driven organization providing speech-generating devices to help people with communication impairments improve their quality of life. They are a leader in augmentative and alternative communication technology, with a fast-paced, goal-oriented culture focused on helping individuals, families, and care teams.
Complete pre-charting and post-charting of comprehensive home health assessments in MatrixCare EMR.
Ensure documentation accuracy, compliance with regulatory standards, and strict confidentiality per HIPAA.
Collaborate with nurses to review and finalize patient records while maintaining strong attention to detail.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff through a global network. They connect clients with qualified professionals and offer tailored services to meet unique business needs.
Review and analyze Medicare claims sampled by the Department of Justice to determine correct coding and payment based on coverage and utilization.
Conduct in-depth claims analysis to detect fraudulent or abusive billing practices using ICD-10, CPT-4, and CMS guidelines.
Complete summary reports and communicate findings internally while maintaining confidentiality and compliance with DOJ and CMS regulations.
Empower AI provides AI-powered solutions for federal government agencies, helping them transform their workforce and operations. Headquartered in Reston, Va., the company has three decades of experience in Health, Defense, and Civilian missions and is recognized as a 2024 Military Friendly Employer.
Serve as the primary financial contact for caregivers during onboarding, explaining insurance benefits and estimated costs.
Collaborate with care coordination and clinical teams to ensure a seamless onboarding experience.
Maintain accurate documentation of all caregiver interactions while upholding HIPAA and privacy standards.
Lyra Health is a leading provider of evidence-based mental health care, serving over 20 million people globally. The company has a collaborative culture focused on delivering transformative care through technology.
Provide medication prior authorization support for assigned clinics using the Epic In Basket system.
Manage prior authorizations from clinic to pharmacy, including submission, tracking, and follow-up.
Communicate with clinics, pharmacies, and insurance payers to ensure timely approvals and patient access.
UnityPoint Health is a healthcare system delivering medical services across the Midwest. Recognized as a Top 150 Place to Work in Healthcare, it fosters a culture of belonging and supports team members with development and well-being.
Perform audits of enrollment, disenrollment, eligibility, and plan/PCP change transactions for health plan enrollment associates.
Review enrollment (834) file transactions and coordinate with state systems to confirm member effective dates and eligibility.
Collate, compile, and report QA performance to management and individuals, providing feedback for improvement.
HealthEdge provides AI-powered operational infrastructure for health insurance companies. UST HealthProof has a global workforce of over 4,000 people built on a foundation of simplicity, integrity, people-centricity, and leadership.
Support all aspects of credentialing and state licensing for the Medical Team, including Nurse Practitioners and Registered Nurses.
Maintain accurate provider credentials, ensure ongoing compliance, and contribute to departmental goals.
Manage credentialing files, perform primary source verifications, and obtain new/renewed state licenses.
Meds.com is a rapidly growing consumer technology firm operating healthcare businesses like BlueChew & MOD, aiming to better patients' lives through innovative solutions. With a team of 350 professionals, they've built scalable pharmacy, telemedicine, and e-commerce platforms using cutting-edge technology.
Review, process, and troubleshoot incoming Prior Authorization requests for various medications.
Accurately process requests according to regulatory and client-specific guidelines while meeting departmental performance metrics.
Work with clinical teams and handle requests via phone, fax, and web submission.
Navitus is a pharmacy benefit manager (PBM) alternative focused on reducing drug costs to make medications more affordable. The company offers a diverse and creative work environment with numerous employee benefits and growth opportunities.
Submit and track prior authorization requests across multiple insurance payers
Gather and review clinical documentation required to support authorization requests
Follow up with payers on pending requests and monitor authorization status through resolution
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company operates with a fully remote workforce and emphasizes a detail-oriented, collaborative culture.
Process approved physician orders and manage referrals with attention to detail.
Track documentation requiring physician signatures and escalate as needed.
Ensure timely billing and complete EMR files for discharged patients.
CommonSpirit Health at Home is a full-service health care organization that provides home health and hospice services. As a faith-based organization, it is committed to improving patient health and community well-being through compassionate care.
Prepare and maintain Trial Master Files for clinical studies, ensuring completeness and compliance.
Review documentation for accuracy and alignment with protocols and regulations.
Communicate with sponsors, project managers, and sites to resolve documentation issues.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They foster an inclusive, collaborative, and respectful workplace, utilizing technology to ensure fair recruitment.
Respond to new patient leads and booked patients quickly across phone, messaging, and internal systems.
Communicate with patients clearly, warmly, and professionally in both spoken and written English.
Support appointment scheduling, rescheduling, intake completion, paperwork follow-up, and onboarding tasks.
Legion Health is a full-stack AI-native psychiatry network delivering mental health care at scale. The company is a startup focused on improving patient experience through technology and human care, powered by both humans and AI.
Conduct a high volume of outbound calls, including cold calls, to medical offices and healthcare facilities.
Research medical facilities and use creative problem-solving to identify additional sources when information is hard to find.
Accurately document outreach, findings, and case-related information in internal systems and prepare professional email communications.
Magna Legal Services is a trusted nationwide partner to law firms, corporations, insurance carriers, and government agencies, delivering comprehensive legal support at every stage of a case. The company fosters a culture where talented people can do meaningful work and grow their careers.
Answer incoming patient phone calls and provide professional support.
Schedule and coordinate patient appointments and follow up on billing claims.
Manage prior authorizations and document patient communications in the EHR.
Assist World is a remote staffing company that connects virtual assistants with healthcare practices. They are a growing company with a focus on 100% remote work and a no-tracker policy.