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  • Apply Truemed's product eligibility framework to categorize products within assigned Eligibility Category Groups.
  • Conduct daily SKU reviews and maintain category-specific comparable items.
  • Ensure compliance with IRS Publication 502 and escalate borderline cases to Clinical Operations.

Clinical Knowledge Compliance Attention To Detail Regulatory

20 jobs similar to Categorization Specialist

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US

  • Ensure regulatory readiness and classification accuracy for import operations.
  • Assign HTS classifications using GRIs, CBP guidance, and validate PGA implications.
  • Conduct structured research on tariff updates, regulatory changes, and trade actions.

Spreetail propels brands to increase their ecommerce market share globally while improving operational costs. It is building one of the fastest-growing ecommerce companies, offering a flexible work culture with quarterly in-person gatherings.

US

  • Oversee end-to-end health plan enrollment process and manage vendor performance.
  • Ensure accurate and timely processing of enrollment requests while maintaining compliance with SLAs.
  • Act as subject matter expert in payer enrollment requirements and resolve enrollment delays.

Medallion is a healthcare technology company that automates licensing, credentialing, and compliance monitoring for healthcare organizations. It is one of the fastest-growing healthcare technology companies, ranked #3 on Inc. Magazine's 2024 Fastest-Growing Private Companies in the Pacific Region and a Glassdoor Best Place to Work in 2024 & 2025.

US

  • Submit and track provider enrollments across Medicare/Medicaid and commercial payers to secure effective dates.
  • Maintain CAQH attestations and accurate provider data across payer portals and internal credentialing systems.
  • Assist with onboarding new providers and respond to payer requests to resolve application issues.

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, they are committed to compassionate, patient-first care.

$23–$25/hr
US

  • Process medical claims by reviewing, validating, and entering data accurately and in compliance with policies.
  • Identify discrepancies, flag unusual cases, and escalate issues while maintaining productivity and quality standards.
  • Collaborate with peers, participate in training, and uphold confidentiality and regulatory requirements like HIPAA.

Sidecar Health is redefining health insurance by making excellent healthcare affordable and accessible for everyone. The passionate team, with backgrounds as tech leaders, policy makers, and healthcare professionals, is driven to fix a broken system and create a more personalized, affordable, and transparent experience.

US

  • Assists with patient medication management and facilitates medication renewal requests.
  • Acts as a liaison between providers, patients, and pharmacies for prescriptions and prior authorizations.
  • Monitors prior authorization status and updates relevant parties throughout the process.

Mass General Brigham is a not-for-profit integrated health care system supporting patient care, research, teaching, and community service. They employ a diverse team of professionals including doctors, nurses, and tech experts, fostering a collaborative culture focused on exceptional care.

$35–$49/hr
US 40w PTO

  • Perform advanced coding for outpatient surgical and observation records with 95% or above accuracy.
  • Monitor compliance with federal and state coding laws and coordinate billing information.
  • Serve as a resource and mentor to coding staff on billing policy and procedure issues.

OHSU is Oregon's only public academic health center, providing patient care, leading groundbreaking research, and training healthcare professionals. As Portland's largest employer, OHSU offers opportunities to learn and advance within a system of hospitals and clinics across Oregon and Southwest Washington.

US

  • Identify, research, process, and resolve customer inquiries regarding health insurance benefits, claims, and eligibility.
  • Analyze medical records and apply medical necessity criteria to determine the appropriateness of benefit requests.
  • Maintain accurate records, meet quality and timeliness standards, and coordinate with internal departments and external organizations.

Blue Cross Blue Shield of Arizona provides health insurance products and services to individuals, families, and businesses, aiming to inspire health and make it easy. The company has been recognized as a Healthiest Employer and has transformed healthcare for over 80 years with teams in Phoenix, Tucson, Chandler, and Flagstaff.

US

  • Manages essential administrative and clinical-adjacent functions such as medication prior authorizations and scheduling.
  • Ensures tasks comply with organizational standards and regulatory requirements to promote a seamless care experience.
  • Supports clinical and operational scheduling and provides flexible administrative support to Care Teams.

This organization provides operational support for healthcare member care. They focus on ensuring accuracy and efficiency in workflows like prior authorizations and toxicology result entry.

US

  • Guide learners through third-party vendor accounts, documentation, and background checks.
  • Monitor learner progress for large cohorts and implement corrective actions.
  • Support training and mentoring of Specialists I and II.

Nightingale Education Group focuses on higher learning in healthcare professions, elevating education, health, and employment systems. They have graduated nearly 5,000 nurses and serve diverse communities with a blended-distance learning platform.

US

  • Coordinate clinician onboarding by maintaining accurate ATS records and distributing required credentialing documentation.
  • Verify licenses, certifications, education, and background checks to ensure compliance with state, federal, and Joint Commission standards.
  • Track expiring credentials, communicate renewal requirements, and proactively manage compliance deadlines to maintain clinician eligibility.

International SOS Government Medical Services supports healthcare programs that improve patient care and operational readiness across the U.S. and internationally. Founded in 1984, the company operates in more than 90 countries, delivering healthcare, medical assistance, emergency response, and workforce support services worldwide.

$16–$22/yr
US

  • Determines records to be released by reviewing requestor information in accordance with HIPAA guidelines.
  • Logs medical record requests into ROI On-Line database and scans records.
  • Answers phone calls and responds to walk-in customers regarding medical records.

MRO provides release of information (ROI) services for medical records. They have employees at client facilities throughout the United States and pride themselves on a positive work environment.

US

  • Coordinate and monitor provider/facility payer credentialing and re-credentialing processes.
  • Send, review, and verify credentialing applications and maintain provider information in online database.
  • Track license and certification expirations and ensure timely renewals for medical staff.

Bozeman Health is a healthcare organization dedicated to caring for the communities of Southwest Montana. They foster a Culture of Excellence emphasizing high performance, transparent communication, and continuous learning.

US

  • Categorize, code, and calculate registry data from patient medical records with high accuracy.
  • Manage multiple tasks and deadlines while flagging obstacles and proposing solutions.
  • Contribute to best practices, data dictionaries, and process improvement opportunities.

Q-Centrix delivers quality solutions to hospital partners across the country by applying clinical expertise to advance patient outcomes and research. The company is large and values making a meaningful impact.

US

  • Manage referral management portals and process incoming referrals.
  • Perform insurance benefit verifications and coordinate admissions.
  • Respond to inquiries about facilities within policy timeframes.

Acadia Healthcare is a national leader in treating individuals with acute co-occurring mood, addiction, and trauma. They emphasize admissions and intake functions to help every possible person in need.

US

  • Provide domain expertise to design and build AI tasks that amplify productivity.
  • Share knowledge about day-in-the-life workflows for regulatory submissions.
  • Generate or review reference ground-truth artifacts for evaluation.

Edison Scientific builds and deploys AI scientist agents to accelerate science and the development of new medicines. The team is ambitious and run by scientists and engineers from leading institutions across biology, physics, chemistry, and AI.

US

  • Create original medical documents such as clinical reports, case studies, and research papers to support AI training.
  • Ensure materials meet strict standards of accuracy, clarity, and educational value while de-identifying confidential information.
  • Collaborate remotely with project teams to curate diverse documentation sets for varied AI training use cases.

Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They use AI to review applications and match top-fitting candidates to roles, operating as a project-based contractor facilitator.

US

  • Act as a patient and family advocate to obtain necessary information and fulfill payer authorization requirements.
  • Collaborate with providers and staff to ensure successful referral and authorization processes.
  • Track, follow up, and resolve authorization issues to minimize financial risks.

Lucile Packard Children's Hospital Stanford provides world-renowned pediatric care combining advanced technologies with family-centered care. It is a major children's hospital dedicated to caregiver education and state-of-the-art facilities.

US 16w PTO

  • Manage the full Authorization process, from initial notification to determination and discharge, with detailed documentation in EMR and payer systems.
  • Verify patient eligibility and benefits, act as a liaison between hospital staff and health payers, and track pending authorizations for timely responses.
  • Maintain HIPAA compliance, escalate issues causing delays or denials, and manage workloads through accurate record keeping.

CorroHealth is a partner to healthcare providers, solving revenue cycle challenges through a mix of services, consulting, and technology. The company focuses on scalability and clinical expertise, building long-term careers by investing in employee development.

$65,450–$90,000/yr
US 4w PTO

  • Support Clinical Trial Managers in the day-to-day execution of clinical trials from start-up through close-out.
  • Own critical study coordination workflows such as maintaining trackers, decision logs, and training records.
  • Ensure study documentation and training records are complete, current, and audit-ready.

Oura is a health technology company that produces the Oura Ring, a wearable device for tracking sleep, activity, and readiness. It is a quickly growing company with a mission-driven culture focused on employee well-being and innovation.

US

  • Provide administrative and programmatic support to VA Research Office, including committee support and research proposal processing.
  • Coordinate communication between committees and ensure compliance with regulatory guidelines.
  • Conduct database administration, audits, and project tracking using IRBNet and Excel.

Aptive partners with federal agencies to achieve their missions through improved performance, streamlined operations and enhanced service delivery. Founded in 2012, we have over 300 employees nationwide and specialize in applying technology, creativity and human-centered services to optimize mission delivery.