Perform complete, accurate, and timely processing of reimbursement/payment audits in compliance with policies, payer contracts, and government fee schedules.
Collaborate with operations consultants, RCM AR staff, and management to address Care Center payment performance audits and maximize cash flow.
Identify, monitor, and manage denial management trends, and work closely with Revenue Cycle Teams and payer representatives.
Reconcile daily payment batches in Candid against bank deposits and resolve unapplied items.
Audit claim and payment data for accuracy, proper denial status, and correct payer assignment.
Validate reimbursement amounts against contracted fee schedules and expected payments.
Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services. Since 2019, we have served thousands of clients and are a fast-growing, fully remote team dedicated to parent-focused intervention and improving outcomes.
Perform advanced healthcare payment audits by analyzing claims data and identifying discrepancies.
Develop and improve audit concepts focused on payment accuracy and reimbursement policies.
Collaborate with audit, engineering, and business teams to ensure accurate findings and process improvements.
Jobgether is an AI-powered job matching platform that uses technology to connect candidates with roles. The company operates remotely and focuses on efficient, objective hiring processes.
Manage high-value medical claims, denials, and appeals to ensure accurate and timely reimbursement.
Analyze unpaid/underpaid claims, investigate billing errors, and communicate with insurance payors via portals, phone, and email.
Maintain detailed documentation, process updates, and collaborate with internal teams to resolve complex accounts receivable issues.
Our partner operates within the healthcare revenue cycle, ensuring accurate reimbursement for medical services. They are a collaborative team focused on improving financial outcomes and maintaining compliance with healthcare regulations.
Process medical records requests accurately and within required turnaround timelines.
Manage incoming payer communications and support billing operations, including refunds and claim-related activities.
Collaborate with internal teams to improve workflows and ensure compliance with healthcare requirements.
Our partner company is a mission-driven organization focused on improving access to quality care. They are a growing organization that values operational excellence and patient experiences.
Oversee specialized teams supporting revenue integrity ROI activities, ensuring compliance with policies and timely completion.
Act as liaison between MRO and client audit and PFS leaders, managing workflow and client relationships.
Manage labor and expenditures to budget, and conduct performance reviews for direct reports and area managers.
MRO is the industry leader in Release of Information (ROI) and Health Information Management (HIM) services, partnering with hospitals and health systems nationwide. The company emphasizes compliance, operational excellence, and client-focused service.
Develop and maintain audit concepts by researching regulatory, coding, or payer policy changes and updating rule documents and code lists.
Perform QA reviews to ensure audit concepts comply with coding standards, payment methodologies, and payer policies prior to deployment.
Collaborate with cross-functional teams including operations, clinical, and client services to support policy execution and drive concept quality.
Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering value and efficiency to health plan clients. Deployed by over 85 health plans representing more than 270 million lives, we are a digital-first, AI-powered platform that reimagines what's possible in healthcare.
Manage and resolve claims rejections and denials, escalating trends as identified.
Verify patient eligibility and benefits, and coordinate with insurance payers.
Maintain compliance with HIPAA regulations and meet productivity standards.
Workit Health is an industry-leading provider of on-demand, evidence-based telemedicine care for addiction. They are a growing company with a dedicated team passionate about making judgment-free care accessible.
You process patient payments and manage payment plans with accuracy and empathy.
You handle insurance verification, claims support, and billing education for patients.
You research account issues and resolve billing discrepancies while maintaining professionalism.
Privia provides healthcare billing and payment solutions, helping patients with insurance claims and financial responsibilities. They operate with a remote team and emphasize compassionate, compliant service.
Review and accurately post insurance and patient payments with precision and efficiency, ensuring alignment with company policy and regulatory standards.
Resolve auto-posted ERA errors daily and assist with month-end reconciliation to maintain clean patient ledgers.
Collaborate with billing staff and client relations to research payment discrepancies and support accounts receivable processes.
Prompt is revolutionizing healthcare by delivering highly automated software to rehab therapy businesses. As the fastest-growing company in the therapy EMR space, Prompt has a talented team passionate about creating a positive impact on patient care and reducing environmental waste.
Process medical records requests and manage incoming payer mail with timely and accurate turnaround.
Process billing-team refunds, payer reconsiderations, and manual 837 claim pulls and postings.
Collaborate with the Internal Audit & Compliance Associate to support audit-related documentation and identify process inefficiencies.
Ophelia helps people end their opioid use and restore their quality of life by providing evidence-based treatments for opioid use disorder through a telehealth platform. It is a venture-backed healthcare startup operating in 14 states for almost six years, with a team of physicians, scientists, entrepreneurs, researchers, and White House advisors.
Validate accuracy of CPT, HCPCS, revenue codes, and billed line-item charges on outpatient and inpatient facility claims.
Apply CMS guidance, coding guidelines, and industry standards during claim review, including hospital bill audits and itemized bill reviews.
Prepare appeal responses using applicable coding guidance and maintain required certifications and continuing education.
Trend Health Partners is a tech-enabled payment integrity company that facilitates collaboration between payers and providers to reduce waste and improve access to healthcare. They are a dynamic growing organization promoting a collaborative and innovative work environment.
Oversee the entire claims submission and follow-up process, ensuring accuracy and timeliness.
Lead and manage large payer projects and care center support, updating leadership on opportunities.
Manage accounts receivable, analyze denial patterns, and implement process improvements.
Privia Health is a technology-driven national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices. The company is led by top industry talent and exceptional physician leadership, and fosters an inclusive work environment.
Follow-up with payers to ensure timely resolution of outstanding claims via phone or websites.
Maintain daily productivity/quality standards and utilize workflow systems to collect payments.
Analyze claims issues to reduce denials, initiate appeals, and handle under/over-payments while adhering to HIPAA standards.
Limitlessli specializes in recruiting, hiring, and managing high-caliber remote staff for dynamic healthcare facilities. They are a fast-growing company with a supportive, remote-first culture.
Process and post accounts receivable from assigned payers within turnaround time.
Research payer websites and electronic remittance to balance files with money received.
Identify issues and trends with payers, ensuring aged receivables are handled per procedures.
Labcorp is a global leader in diagnostics, drug development, and healthcare innovation, harnessing data and AI to improve health outcomes. With nearly 70,000 employees serving clients in over 100 countries, Labcorp fosters a culture of discovery and career growth.
Complete billing tasks daily and monitor assigned accounts to minimize write offs.
Submit clean claims to insurance companies electronically or by paper according to guidelines.
Research, correct, and resubmit rejected and denied claims, and prepare appeals.
Enhabit Home Health & Hospice provides home health and hospice services. It is a large corporate agency with a focus on employee growth and competitive benefits.
Conducts baseline, routine, and focused audits comparing medical record documentation to reported CPT/HCPCS and ICD-10-CM codes.
Researches, interprets, and communicates federal and state laws and guidelines pertaining to CMS and Medicare.
Acts as an internal expert on coding issues to ensure compliance with state and federal regulations.
Privia Health is a technology-driven national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The company is led by top industry talent and focuses on scalable operations and cloud-based technology to reduce healthcare costs.
Apply deep clinical, coding, and reimbursement expertise to enhance AI-enabled claim selection tools.
Partner with data science teams to validate AI outputs and improve model performance.
Serve as a coding subject matter expert to support audit concept development and optimization.
Cotiviti is a healthcare analytics company specializing in payment integrity and data-driven solutions. The company fosters a collaborative culture and emphasizes innovation in healthcare audit and analytics.
Manage the complete revenue cycle for Wisconsin payors, including claim submission, denial resolution, and follow-up.
Investigate and resolve claim denials and payment discrepancies by collaborating with internal teams and payors.
Prepare weekly AR reports and support departmental KPIs to optimize reimbursement.
LEARN Behavioral is a national organization dedicated to nurturing children with autism and special needs through evidence-based applied behavior analysis. With 20 years of clinical insights, the company focuses on personalized treatment plans and is an Equal Opportunity Employer.
Submit provider and organizational contract requests to commercial, Medicare, Medicaid, and managed care payers.
Monitor contract application status and maintain detailed tracking of all submissions and negotiations.
Coordinate with internal teams to facilitate successful implementation of newly executed agreements.
Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services. Since 2019, we have served thousands of clients and maintain a fully remote culture focused on collaboration and personal connection.
Manages full cycle accounts receivable including invoicing, payment posting, and reconciliation.
Communicates with patients, insurance carriers, and internal teams to resolve billing discrepancies.
Processes insurance claim denials, resubmits claims, and maintains timely follow-up on outstanding balances.
Oral Surgery Partners is a dental and oral surgery practice providing surgical care. The company offers a supportive team environment with benefits and opportunities for full-time employees.