Coordinate denial and appeal follow-up activities to ensure timely resolution of insurance denials and appeals.
Investigate payment issues with insurance carriers, maintain tracking systems, and document follow-up actions.
Analyze performance data and collaborate with revenue integrity teams to improve billing accuracy and recovery.
This healthcare organization specializes in pediatric care and research, focusing on operational excellence. The team fosters a collaborative culture centered on quality, accountability, and continuous improvement.
Resolve denied claims by reviewing supporting documentation, calculating benefits due, and composing appeal letters.
Analyze claims to determine validity of denial/recovery options and draft convincing correspondence to effect reimbursement.
Build relationships with insurance carriers, patients, attorneys, and employers while documenting all actions to resolution.
Xsolis is an AI-driven technology company reducing administrative waste in healthcare by enabling smarter collaboration between providers and payers. Recognized on the Inc. 5000 and Deloitte Technology Fast 500 lists, it is one of the fastest-growing privately-held companies in North America with a passionate, fast-moving culture.
Manage end-to-end denials and appeals to maximize reimbursement recovery.
Analyze payer policies and medical documentation to develop appeal strategies.
Collaborate with clinical and financial teams to improve revenue cycle performance.
Our partner organization focuses on improving patient outcomes and supporting cancer care. They are a collaborative remote team blending clinical, financial, and administrative expertise.
Review, investigate, and appeal denied hospital insurance claims using clinical documentation and payer policies.
Develop evidence-based appeal letters addressing medical necessity, level-of-care, and charge discrepancies.
Collaborate with nursing, revenue integrity, and financial teams to resolve denials and prevent future rejections.
This partner company is a healthcare system that provides hospital services and focuses on revenue integrity. It supports fully remote work and values clinical expertise, collaboration, and financial sustainability.
Serve as a subject matter expert in claim denials, payment posting, and remittance reconciliation, independently managing complex queues.
Analyze Explanation of Benefits (EOBs) and remittance advice to identify root causes of denials and payment discrepancies.
Collaborate with team members to optimize workflow, resolve billing issues, and mentor junior staff.
Lyra Health is a leading provider of evidence-based mental health care, serving more than 20 million people globally through employer and health plan partnerships. The company has delivered over 15 million sessions of care and fosters a culture focused on innovation, collaboration, and high-quality outcomes.
Perform collections and manage outstanding balances from insurance companies for behavioral health services.
Investigate and resolve payer denials, prepare appeals, and communicate with insurance representatives.
Collaborate with internal teams to ensure accurate reimbursement and maintain detailed records.
Northpoint is a behavioral healthcare provider offering evidence-based treatment for substance use and co-occurring disorders for adults and mental health treatment for adolescents. Grown from two facilities to twenty across the Western U.S., they are guided by values of humility, heart, inspiration, and conviction.
Manage accounts receivable, including analysis of aged AR and identification of root cause issues.
Investigate, resolve, and appeal insurance claim denials, contacting payer representatives as needed.
Collaborate with internal teams and care center staff to drive optimal revenue cycle performance.
Privia Health is a technology-driven physician enablement company that partners with medical groups and health systems to optimize practices and improve patient experiences. It is led by top industry talent and physician leadership with a focus on scalable operations and cloud-based technology.
Manage pre-service authorization denials and coordinate reconsiderations, appeals, peer-to-peer reviews, and payer exception requests within applicable timeframes.
Interpret payer policies, medical necessity criteria, and coverage requirements to determine appropriate resolution pathways and obtain supporting documentation.
Collaborate with providers, payers, and internal teams to resolve complex cases, identify denial trends, and support process improvement.
IVX Health is a national provider of infusion and injection therapy for patients managing complex chronic conditions. They are a growing healthcare organization with a culture built on collaboration, innovation, and purpose, offering professional development and meaningful work.
Research denied claims and complete portal inquiries or outbound calls to insurance reps to identify root causes.
Resubmit corrected claims using CMS 1500 knowledge and draft appeals in line with medical policies.
Prioritize denials using the internal Claim Prio Model and flag system improvements to reduce denial inflow.
Grow Therapy is a mental health care platform operating a three-sided marketplace that connects providers, insurance payors, and patients to expand access to quality care. Backed by over $328M in funding and a $3B valuation, the company fosters an ambitious, ownership-driven culture.
Prepare and submit state-level reimbursement disputes through state portals, agencies, and arbitration entities.
Track deadlines, fees, and payments while keeping accurate case records from filing through resolution.
Monitor state requirements, flag rule changes, and collaborate with analytics teams to keep case data clean.
Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in a complex reimbursement landscape. We are a collaborative, low-ego team building AI-driven solutions to simplify reimbursement workflows.
Acts as a central point of contact and provides analytical problem-solving support to Commercial and Medicare Appeals and Grievances staff.
Researches, analyzes, and implements changes to processing procedures to increase department efficiency and meet regulatory compliance.
Supports training, documentation, and compliance activities while serving as a subject matter expert on appeals module configuration.
Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association, providing health insurance and wellness programs. The company fosters a flexible, caring culture and is consistently voted one of the "Best Places to Work in PA."
Serves as the primary source of knowledge for revenue cycle functions and drives performance improvement.
Analyzes trends, identifies opportunities, and ensures appropriate system configurations.
Manages denial trend research and translates policies into action plans.
Natera is a global leader in cell-free DNA testing dedicated to oncology, women's health, and organ health. The team consists of highly dedicated professionals from world-class institutions who care deeply for their work and each other.
Oversee revenue cycle performance across a portfolio of 5-9 ambulatory surgery centers.
Drive AR collections, denial resolution, billing accuracy, and reimbursement improvement.
Partner with center leadership and vendors, leveraging AI and automation to enhance workflows.
Compass Surgical Partners is a leading independent full-service ambulatory surgery center (ASC) development and management partner, creating joint ventures with health systems and physicians. With a leadership team that has developed more than 250 ASCs, the company emphasizes partnership, agility, and STAR values—Service, Teamwork, Accountability, and Respect.
Follow up on submitted insurance claims to ensure accurate and timely reimbursement
Manage assigned payer accounts and work outstanding balances through resolution
Investigate denied, underpaid, and unpaid claims to determine appropriate next steps
LUX Infusion reimagines infusion care to be more human, supportive, and connected, guiding patients and providers with clarity and compassion. It is a clinician-led, U.S.-based organization with a culture centered on inclusion, diversity, equity, and advancement (IDEA).
Manage end-to-end case activities for insurance verification, authorization, and reimbursement.
Serve as the single point of contact among patients, providers, payors, and internal teams.
Prioritize competing demands to ensure timely patient access to therapy.
PRO-Spectus supports patient services programs by navigating patient access from benefit verification through claims and reimbursement resolution. The company fosters a supportive, teamwork-driven culture focused on improving patients' lives.
Develop accurate reporting on revenue cycle performance, including AR, denials, and reimbursement trends.
Analyze payer contracts and reimbursement rates to support financial evaluation and negotiations.
Leverage AI and automation tools to streamline data analysis and improve reporting efficiency.
Compass Surgical Partners is a leading ambulatory surgery center development and management partner, collaborating with health systems and physicians to build high-performance ASCs. The company has developed over 250 ASCs over three decades and values service, teamwork, accountability, and respect.
Acts as a subject matter expert in Revenue Integrity products including DRG, DRGV, and Medical Necessity Denials.
Defines departmental goals, financial targets, and KPIs while overseeing quality and productivity metrics.
Leads a high-performing team through hiring, training, coaching, and performance monitoring.
EnableComp provides revenue integrity solutions for healthcare providers, specializing in DRG validation, medical necessity denials, and revenue recovery. The company values leadership, operational excellence, and cross-functional collaboration in a remote-first environment.
Oversee contracted patient support agents and develop SOPs for reimbursement programs.
Liaise with cross-functional teams to resolve complex reimbursement issues and ensure training.
Manage patient and provider program issues, audits, and data analytics for continuous improvement.
Iovance Biotherapeutics is the global leader in innovating, developing, and delivering tumor infiltrating lymphocyte (TIL) cell therapies for patients with solid tumors. The company operates as an end-to-end cell therapy company with U.S.-based manufacturing scaled to serve thousands of cancer patients worldwide each year.
Lead RCM teams across onshore and offshore environments, driving patient access and operational performance.
Leverage data analytics and automation to accelerate collections, reduce costs, and improve denial management.
Collaborate with clinical, IT, AP, and operations teams in a fully remote setting with 10–20% travel.
SimonMed Imaging provides radiology and imaging services through a nationwide network. They foster a collaborative, purpose-driven culture with a focus on patient access to care and employee well-being.
Sell Qualtrics' XM platform to healthcare payer accounts and develop relationships at all levels.
Manage complex contract negotiations and maintain competitive knowledge for win-based proposals.
Collaborate with internal teams to secure large enterprise engagements.
Qualtrics builds experience management software for leading brands to improve frontline experiences. With 18,000+ clients and 5,000+ employees, it values close-knit teams and collaborative problem-solving.