Draft new contacts and amendments and related customer documentation.
Serve as the single point of contact for internal and external Customers regarding sales contract activities.
Work within Salesforce CPQ to assist Field Sales through the configuration, pricing, and quoting processes.
PROCEPT BioRobotics is committed to revolutionizing treatment for benign prostatic hyperplasia (BPH) through innovation in surgical robotics. They are focused on creating an evolving landscape for your career, brimming with transformative opportunities that provide continuous career growth opportunities.
Partner with RCM leadership to monitor performance trends and identify revenue cycle opportunities.
Support payer contracting activities, including onboarding clinical network agreements.
Act as program manager for strategic payer partnership initiatives and drive implementation.
Headspace provides access to lifelong mental health support. They combine content, clinical care, and technology to help millions of members around the world get support. Their culture is collaborative, inclusive, and grounded in their values.
Lead the direct negotiation of CareCentrix provider contracts.
Manage the full lifecycle of contract negotiations.
Collaborate with stakeholders to ensure contract terms align with requirements.
CareCentrix manages the provider network. They support contracting activities and oversee network providers across multiple payers; they have an award winning culture and value their employees.
Analyze benefit plan documents to accurately build benefit categories and adjudication rules.
Be a leader on the configuration team by supporting training, process development, and peer review / QA.
Support cross-functional teams during implementations/renewals and develop solutions for plan variations.
Gravie aims to improve healthcare access through consumer-centric health benefit solutions. They foster a diverse and authentic work environment where individuals can contribute uniquely to industry-changing products and services.
Collaborates with departments to ensure timely and accurate charge capture, entry, documentation, and reconciliation.
Works with departments to develop processes that eliminate billing edits related to revenue integrity functions.
Stays current on government regulatory changes and proposals affecting charging, reimbursement methodologies, and payment systems.
The University of Vermont Medical Center aims to be a national model for high-quality academic health care in a rural region. They ensure equal employment opportunities, basing decisions on job-related criteria without discrimination.
Negotiate pharmacy agreements across retail, mail, and quality-based channels.
Create and manage network contracting campaigns, analyzing performance metrics.
Work with analytics teams to assess network adequacy and compliance.
Jobgether is a company that uses AI to power the job application process. They ensure applications are reviewed quickly, objectively, and fairly against a role's core requirements.
Lead development and execution of pricing and contracting strategy across all commercial channels
Own all government price reporting obligations including Medicaid Best Price, AMP, ASP, and 340B program compliance
Implement and optimize systems and processes to ensure scalable, accurate, and auditable contracting operations
Definium Therapeutics is a clinical stage biopharmaceutical company developing novel product candidates to treat brain health disorders. Founded in 2019, they are continuously expanding their presence and global footprint with patient-centric, intelligent individuals.
Serves as principal lead on a defined number of providers for negotiation, strategy, and market intelligence.
Assist in the establishment of contract-related criteria and contracting guidelines to optimize financial performance and minimize Plan risk.
Responsible for understanding provider partners’ service needs and incorporating contract solutions to support providers and Capital Blue Cross in reaching shared goals.
Capital Blue Cross aims to go the extra mile for their team and community. Employees consistently vote them one of the “Best Places to Work in PA” due to their supportive colleagues and focus on professional and personal growth.
Develop the provider network through contract negotiations, relationship development, industry analysis and servicing.
Analyze, review, and project financial impacts of network contract arrangements.
Implement reimbursement strategies designed to control healthcare costs.
Blue Cross of Idaho is an Idaho-based health insurance company that has been around since 1945. As a not-for-profit, they are driven to help connect Idahoans to quality and affordable healthcare while building strong networks and services with the help of customer-centric professionals.
Ensure coordination of provider invoice activities to support timely reimbursement.
Research and resolve claim denials that fail payer edits, preparing corrections and appeals.
Verify patient eligibility, benefits, and health‑plan information using payer databases.
CareCentrix supports value-based care by providing care management and transition of care services. They focus on improving patient outcomes and managing healthcare costs through a range of programs and services. The company values caring, doing the right things and striving for excellence.
Assigns ICD-10-CM/PCS codes and assigns DRGs for inpatient medical records accounts; assigns ICD-10-CM/PCS codes and CPT codes for outpatient medical record accounts
Abstracts key data elements required for billing
Interacts with providers for clarification of documentation/education
UChicago Medicine has been at the forefront of medicine since 1899 and provides superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, they need employees with passion, talent and commitment… with patients and with each other.
Analyze and improve UM business workflows, including clinical assessments, rules, and documents.
Validate Health Services programs against business requirements and acceptance criteria.
Partner with medical directors and cross‑functional teams to review, evolve, and update InterQual and custom clinical criteria.
Wellmark is a mutual insurance company owned by its policy holders across Iowa and South Dakota, and it has built its reputation on over 80 years of trust. They are motivated by the well-being of their members and committed to sustainability and innovation.
Maintain and deepen senior-level relationships across national and regional payers.
Wheel is evolving the traditional care ecosystem by equipping the nation's most innovative companies with a premier platform to deliver high-quality virtual care at scale. They offer proven strategies and cutting-edge technologies to foster consumer engagement, build brand loyalty, and maximize return on investment.
Oversees the management of contractual documents that establish business relationships with vendors, customers and/or partners.
Advises management of contractual rights and obligations and provides interpretation of terms and conditions.
Manages team responsible for data entry, configuration within systems and maintenance of all changes in terms and conditions of payor contracts.
Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value.
Maintains and processes assigned work queue items accurately and within established timelines.
Analyzes account activity to determine refund eligibility and ensure correct payment handling.
Works with both government and commercial payers to resolve overpayments.
US Anesthesia Partners validates and tracks credits due to insurance companies, patients and other payers. They are an equal opportunity employer that values diversity.
Determines denials from remittance and explanation of benefits, trend root cause.
Crafts detailed appeal letters and contacting insurance payers for resolution.
Documents all actions taken for each claim within a claims recovery system.
TREND Health Partners is a tech-enabled payment integrity company with a mission to facilitate collaboration between payers and providers. They aim to improve access to healthcare by aligning common goals through a shared technology platform and seamless workflows. It is a dynamic, growing organization that promotes a collaborative and innovative work environment.
Assist Revenue Cycle Consultant and Technical Consultant teams in the implementation of Experian's Claim Source revenue cycle management system.
Review internal process, recommend and develop changes to improve systems efficiency, automation, and effectiveness.
Document complex solutions to internal and external clients.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. They operate across a range of markets, from financial services to healthcare, automotive, agrifinance, insurance, and many more industry segments, with corporate headquarters in Dublin, Ireland, and a team of 23,300 people across 32 countries.
Manage home infusion billing and reimbursement workflows
Handle accounts receivable and payor collections
Resolve complex claims and denials
We connect growth-minded companies with high-impact professionals who drive real results. Whether you're building a team or building a career, our approach is precise, people-first, and built for long-term success.
Resolve aged claims and appeals via payer portals & outbound phone calls.
Prioritize assigned work queue to ensure timely work is balanced with working the most payable claims.
Work professionally with Revenue Cycle teammates to be responsive to requests that require your assistance.
CareDx, Inc. is focused on providing healthcare solutions for transplant patients and caregivers. They are the leading provider of genomics-based information for transplant patients.
Perform data mapping activities, translating client data into defined global and consumer data standards according to Cotiviti requirements.
Collaborate with internal stakeholders to analyze, understand, and document data requirements and transformation rules.
Explore large and complex datasets to identify trends, patterns, and anomalies.
Cotiviti transforms information into actionable insights that fuel business growth and innovation. They offer a dynamic environment where priorities can shift quickly based on business needs, but specific employee numbers are not mentioned in the job description.