Supervises representatives, manages performance, and provides feedback through side-by-side and recorded call reviews.
Handles escalated calls, partners with business units, and coordinates team schedules to maximize efficiency.
Monitors volumes for pending queues and ensures timely processing of prior authorization forms.
PharMerica is a long-term care pharmacy services provider that supplies medications, clinical support, and pharmacy management to healthcare organizations across the United States. It operates as part of BrightSpring Health Services, combining personalized care with the resources of a national network.
Verify insurance, obtain benefits, calculate estimates, and secure prior authorizations for outpatient services.
Act as liaison between payers and clinic staff; follow up on denied or delayed authorizations.
Maintain detailed documentation and resolve issues with physicians, nurses, and financial advocates.
University of Utah Health is a patient-focused organization enhancing health through care, research, and education. It operates five hospitals and eleven clinics with a culture of collaboration, excellence, leadership, and respect.
Oversee referral and authorization processing, ensuring accuracy and compliance with performance standards.
Coordinate team workloads, serve as a resource for associates, and resolve complex operational issues.
Provide coaching, training, and performance management to support professional development and team success.
The company provides healthcare administration services, managing referrals and authorizations for healthcare-related requests. The organization supports a remote team and emphasizes operational performance, professional development, and employee well-being.
Coordinates utilization review and prior authorization requests, ensuring accurate entry into the UM platform.
Provides customer service to providers and members, confirming benefits and answering authorization questions.
Facilitates communication between reviewers, hospitals, and physicians to ensure timely decisions.
University of Utah Health Plans is a patient-focused organization that enhances health through patient care, research, and education. It is part of a nationally ranked academic medical center with five hospitals and eleven clinics, fostering a culture of collaboration and excellence.
Oversee daily operational performance across healthcare client accounts, including A/R days, cash performance, and denial trends.
Serve as senior operational liaison between client stakeholders and internal delivery teams to drive corrective actions and reimbursement optimization.
Mentor operational leaders and staff, ensuring consistent execution standards and strong financial outcomes.
This company specializes in healthcare revenue cycle operations, including billing, collections, and accounts receivable management for hospitals. It fosters a collaborative remote work environment focused on supporting healthcare providers and improving financial and operational outcomes.
Provide leadership and coaching to Accounts Receivable Specialists, focusing on performance, accountability, and continuous improvement.
Analyze AR trends, develop KPIs, and execute strategies to improve collections and reduce aging.
Collaborate cross-functionally with revenue cycle, compliance, and operations teams to resolve complex payer issues.
Helping Hands Family is a top-rated provider of applied behavior analysis (ABA) therapy for children. They are a Great Place to Work Certified company with a supportive and inclusive culture.
Reviews complex hospital service accounts to ensure completeness prior to patient arrival.
Verifies patient insurance, confirms benefits, and determines authorization requirements.
Initiates pre-certification and creates patient liability estimates.
Piedmont Healthcare is a healthcare system providing comprehensive medical services across Georgia. It is a large organization focused on patient-centered care and community health.
Generate, review, and transmit claims for hospital-based services to third-party payors.
Collaborate across Revenue Cycle departments to resolve billing edits and other up-front issues efficiently.
Report to the Manager of Hospital Billing and support daily billing operations.
Piedmont Healthcare is a healthcare organization providing hospital-based services in Georgia. The company operates a corporate revenue cycle team focused on billing and claims management.
Lead strategic customer relationships and drive revenue growth across enterprise healthcare accounts, owning the full customer lifecycle from onboarding to expansion.
Partner with hospitals, healthcare practices, and technology providers to deliver integrations and measurable business outcomes, focusing on maximizing reimbursement and improving operational performance.
Build trusted relationships with technical and executive stakeholders, clearly communicating value using financial and business outcomes rather than production metrics or SLA adherence.
The partner company is a healthcare technology provider that improves revenue cycle performance and patient care. They foster a collaborative, growth-oriented environment, working with cross-functional teams and healthcare stakeholders across a dynamic organization.
Acclimate to client implementations to facilitate updates, additions, and fixes.
Partner with internal teams to navigate client tickets and enhancement requests with minimal delay.
Evaluate customer use of healthcare revenue cycle products to recommend best practices and solutions.
Experian is a global data and technology company that powers opportunities for people and businesses across multiple markets including financial services, healthcare, and automotive. With a team of 25,200 employees in 32 countries, Experian fosters a people-first, inclusive culture that has been recognized as one of the World's Best Workplaces.
Manage day-to-day health plan relationships, program commitments, and client communications.
Coordinate onboarding and delivery with internal teams, monitor service levels, and resolve issues.
Lead business reviews with performance insights and maintain alignment between client expectations and deliverables.
This role is with a healthcare services company that partners with health plans to deliver clinical assessments and close care gaps. The company uses AI to review applications and is committed to fairness and transparency in hiring.
Manage end-to-end drug prior authorization and claims cases, assessing requests against clinical guidelines and plan provisions.
Communicate authorization outcomes clearly to members, providers, and internal stakeholders while resolving escalated and complex scenarios.
Serve as a subject matter expert to support teams, training, and continuous improvement initiatives.
The hiring company operates in the insurance and benefits sector, managing complex drug prior authorization and claims cases. It is a global organization with a collaborative culture that values flexibility, continuous improvement, and employee well-being.
Process and maintain accurate Medicare enrollment and disenrollment requests, ensuring compliance with CMS regulations.
Reconcile membership reports and resolve enrollment system rejections, building case files for CMS approval.
Mentor junior team members and collaborate on special projects, including process documentation and quality reviews.
HealthEdge provides AI-powered operational infrastructure for health insurance companies, aiming to modernize operations and improve competitiveness. UST HealthProof, a fast-growing company, focuses on reducing administrative costs and improving healthcare experiences, led by seasoned leaders fostering a supportive, growth-oriented environment.
Receive medical claims from healthcare providers or patients and verify supporting documentation to ensure completeness.
Interpret Explanation of Benefits (EOB) and CMS-1500 forms, then evaluate claims against program-specific business rules for approval or rejection.
Provide support to customer inquiries via phone, email, or fax while maintaining HIPAA compliance and meeting daily productivity goals.
IQVIA is a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. With operations in over 100 countries, they cultivate a diverse, collaborative culture focused on improving patient outcomes.
Serve as the first point of contact, greeting patients and handling inbound calls.
Verify insurance, update demographics, and register patients in EMR (EPIC).
Document patient concerns, triage messages, and escalate emergent issues promptly.
U.S. Urology Partners provides urology and specialty services, including surgery and cancer treatment. It has over 50 offices across the East Coast and Midwest, with values of compassion, collaboration, respect, and accountability.
Lead and oversee the Zero Balance team to identify and recover underpaid hospital claims deemed 'zero balance'.
Provide daily supervision, coaching, and performance management to team members.
Analyze claim payments, prepare appeals, and communicate with clients and insurance companies.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, using proprietary algorithms and intelligent automation to improve financial sustainability. The company is a multi-year Top Workplaces award recipient and has been on the Inc. 5000 list of fastest-growing private companies for eleven years.
Lead day-to-day billing and coding operations across multiple markets, payers, and service lines.
Coach and develop Billing and Coding Supervisors to drive performance and accountability.
Own Revenue Cycle KPIs, process improvements, and cross-functional partnerships.
Imagine Pediatrics is a tech-enabled, pediatrician led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care, working alongside families, providers, and health plans.
Manage the full revenue cycle from patient registration through claims resolution.
Accurately submit and track medical claims to various insurance payers.
Perform accounts receivable follow-up, identifying and resolving denied, underpaid, or unpaid claims.
Allara is a comprehensive women's health provider that offers expert, longitudinal care for hormonal, metabolic, and reproductive conditions. It is one of the fastest-growing women's health platforms in the U.S., trusted by thousands of women nationwide.
Serve as the first point of contact for patients, scheduling appointments and coordinating referrals.
Verify insurance and demographic information, ensuring accuracy and compliance.
Document interactions in electronic medical records and escalate complex issues appropriately.
This role is posted on behalf of a partner company, and managed through Jobgether's AI-powered matching process. The company is a healthcare support provider that values compassion and efficiency in patient access services.