Submit clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers.
Review provider documentation and assign accurate codes per ICD-10-CM, CPT, and HEDIS/quality reporting guidelines.
Maintain and contribute to the internal billing rules matrix (payer, state, provider type, modifiers).
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group that reimagines care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care. They enhance existing care teams with compassion, creativity, and an unwavering commitment to children with medical complexity.
Maintains practice management systems, processes insurance claims, and reconciles patient accounts.
Investigates rejected claims, corrects denials, and facilitates payment through collections and billing reminders.
Ensures HIPAA compliance, resolves patient billing issues, and provides professional customer service.
US Anesthesia Partners provides anesthesia services and revenue cycle management. It is a large US-based healthcare organization focused on billing and insurance operations, emphasizing accuracy and compliance.
Review and analyze insurance denials using EOBs, payer correspondence, and claims data to determine appropriate resolution strategies.
Differentiate between clinical and technical denials and identify required next steps for appeals or reprocessing.
Prepare and submit appeals using supporting documentation such as medical records, appeal letters, and clinical justification when necessary.
Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They use automated technology to review applications and share top-fitting candidates directly with employers, ensuring a fair and efficient hiring process.
Resolve aged claims and appeals via payer portals & outbound phone calls.
Identify non-payment trends and escalate groups of claims to the Dispute Resolution teams.
Propose solutions and collaborate cross-functionally with the Denials Management Steering Committee.
CareDx, Inc. is a precision medicine solutions company focused on healthcare solutions for transplant patients. They offer products, testing services, and digital healthcare solutions. They are the leading provider of genomics-based information for transplant patients.
Manage insurance account workflows and ensure accurate resolution of billing and reimbursement issues.
Investigate, resolve, and appeal insurance denials while documenting actions in compliance with standards.
Monitor aged accounts receivable and prioritize workloads to optimize collections and reduce outstanding balances.
Our partner is a healthcare services organization focused on revenue cycle management. They offer a collaborative and mission-driven environment with a comprehensive benefits package.
Manages medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted.
Utilizes clinical background to address the clinical denials, as well as write sound, compelling factual arguments for appealing denials.
Responsible for maintaining a detailed knowledge of Third Party Payors and Governmental Payors clinical/medical necessity criteria, as well as filing compliant appeals.
Shriners Children’s respects, supports, and values each other. They are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact and were named as the 2025 best mid-sized employer by Forbes.
Accurately translate patients’ medical records into standardized codes for diagnoses and treatments.
Ensure compliance with legal, regulatory, and organizational standards.
Ensure claims are processed correctly and on time through clear communication and efficient management of records.
Dignity Health Medical Foundation provides comprehensive health care services. They have care centers throughout California and are affiliated with Dignity Health, one of the largest health systems in the nation. They strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships.
Improve first-pass claim acceptance by ensuring correct coding, flagging inconsistencies, and reviewing EOBs and denial trends to identify recurring issues.
Work closely with billing teams and vendors to resolve complex claim issues, review clinical documentation, and support coding corrections and resubmissions.
Ensure compliance with CMS, state Medicaid, and managed-care guidelines while monitoring payer policy changes to optimize coding and billing practices.
ReKlame Health is a clinician-led, tech-enabled provider group providing culturally competent behavioral health and addiction care. As an early-stage organization focused on expanding access to care and health equity, they are building a purpose-driven team dedicated to making a positive impact.
Evaluate and present audit results and educational instruction to physicians, coders, and staff.
Review clinical documentation to ensure adherence to billing guidelines and internal coding policies.
Provide instruction on documentation standards and correct use of CPT‑4 and ICD‑10 codes.
Pediatrix Medical Group is a leading provider of specialized healthcare for women, babies, and children. Since 1979, they've grown into a national, multispecialty medical group with a commitment to coordinated and compassionate care, bolstered by investments in research, education, and safety.
Accurately codes and abstracts outpatient medical records utilizing ICD-10-CM and CPT-4 coding systems.
Assigns modifiers when appropriate.
Must be able to maintain a minimum 95% coding accuracy.
Montefiore St. Luke’s Cornwall (MSLC) has been a cornerstone of high-quality healthcare in Orange County for 150 years. MSLC is a member of the Montefiore Health System and provides care to more than 250,000 patients annually; it strives to be the employer of choice by offering comprehensive benefit packages.
Own the full AR cycle: payment posting, cash reconciliation, aging management, and payer follow-up across district, health plan, and member inquiries.
Investigate and resolve complex claim denials and rejections, submit corrected claims and appeals, and drive systemic fixes to improve clean claim rates.
Serve as internal subject matter expert on payer requirements, billing regulations, and compliance standards, fielding escalations from clinical and operations teams.
Cartwheel is building a new kind of mental health program for kids that puts schools at the center. Backed by top investors, it has grown to serve more than fifty school districts across six states and is driven by a mission to help millions of students experience joy.
Monitors and verifies insurance information for patient visits.
Communicates with patients about co-pays, benefits, coverage, and care authorization.
Aviary is an organization in the healthcare sector. We value employees who are rigorous analytical thinkers and problem solvers with a strong work ethic.
Conduct coding audits to ensure accuracy and compliance with coding guidelines.
Identify compliance risks and recommend corrective action plans.
Provide education and training to physicians and staff on coding best practices.
Theoria Medical is at the forefront of healthcare innovation and quality, offering a blend of medical excellence and technological advancements, primarily serving the post-acute sector. Their network includes multispecialty physician services across skilled nursing facilities nationwide, fostering a mission-driven culture that values expertise and innovation.
Review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10-CM and ICD-10-PCS codes for various purposes.
Abide by the Standards of Ethical Coding and official coding guidelines, staying updated on coding changes and interpretations.
Perform detailed reviews of Inpatient records, assign diagnosis and procedure codes, and meet established productivity guidelines with high accuracy.
Rochester Regional Health is an integrated health services organization serving the people of Western New York, the Finger Lakes, St. Lawrence County, and beyond. The system includes nine hospitals; primary and specialty practices, rehabilitation centers, ambulatory campuses and immediate care facilities; innovative senior services, facilities and independent housing; a wide range of behavioral health services; and Rochester Regional Health Laboratories and ACM Global Laboratories, a global leader in patient and clinical trials.
Verify insurance eligibility and benefits for all new Boulder Care commercial enrollments.
Answer incoming questions from patients about balances due and non-covered charges.
Serve as subject matter expert for internal insurance training and identify billing errors.
Boulder Care is an award-winning digital clinic for addiction medicine, recognized for innovation and high quality of patient care. Named by Fortune as one of the Best Workplaces in Healthcare, Boulder fosters a culture of kindness, respect, and meaningful work.
Partner with Clinical, Claims, and Payment Integrity peers to review claims for DRG related issues on a prospective and retrospective basis that drive inaccurate payments to providers.
Proactively identify overpayments to ensure accurate claims payments on inpatient services.
Participate in collaborative discussions with MDs to verify the clinical rationale behind billed procedures.
Clover Health is reinventing health insurance by combining the power of data with human empathy to keep its members healthier. They have created custom software and analytics to empower their clinical staff to intervene and provide personalized care to the people who need it most.
Responsible for the review and processing of claims within the claims transactional system, according to plan benefits and contractual reimbursement terms.
Follows established policies and procedures to pay, pend for additional information, or deny claims.
Accountable to meet and maintain established department production and quality standards.
Evry Health is on a mission to bring humanity to health insurance by expanding benefits, increasing access and transparency, and featuring a personalized, human approach. Evry Health is the major medical division of Globe Life (NYSE:GL) with more than 3,000 corporate employees and 15,000 agents.