Monitor and resolve escalated credit balances and refunds from billing system overages.
Review refund request letters and determine appropriate resolutions based on contract and timely guidelines.
Analyze data from reports, identify trends, and ensure refund checks are processed and cleared.
Ventra Health provides revenue cycle management and business solutions for facility-based physicians in specialties like anesthesia, emergency medicine, hospital medicine, pathology, and radiology. They foster a collaborative, team-oriented culture with a focus on transparency, data-driven solutions, and performance-based rewards.
Research and analyze credit balances on patient accounts to determine if overpayments have been made.
Prepare and process refund requests, payment corrections, and transfers of patient payments to resolve outstanding balances.
Ensure compliance with credit balance review processes and maintain accurate documentation in EPIC.
Clinical Health Network for Transformation (CHN) is a collaboration between Planned Parenthood affiliates across the United States, aiming to bring high-quality, affordable care to communities. CHN is committed to advancing health equity and racial justice, and fosters a culture of accountability and inclusivity.
Analyze and evaluate worker's compensation claim payments using proprietary software and tools.
Research and acquire medical records and submit claims with supporting documentation to insurance companies.
Conduct telephone follow-up with payers to ensure claims are received and facilitate prompt reimbursement.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging a unified platform to improve financial sustainability. The company is a multi-year Top Workplaces award recipient and has been among the fastest-growing private companies in the US for eleven years.
Responsible for monthly revenue recognition, including analysis of patient billing trends and reserve calculations.
Prepares general ledger entries and reconciliations for patient accounts receivable and revenue.
Produces business intelligence reports and assists with audits, budgets, and process improvements.
Emerus is the leader in small-format hospitals, partnering with health systems to provide care patients need in their neighborhoods. The company fosters a teamwork-focused culture that celebrates diversity and promotes equity and opportunity for all employees.
Support account teams and manage client records to ensure data reliability.
Investigate billing issues and communicate changes directly with clients.
Work independently in a virtual-first environment while meeting monthly deadlines.
The partner company is a data-driven organization focusing on customer success and account management. It operates in a virtual-first environment with a collaborative culture emphasizing innovation, accountability, and customer satisfaction.
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.
Identify fair market rates and negotiate costs for medical procedures.
Manage complex healthcare cases to ensure fair pricing and member satisfaction.
Coordinate with internal teams and external partners to resolve pricing disputes.
CrowdHealth is a community-powered alternative to health insurance, enabling individuals to access and fund healthcare with transparency, simplicity, and control. The company values excellence and humanity and operates with a remote team.
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.
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.
Respond to patient inquiries regarding healthcare accounts receivables across an integrated delivery system.
Communicate effectively with patients, colleagues, providers, and operational staff.
Work independently in a high-volume billing call center to efficiently resolve billing and payment issues.
We are an academic health system providing a comprehensive continuum of care, including primary and preventive services, specialty care, virtual care, pharmacy, and health insurance. With 12 hospitals and hundreds of ambulatory locations across Michigan, we are headquartered in Detroit and committed to innovation, research, education, and community impact.
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.
Serve as primary financial contact for infusion patients, educating them on insurance coverage and costs.
Assess financial need, enroll patients in copay assistance and grant programs, and arrange payment plans.
Collaborate with infusion coordinators and BVPA team to ensure patients are financially cleared before treatment.
Nira Medical specializes in infusion therapy and revenue cycle management for patients. The company culture emphasizes compassionate patient communication and collaborative teamwork among clinical and billing staff.
Represent PayZen values and deliver empathetic service in every patient and provider interaction.
Handle inbound and outbound calls and emails covering billing issues, account questions, and payment plan enrollment.
Educate patients on digital payment options and collaborate with providers to resolve payment plan issues.
We are on a mission to bring financial health to healthcare, improving access and affordability for patients while reducing administrative complexity for providers. Backed by leading VCs, we serve a rapidly growing number of health systems and hospitals.
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.
Conduct thorough insurance eligibility verification and resolve discrepancies.
Analyze and resolve claim errors, including coding and billing discrepancies.
Ensure timely and accurate financial clearance of patient accounts.
CareDx is a leading precision medicine diagnostics company advancing care in transplant, specialty oncology, and cell therapy. The company fosters a collaborative culture where every employee contributes to improving patient outcomes.
Investigate claim denials, navigate evolving payer requirements, and ensure complex claims are prioritized and resolved accurately.
Partner with cross-functional teams to identify operational and denial trends, optimizing workflows and claim outcomes.
Act as the pod’s go-to expert for payer workflows, claim resolutions, and best practices, supporting new-hire onboarding and team performance.
Rula is a mental healthcare company dedicated to providing quality, evidence-based care and reducing stigma around mental health. It is a remote-first company with a focus on inclusion, employee well-being, and making mental healthcare work for everyone.
Identify, analyze, and recover claim overpayments for commercial health insurance companies and state healthcare programs.
Research client claims adjudication systems, contracts, and policies to develop and validate overpayment detection concepts.
Collaborate with clients and team members to resolve disputed overpayments and identify new opportunities for payment accuracy.
TREND Health Partners is a tech-enabled payment integrity company that facilitates collaboration between payers and providers to reduce waste and improve healthcare access. It is a dynamic, growing organization with a collaborative and innovative work environment.
Prepare and submit insurance claims for home infusion services, including medications, nursing services, and supplies.
Process electronic pharmacy claims for Medicare Part D, Medicaid, and commercial insurance plans.
Review documentation to ensure alignment with billed services, coding, and expected reimbursement.
LUX Infusion reimagines infusion care to be more human, supportive, and connected, guiding patients through complex therapies with clarity and compassion. As a clinician-led, U.S.-based organization, they prioritize inclusion, diversity, and empowerment, ensuring every team member feels valued.
Perform line-by-line review of high-dollar facility itemized bills and claim forms to identify billing errors.
Apply coding and reimbursement expertise to validate accuracy and ensure claims are paid correctly.
Serve as a subject matter expert for complex billing issues and drive payment integrity improvements.
Oscar is a health insurance company built on a full-stack technology platform with a focus on serving members. Founded in 2012, it fosters a culture of transparency and collaboration, working to change health care.
Help members navigate US health insurance, including billing questions, denied claims, and appeals.
Coordinate with providers, insurers, and members to resolve coverage issues and prior authorizations.
Translate complex insurance benefits into clear guidance and identify trends to improve the member experience.
This company provides a global safety net for remote workers, offering health, income, and travel coverage. It operates as a remote-first organization with a culture of empathy, integrity, and a mission to improve access to healthcare worldwide.