Serve as the vendor’s lead clinical subject matter expert on clinical denials management and prevention.
Partner with provider clients to design and implement best practices for denial prevention and appeal workflows.
Conduct complex clinical case reviews for DRG validation, identifying and defending clinically appropriate DRG assignments.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations. They leverage over 24 years of expertise and their E360 RCM ™ platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers. EnableComp is a multi-year recipient of the Top Workplaces award recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024.
Ensure excellence in revenue cycle solution delivery across all new and existing customer deployments.
Recruit, mentor, and lead a high-performing team of client-facing revenue cycle solution consultants.
Partner with Implementation, Product, and Engineering teams to align complex solutions with product strategy and client timelines.
SmarterDx, a Smarter Technologies company, builds clinical AI that is transforming how hospitals translate care into payment. Founded by physicians in 2020, their platform connects clinical context with revenue intelligence, helping health systems recover millions in missed revenue, improve quality scores, and appeal every denial.
Lead structured discovery across RCM workflows, data requirements, integrations, and success metrics
Deliver tailored, credibility-driven demos that surface real operational pain points (eligibility, denials, AR follow-up, prior auth, etc.)
Translate customer workflows into realistic automation plans
Smarter Technologies is a healthcare technology company focused on transforming how healthcare services are delivered, managed, and reimbursed by applying intelligent software, automation, and AI to high-impact clinical and financial workflows. Formed in 2025 under New Mountain Capital, Smarter Technologies brings together Access Healthcare, SmarterDx, Thoughtful AI, and Pieces—combining deep healthcare services expertise with advanced data, automation, and AI capabilities.
Review, analyze, and estimate reimbursement across clinical, technical, and DRG‑related denials.
Conduct daily client transaction reviews and calculate expected payments and Corro reimbursement.
Identify payer and referral trends, monitor denial patterns, and support appeal strategies.
CorroHealth aims to help clients exceed their financial health goals by providing scalable solutions and clinical expertise across the reimbursement cycle. They enable their teams with leading technology and believe in investing in their employees' professional development and personal growth.
Manage project scope, schedule, resources, project documentation and reporting
Schedule client meetings and project planning activities and coordinate internal resource support
Identify and escalate project risk/roadblocks and develop risk mitigation/resolution plans
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, employing a team of 23,300 people across 32 countries with corporate headquarters in Dublin, Ireland. Experian focuses on investing in people and new advanced technologies to unlock the power of data and to innovate.
Serve as the single accountable owner for full client setup and ongoing RCM performance across all sites.
Actively monitor AR aging, denials, authorization timeliness, claim submission lag, payer trends, utilization, and workflow metrics.
Own performance reporting and visibility across accounts and build and maintain dashboards.
Prompt Therapy Solutions is building software for rehab therapists, helping outpatient rehab organizations treat more patients and deliver better care with less environmental waste. They are a talented team of individuals who have built software to turn a paper-heavy industry digital.
Responsible for complete, accurate and timely processing of all designated claims.
Investigating denial sources, resolving and appealing denials which may include contacting payer representatives.
Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership.
Supports Ambient AI Scribe testing, technical troubleshooting, workflow validation, and operational readiness.
Contributes to the development and refinement of standardized testing methodologies and workflow validation frameworks.
Translates technical findings into structured insights and recommendations for program leadership.
GovCIO is a company that transforms government IT, delivering innovative IT services and solutions. They foster a collaborative team environment and invest in their people, prioritizing continuous enhancement of the employee experience.
Interpret and apply CMS, Medicare, Medicaid, and AMA policies to define claims editing logic.
Analyze claims and edit performance data to confirm accuracy and prioritize enhancements.
Monitor regulatory updates and coding changes to keep edits current and compliant.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients. They use an AI-powered platform with expertise across the payment continuum, serving over 85 health plans and 270 million lives.
Participate in end-to-end implementation activities.
Develop an understanding of Experian Health's product suite and apply best‑practice workflows.
Facilitate requirements gathering, workflow mapping, configuration reviews, and user acceptance testing.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. A FTSE 100 Index company listed on the London Stock Exchange, they have a team of 23,300 people across 32 countries and are headquartered in Dublin, Ireland.
Auditing to ensure new provider and care center information is accurate.
Conducting Care Center audits based on the number of providers.
Identifying, monitoring, and managing denial management trends.
Privia Health is a technology-driven, national physician enablement company. They collaborate with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. Their platform is led by industry talent and cloud-based technology.
Serve as senior escalation point for client performance.
Lead Quarterly Business Reviews (QBRs).
Ternium RCM specializes in resolving complex healthcare insurance claim denials and delays. They empower hospitals and health systems by optimizing their revenue cycle, allowing them to focus on patient care. The company delivers outstanding results and enhances the patient experience.
Partner with Sales on strategic opportunities involving quality measurement and Star Ratings solutions.
Lead product demonstrations showcasing HEDIS performance analytics, care gap identification, and quality improvement capabilities.
Articulate how Cotiviti's solutions address NCQA HEDIS certification requirements.
Cotiviti is a healthcare analytics company. They focus on improving healthcare outcomes and reducing costs through data-driven solutions, serving health plans and providers. Cotiviti values diversity and inclusivity, and they are an equal opportunity employer.
Lead and operationalize the end-to-end revenue cycle across a multi-state behavioral health organization.
Manage a team of 3–4 billing specialists and take full ownership of billing operations.
Strengthen billing infrastructure, improve collections performance, and accelerate cash flow.
Backpack Medical Group is dedicated to providing mission-driven care by focusing on behavioral health services. They aim to support underserved Medicaid populations with a strong emphasis on diversity and employee wellbeing within their team.
Be responsible for the monitoring and management of the end to end data flow of data submissions to vendors and government agencies to mitigate data leakage and submission errors.
Own the claim and supplemental submission workflow for CMS EDS submissions.
Develop data pipeline tracking reports and analyze, research, and resolve encounter data errors.
Clover Health is reinventing health insurance by combining data with human empathy to keep members healthier. They've created custom software and analytics to empower their clinical staff to intervene and provide personalized care to the people who need it most. They are passionate and mission-driven individuals with diverse areas of expertise. From Clover’s inception, Diversity & Inclusion have always been key to their success.
Hire and lead high-performing teams for revenue cycle operations.
Drive RCM KPIs by addressing claim-level issues alongside billing teams.
Build and scale the department using playbooks and data management frameworks.
Candid Health helps clients with revenue cycle operations. They appear to be a mid-sized company that values growth, excellence, and close collaboration through valuing equity in their compensation package.
Research and interpret payer policies in accordance with healthcare coding and regulatory requirements.
Identify common error areas that can be made into automated software logics that prevent overpayments.
Develop claims editing logics that promote payment accuracy and transparency across lines of business.
Rialtic is an enterprise software platform empowering health insurers and healthcare providers to run their most critical business functions. Founded in 2020 and backed by leading investors, they are tackling a $1 trillion problem to reduce costs, increase efficiency and improve quality of care.
Support Rula’s Revenue Cycle and payer expansion initiatives.
Own post-launch performance monitoring and optimization.
Diagnose issues, improve workflows, and build scalable systems.
Rula is dedicated to treating the whole person and aims to create a world where mental health is no longer stigmatized or marginalized. They are passionate about making a positive impact on the lives of those struggling with mental health issues.