Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
Assess payment determinations using clinical information and established guidelines.
Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
Broadway Ventures transforms challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), they empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth.
Use play, games, and evidence-based strategies to help kids build communication, social, and life skills in a remote environment.
Bring energy and compassion to each session — whether it’s at a child’s home, one of our centers, or out in the community.
Follow personalized plans designed by our clinical leaders while celebrating small wins that lead to big growth.
Center for Social Dynamics (CSD) believes in possibilities, building futures filled with play, progress, and joy through Applied Behavior Analysis (ABA). They meet kids where they are and are known for their vibrant culture, hands-on training, and career pathways.
Serve as the primary contact for patients, responding to inquiries with clarity, empathy, and efficiency.
Educate patients and providers on home infusion processes, including medication handling, storage, and administration protocols.
Schedule and confirm treatment appointments, coordinating with nursing agencies to ensure timely, accurate care delivery.
Leap is a benefits solution company and a pioneer in employer specialty pharmacy. They are reshaping how life-changing therapies are delivered and financed, ensuring patients get the treatment they need while employers get a fair deal.
Provide remote speech-language therapy services to clients
Conduct online speech-language assessments to determine eligibility for speech services
Develop, coordinate, implement, and monitor an individual's plan of care via teletherapy
All Care Therapies provides speech, occupational, and physical therapy—virtually and in person. With clinics in California, Texas, and Nevada, we support clients of all ages and backgrounds while valuing flexibility, collaboration, and meaningful care.
Conduct timely post-discharge follow-up calls with patients after inpatient visits to assess needs and reinforce the plan of care.
Review and reconcile discharge medications and escalate any concerns to the Primary Care Provider.
Assist in coordinating and/or scheduling follow-up appointments with the patient's Primary Care Provider and/or specialists
Privia Health is a technology-driven physician enablement company that collaborates with medical groups, health plans, and systems. They optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care. The company is led by top industry talent and exceptional physician leadership.
Providing case management for children on the autism spectrum ages 2-18.
Complete intake and assessments.
Mentorship for a team of RBTs, MLPs, and BCaBAs.
Sunrise ABA provides center-based and in-home ABA therapy. They are committed to ethical treatment and offer opportunities in California, Oregon, Washington, and Tennessee.
Conduct high-volume outbound and inbound calls with patients, providers, and pharmacies.
Collaborate with patients to identify and remove barriers to medication adherence.
Accurately document all interactions, outcomes, and identified barriers in appropriate systems.
Aledade empowers independent primary care practices. They were founded in 2014 and have become the largest network of independent primary care in the country, with a collaborative, inclusive, and remote-first culture.
Provide remote speech-language therapy services to clients.
Conduct online speech-language assessments to determine eligibility for speech services.
Develop, coordinate, implement, and monitor an individual's plan of care via teletherapy.
All Care Therapies provides speech, occupational, and physical therapy—virtually and in person. With clinics in California, Texas, and Nevada, we support clients of all ages and backgrounds. Our team is made up of passionate clinicians who value flexibility, collaboration, and meaningful care.
Conduct timely post-discharge follow-up calls with patients after inpatient visits to assess needs and reinforce the plan of care.
Review and reconcile discharge medications and escalate any concerns to the Primary Care Provider.
Assist in coordinating and/or scheduling follow-up appointments with the patient's Primary Care Provider and/or specialists.
Privia Health is a national physician platform transforming the healthcare delivery experience by providing tailored solutions for physicians and providers. They create value and secure the future through high-performance physician groups, accountable care organizations, and population health management programs.
Collaborates with members, family, and healthcare providers to coordinate services and address barriers.
Guides members to achieve optimal health by providing tools and information to understand their healthcare options.
Identifies and assesses members’ medical, behavioral, social, emotional, and financial needs.
Capital Blue Cross promises to go the extra mile for their team and community. They are one of the “Best Places to Work in PA”, with a caring and supportive culture that values professional and personal growth through training and continuing education.