Ensures optimum reimbursement and works improve the day-to-day operations of the revenue cycle. Responsible for timely responses to internal and external customers and provides a variety of revenue cycle support services in connection to day-to-day operations. Processes and follows up on payer issues with various entities for completion.
The Senior Premium Audit Operations Specialist manages complex audit reviews, escalated adjustments, and advanced regulatory compliance across multiple states and jurisdictions. This role leads classification reviews, oversees intricate billing and endorsement scenarios, and serves as an expert on special bureau requirements. The specialist handles challenging customer engagements, resolves disputes, and develops best practices for communication and service excellence.
In this high-impact, detail-oriented role at the intersection of finance, billing, and customer operations, you will own critical systems, help customers, and build better processes in a fast-growing SaaS company. This role is critical to keeping revenue operations running smoothly and efficiently.
The Revenue Assurance Manager is responsible for leading and managing a team of Revenue Assurance Specialists and Agency Specialists, overseeing all aspects of revenue and billing assurance, ensuring accuracy, efficiency, and compliance across multiple regions, and working closely with the VP of Business Operations, CFO, and COO to standardize and centralize billing and reporting functions.
The reimbursement coordinator is responsible for collecting and managing account payments. This position is responsible for submitting claims and following up with insurance companies for payment fulfillment. This is a fully remote position but must be within driving distance of a branch.
In a post-adjudication work environment, the Pharmacy Desk Auditor I will review pharmacy claims submission data to identify payment errors, provide outreach and education to pharmacies, ensure legal compliance and Navitus PBM adherence to contract agreement rules. This position requires knowledge of pharmacy billing and operational practices.