Conduct in-depth analysis of claim payments, identifying trends and patterns for cost avoidance through internal and external collaboration.
Ensure medical claims comply with guidelines, contracts, and standards while detecting billing inefficiencies and recommending corrective actions.
Provide data-driven recommendations to management on payment-affecting issues, supporting necessary system and policy updates and provider education.
BCBSRI is dedicated to serving Rhode Islanders by providing access to high-quality, affordable, and equitable care. They actively support associate well-being and work/life balance, fostering a culture of belonging where diverse perspectives are valued and employees are equipped for success.
Review and analyze CDM data to ensure accuracy and compliance.
Conduct regular audits to identify discrepancies and areas for improvement.
Work with clinical, billing, and coding teams to resolve charge capture issues.
LCMC Health is a community-focused healthcare provider deeply rooted in New Orleans, Louisiana. They are committed to providing exceptional care and education, with a culture that celebrates authenticity, equity, and inclusion.
Act as the primary relationship manager with third-party reporting partners.
Communicate proactively with internal stakeholders about external reporting requirements.
Perform data pulls and validations to support credit reporting issue resolution.
Jobgether is a platform that uses AI-powered matching to connect candidates with jobs. They ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements.
Process and/or underwrite mortgage loans across their full lifecycle.
Manage a high-volume pipeline while maintaining accuracy and compliance.
Resolve layered risk and guideline conflicts using sound judgment.
Jobgether is a company that connects job seekers with potential employers through an AI-powered platform. They focus on ensuring fair and objective application reviews, so the best-fitting candidates are identified for hiring companies.
Develop and maintain a comprehensive backbook risk framework.
Lead portfolio performance analytics and targeted risk mitigation.
Drive cross-functional optimisation of risk capabilities.
Affirm is reinventing credit to make it more honest and friendly, giving consumers the flexibility to buy now and pay later without any hidden fees or compounding interest. The company is remote-first and proud to offer competitive benefits that are anchored to its core value of people come first.
Participate in the execution of SOX compliance activities.
Build effective working relationships and trust with partners.
Develop a detailed understanding of Yelp's business processes.
Yelp is in that sweet ‘Goldilocks’ spot of being a company that’s not too big or too small. Here you will have your voice and recommendations heard, contributing process and control enhancements that will impact the business in the near term and future. YAR fosters a culture where auditors are not looked upon as “scary”’ - people here will be receptive to your ideas!
Utilizing healthcare experience to perform audit recovery procedures.
Identifying and validating incorrect claim payments.
Researching reimbursement regulations for claim payment compliance reviews and documentation to support current audit findings.
Cotiviti Healthcare is the payment accuracy expert, working with healthcare organizations to recover money, improve processes, strengthen relationships, and maximize their value. They are a well-established company with competitive pay, opportunities to develop professionally, and excellent benefits.
Review loan applications and associated community documents for accuracy.
Communicate effectively with communities via digital avenues.
Perform administrative tasks related to loan processing, including data entry.
Zippy aims to simplify and expedite the online loan process for manufactured homes. With headquarters in Dallas, TX, and an office in Tempe, AZ, their remote-first team provides home loans and insurance to manufactured home buyers across the United States, backed by institutional investors, offering competitive pay, stock options, and excellent benefits.
Underwrites complex residential mortgage loans and evaluates risk while ensuring quality.
Acts as senior level loan decision authority for most complex portfolio loans.
Approves loans and issues alternatives based on sound judgment and risk tolerance.
Jobgether is a platform helping partner companies with hiring through AI-powered matching. The company seems to embrace modern recruiting practices using AI to streamline the hiring process.