Support the design, implementation, and optimization of integrated care programs for Dual Eligible and LTSS populations.
Translate strategic priorities into practical operational plans and scalable processes across markets.
Drive program improvement by evaluating processes, identifying risks, and standardizing evidence-based practices.
This partner company specializes in designing and implementing integrated care programs for Dual Eligible and LTSS populations, focusing on operational excellence and improved outcomes. The company's size and culture are not specified, but it offers a collaborative environment with exposure to healthcare operations and cross-functional initiatives.
Conduct independent clinical research and interpret specialty society guidelines to originate automated payment integrity logic.
Author end-to-end logic from scratch, translating clinical documentation and coding frameworks into precise parameters.
Lead cross-functional policy development and own concept rollouts from discovery through post-launch tracking.
Devoted Health is a healthcare company on a mission to improve the health and well-being of older Americans by providing a seamless care platform. Founded in 2017, it fosters a culture of innovation and collaboration, with a focus on data and AI to deliver exceptional member experiences.
Engage Thyme Care members by phone, text, and email to navigate their cancer journey and identify health and social needs.
Connect members to healthcare providers, community resources, and financial grants while assessing urgency and establishing next steps.
Collaborate with an interdisciplinary team in a structured, high-volume environment to ensure holistic member support.
Thyme Care is a cancer care navigation company enabling value-based cancer care, transforming the patient experience through technology-driven support. We are building a diverse team of problem solvers to reshape cancer care delivery, committed to redefining the status quo with a culture of inclusion.
Manage an assigned accounts receivable portfolio, prioritizing accounts by age, balance, and recovery potential
Follow up on unpaid and underpaid claims through payer portals and by phone
Submit appeals and reconsiderations with supporting documentation when appropriate
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company values independence, persistence, and attention to detail in a remote work environment.
Submit and track prior authorization requests across multiple insurance payers
Gather and review clinical documentation required to support authorization requests
Follow up with payers on pending requests and monitor authorization status through resolution
Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. The company operates with a fully remote workforce and emphasizes a detail-oriented, collaborative culture.
Verify patient insurance eligibility, benefits, authorization requirements, and referral needs prior to services.
Obtain referrals from primary care providers and ensure all referral requirements are met before scheduling.
Communicate insurance coverage, financial responsibility, and estimated costs to patients in a clear and empathetic manner.
Oshi Health is a virtual digestive health practice on a mission to transform GI care. As a startup, they offer a remote-first, mission-driven environment with a focus on improving patient lives.
Perform clinical reviews for medical necessity, level of care, and authorization compliance.
Prepare and submit high-quality appeals related to DRG downgrades and clinical validation denials.
Apply payer-specific guidelines and document review findings accurately in designated systems.
CorroHealth helps clients exceed their financial health goals through scalable revenue cycle solutions and clinical expertise. The company builds long-term careers by investing in team members' professional development and personal growth.
Supervise and support Patient Access Representatives in a high-volume contact center environment.
Serve as an escalation point for complex patient inquiries, ensuring compassionate and timely resolution.
Monitor performance metrics, coach staff, and drive process improvements for service excellence.
Partner Company is a healthcare organization dedicated to equitable patient access and high-quality service. They offer a collaborative, inclusive, and mission-driven culture.
Review and interpret medical records to assign ICD-10-CM and CPT codes accurately.
Collaborate with physicians and clinical teams to improve documentation and coding standards.
Maintain productivity, quality, and compliance with payer requirements and regulatory guidelines.
The company provides medical coding services for complex orthopedic and procedural services. They offer a collaborative healthcare environment with opportunities for professional development and career growth.
Apply HEDIS quality measure knowledge to ensure practices and ACOs receive credit for incentivized contract measures.
Access practices in-person or remotely to retrieve documentation and guide gap closure efforts.
Coordinate EHR system access, submit documentation to health plans, and consult with field teams on quality reporting strategy.
Aledade is a public benefit corporation that empowers independent primary care by helping practices thrive in value-based care. Founded in 2014, it is the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.