Monitor and manage post payment queues, conducting outreach and negotiation calls to providers.
Communicate with providers to verify understanding of NSA claims payments and regulations.
Maintain HIPAA compliance and document all conversations, payment rates, and counter offers.
Reliant Health Partners is an innovative medical claims repricing service provider that helps employers achieve maximum health plan savings. The company tailors services to each client’s needs and values a diverse, inclusive workplace.
Manage provider data across health plans, including demographics, reimbursement rates, contracts, and key operational information.
Coordinate provider audits, credentialing activities, service and relationship processes, and contract management systems.
Oversee daily priorities for administrative teams and external vendors, using data analysis to improve provider network operations.
This healthcare organization supports provider network operations across health plans. They offer a collaborative, deadline-driven environment with a focus on independent work and analytical skills.
Diagnose ambulatory workflows and shape proposals in discovery and pitches as the operator in the room.
Lead engagements on throughput, space utilization, patient wait times, and scheduling access, including emerging AI capabilities.
Own dedicated consulting engagements, go on-site to document workflows, and present outcomes and expansion opportunities to customers.
Kontakt.io builds real-time operational intelligence for health systems using proprietary hardware, AI, and integrations with existing technology. Backed by Goldman Sachs and trusted by leading health systems, we've more than doubled revenue and are rapidly scaling toward $100M ARR.
Own relationships with commercial and government health plans, serving as primary escalation contact.
Support contract negotiations and renewals with financial analysis, tracking deadlines and rate changes.
Partner with revenue cycle to resolve denials and underpayments, and report payer performance to leadership.
Adaptive Home Health is fixing US healthcare with an AI-native physical care platform, starting with home health. It pairs one of the best AI teams in the world with healthcare veterans, valuing innovation and problem-solving in a fast-growing environment.
Manage day-to-day credentialing workflows and lead data analysis projects for payer enrollment.
Conduct routine audits of task boards and triage inquiries to improve process efficiency.
Develop and distribute reporting on credentialing status for cross-functional stakeholders.
Natera is a global leader in cell-free DNA testing, dedicated to oncology, women's health, and organ health. The company comprises highly dedicated professionals from world-class institutions, who care deeply for their work and each other, fostering a culture that values hard work and growth.
Prepare, submit, and track payer applications for new health plan partnerships, including follow-up, deficiency resolution, and revalidations.
Audit provider directory listings and reconcile rosters against payer records to ensure members can actually find and access care.
Partner with Revenue Cycle to triage denials, research payer policy, and codify requirements into durable internal references.
Allara is a comprehensive women's health provider offering expert, longitudinal care for hormonal, metabolic, and reproductive health. Trusted by thousands of women and one of the fastest-growing women's health platforms in the U.S., it fosters a collaborative, mission-driven culture focused on improving patient care.
Develop and manage executive relationships with cancer centers, academic medical centers, and research institutions.
Lead consulting engagements in cancer center strategy, clinical research operations, and research administration.
Drive business development, mentor teams, and contribute to practice growth.
Attain Partners is an innovative consulting firm focused on strategy and technology for education, nonprofit, healthcare, and government clients. The company empowers career growth, provides industry-leading benefits, encourages a flexible work environment, and fosters an inclusive culture guided by seven core values.
Reviews DRG assignment for Medicare/Medicaid inpatients to ensure compliance with ICD-10 coding and billing regulations.
Analyzes physician documentation for coding accuracy and queries physicians when documentation is inadequate or unclear.
Provides guidance and education to inpatient coders and Clinical Documentation Specialists on coding guidelines.
Hackensack Meridian Health is a health care network that helps patients live better, healthier lives and serves as a leader in transforming healthcare. With a culture rooted in connection and collaboration, their employees are team members supported by competitive benefits and a focus on community.
Reviews requestor information to determine records to be released in accordance with HIPAA guidelines.
Answers phone calls and processes requests from physician offices, logging them into the ROI On-Line database.
Scans medical records, handles cash payments when needed, and complies with site facility policies.
MRO provides Release of Information (ROI) services for patient medical records requests across the United States. They are proud of the culture they create for employees and offer an outstanding work environment.
Process Release of Information requests remotely using electronic data systems.
Validate requests and authorizations according to HIPAA guidelines.
Communicate with team members and clients to resolve issues and prevent backlog.
MRO specializes in Release of Information (ROI) services for healthcare clients, ensuring accurate and HIPAA-compliant medical record release. They support a remote workforce focused on quality, productivity, and client satisfaction.