Act as a liaison between patients, providers, and insurance companies to ensure accurate data collection and compliance.
Verify insurance benefits, eligibility, and prior authorization requirements for scheduled patients.
Notify patients of estimated liability and act as a financial counselor regarding insurance and payment options.
Vail Health is the world's most advanced mountain healthcare system, providing exceptional care through a 56-bed hospital and various outpatient services. It is a nonprofit organization committed to patient-centered care and community well-being.
Review inpatient claims to identify missed reimbursement opportunities based on ICD-10 coding accuracy.
Analyze hospital billing files and medical records to optimize DRG reimbursement.
Collaborate with leadership on case prioritization and workflow management.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations using intelligent automation. They are a multi-year Top Workplaces award recipient and have been on the Inc. 5000 list of fastest-growing private companies for eleven years.
Process medical records requests accurately and within required timeframes.
Ensure HIPAA compliance and validate patient authorizations.
Perform quality-control reviews and maintain secure handling of protected health information.
The company specializes in securely processing medical records requests for healthcare clients. It maintains a collaborative and compliance-focused culture with a strong emphasis on accuracy and privacy.
Plan, direct, and evaluate potential patients through assigned referral system.
Establish consistent communication with admitting hospitals to ensure a best-in-class admission process.
Work with Outreach Managers to assess patient needs in accordance with the Pre-Screening Evaluation Form.
NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. With locations in Indiana, Michigan, Texas, and Arizona, we are expanding access to our unique model of care across the United States.
Serve as a subject matter expert for specialty value-based programs, establishing evidence-based approaches and priorities.
Lead strategic program delivery, coordinating implementation plans, timelines, and stakeholder commitments.
Evaluate program performance, translate findings into actionable recommendations, and advise executives.
The partner company is a healthcare organization focused on advancing strategic value-based programs within a complex healthcare environment. It operates with a remote-first culture and emphasizes collaboration, innovation, and executive-level impact.
Directly supervise, coach, and develop the non-clinician care team, setting performance expectations and productivity targets.
Own clinician scheduling and coverage planning across a 24x7x365 operation, managing PTO, shift swaps, and real-time staffing decisions.
Drive patient queue management and throughput to meet SLAs, identifying bottlenecks and implementing AI-driven improvements.
Curai Health is an AI-powered virtual multispecialty primary care clinic that uses machine learning to deliver affordable and accessible healthcare. It is a remote-first company with a mission-driven team committed to improving health outcomes at scale.
Review patient records and clinical documentation to determine eligibility accurately.
Communicate with patients, clinicians, and providers to ensure a smooth onboarding process.
Maintain records in EMR systems and manage multiple cases simultaneously.
Our partner is a healthcare organization focused on improving patient access to specialized services. They operate with a remote, patient-focused team committed to efficient and compassionate care delivery.
Manage insurance authorizations for clients in PHP and IOP programs, including pre-certifications and concurrent reviews.
Verify benefits, obtain Single Case Agreements, and build medical necessity cases using ASAM, LOCUS, and CALOCUS criteria.
Maintain accurate authorization, denial, and SCA records and prepare appeals on denied authorizations.
AWA and PRC are dual behavioral health organizations operating PHP and IOP programs across South Florida. They exist to serve clients and families at their most critical moments.
Set daily direction for your UM team, establishing priorities and reinforcing expectations.
Coach reviewers on criteria application, guiding consistent use of medical-necessity criteria.
Monitor workflow health daily, tracking intake volume and turnaround risk.
Personify Health created the first and only personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together. The team is on a mission to empower people to lead healthier lives.