You will lead provider relations initiatives and manage a team of specialists to ensure strong collaboration with healthcare providers.
You will serve as the primary escalation point for complex provider issues and educate providers on policies and compliance.
You will monitor provider performance metrics, analyze data, and drive continuous improvement in healthcare delivery.
The partner company operates a large-scale healthcare program, managing provider relationships and improving healthcare delivery. It is a mission-driven organization with a focus on collaboration and continuous improvement, though the exact size is not specified.
Facilitate improvement in provider-based clinical documentation accuracy to reflect patient acuity and severity.
Conduct concurrent record reviews and formulate compliant documentation queries to improve accuracy.
Educate clinicians and facility management on documentation opportunities and coding reimbursement issues.
Banner Health is a large nonprofit health care system with hospitals, clinics, and research centers across multiple states. They focus on skilled and compassionate care using advanced technology to improve patient outcomes.
Monitor and evaluate telephone and electronic interactions for adverse events, product quality complaints, and medical information requests to ensure compliance with regulatory and client standards.
Identify quality and performance trends and partner with leadership to provide coaching, feedback, and training for continuous improvement.
Compile and report QA metrics, support internal and client audits, and maintain confidentiality of sensitive information.
Inizio Engage is a healthcare services company specializing in medical information, pharmacovigilance, and patient support programs. The company is part of a global organization and is committed to providing equal employment opportunities and fostering a diverse and inclusive workplace.
Process medical claims by reviewing, validating, and entering data accurately and in compliance with policies.
Identify discrepancies, flag unusual cases, and escalate issues while maintaining productivity and quality standards.
Collaborate with peers, participate in training, and uphold confidentiality and regulatory requirements like HIPAA.
Sidecar Health is redefining health insurance by making excellent healthcare affordable and accessible for everyone. The passionate team, with backgrounds as tech leaders, policy makers, and healthcare professionals, is driven to fix a broken system and create a more personalized, affordable, and transparent experience.
Oversee multiple functional areas within the RCM department including scheduling, eligibility, prior authorizations, and billing.
Review daily and monthly performance metrics to ensure service level agreements are met.
Collaborate with regional and line management to provide seamless interface with patients and external customers.
Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering advanced O&P solutions and clinically differentiated programs. With 160 years of clinical excellence, Hanger's employees touch thousands of lives daily, helping people achieve new levels of mobility and freedom.
Develop and maintain impactful learning resources and educational materials to build organizational capacity in population health.
Manage end-to-end internal communications, including the centralized intake process and distribution of team communications.
Support Employee Resource Groups by facilitating the annual impACT project and providing strategic guidance to leadership.
Aledade is a public benefit corporation that empowers independent primary care by building the largest network of its kind in the US. Founded in 2014, the company fosters a collaborative, inclusive, and remote-first culture with a shared passion for public health.
Perform detailed medical record reviews to validate DRG assignments and ensure billing accuracy.
Conduct clinical and coding audits to identify discrepancies and support cost containment.
Collaborate with quality teams and medical professionals to ensure compliance with payer regulations.
The company partners with healthcare organizations to ensure accuracy in medical coding and reimbursement. They offer a fully remote, supportive environment with comprehensive benefits and professional growth opportunities.
Deliver healthcare consulting services independently, ensuring compliance with industry regulations.
Analyze and reconcile financial and operational data, including claims and reimbursements.
Prepare client-ready reports and maintain knowledge of healthcare regulations and payer requirements.
Wipfli provides consulting services including financial and operational analysis and regulatory readiness for healthcare organizations. The firm values flexibility, relationships, and individual growth, fostering a culture where people count.
Support accurate risk adjustment coding by performing first-pass reviews of member medical records.
Maintain compliance with CMS risk adjustment diagnosis coding guidelines and HCC coding standards.
Collaborate with a remote team and contribute to team success through proactive communication and continuous learning.
BlueCross BlueShield of Tennessee is Tennessee's largest health benefit plan company, helping members since 1945. As a remote-first organization, it fosters a culture of innovation and collaboration with a focus on employee well-being.