Conduct quality audits and validate provider data to ensure accuracy, integrity, and compliance with regulatory standards.
Analyze trends, investigate discrepancies, and recommend corrective actions to strengthen provider network operations.
Collaborate with cross-functional teams to document evidence, support accreditation reviews, and drive continuous improvement.
Alliance Health is a managed care organization that coordinates services for individuals with complex needs in North Carolina. They foster a collaborative, mission-driven culture focused on quality, compliance, and remote work flexibility.
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.
Manage the full revenue cycle from patient registration through claims resolution.
Accurately submit and track medical claims to various insurance payers.
Perform accounts receivable follow-up, identifying and resolving denied, underpaid, or unpaid claims.
Allara is a comprehensive women's health provider that offers expert, longitudinal care for hormonal, metabolic, and reproductive conditions. It is one of the fastest-growing women's health platforms in the U.S., trusted by thousands of women nationwide.
Complete coverage analysis tasks to support efficient clinical trial start-up for site clients.
Read and analyze clinical trial protocols and develop activity grids to identify required tests and assessments.
Interpret Medicare policies and billing guidelines to make determinations for clinical trial coverage.
WCG delivers transformational solutions that accelerate clinical research and advance human health. They invest in their people and foster a culture of growth and empowerment.
Complete credentialing and re-credentialing applications for physicians, ancillary providers, and facilities with third-party payers and governmental programs.
Partner with client liaisons and payers to manage enrollment status, follow up on applications, and communicate updates to providers and clients.
BerryDunn is a professional services firm providing tax, advisory, and consulting services to businesses, nonprofits, and government agencies across the US. The firm is known for its client-centered, people-first culture and commitment to diversity, learning, and well-being.
Collaborate with health plan leaders to develop quality data strategies and reporting on HEDIS and CAHPS performance.
Oversee data ingestion, validation, and documentation to improve accuracy across EHR, HIE, and supplemental data.
Support regulatory compliance and HEDIS audit readiness while monitoring quality programs and reporting risks.
This organization is a healthcare quality partner focused on national performance initiatives, including HEDIS, CAHPS, and data analytics. It provides a highly collaborative, matrixed environment with opportunities for cross-functional exposure and remote work.
Oversee EMEA clinical trial operations, partnering with CROs and sites to ensure compliance and timely execution.
Lead regional regulatory submission strategies and proactively resolve operational challenges to maintain study timelines.
Mentor junior team members, review data and TMF documentation, and provide regular study updates to stakeholders.
Akero Therapeutics, a Novo Nordisk company, is a clinical stage biopharmaceutical company focused on developing transformative treatments for metabolic diseases. The company fosters a collaborative culture of problem solvers dedicated to bringing bold scientific approaches to patients.
Must hold AHIMA or AAPC certification (CPC, CIC, COC) with at least two years of recent inpatient coding in acute care.
Requires proficiency in ICD-10-CM and ICD-10-PCS coding, MS DRG classification, and remote connectivity tools.
Must meet productivity targets and maintain coding quality of 95% or greater.
UASI is a coding and HIM services provider with over 40 years of experience, offering remote work opportunities for healthcare professionals. They have been recognized as a Top Workplace by the Cincinnati Enquirer for five consecutive years and value long-term employee stability and growth.
Own outcomes measurement and savings analysis to quantify the impact of RightMove's care model on total cost of care and patient outcomes.
Analyze medical claims, referral patterns, and provider performance to identify savings opportunities and guide patients to high-value care.
Communicate findings through executive-ready reports and presentations to support commercial teams and customer stakeholders.
RightMove is redefining musculoskeletal (MSK) care by shifting from fragmented, volume-driven care to a coordinated, expert-led model powered by AI and data. Backed by leading investors and built in partnership with the Hospital for Special Surgery, the company is a rapidly expanding startup with a high-performing team that values impact, direct communication, and collaboration.
Respond to service requests from internal and external customers accurately and on time.
Maintain case documentation with precision to keep records audit-ready.
Compile and distribute monthly reports and data summaries for leadership.
Personify Health offers a personalized health platform combining health plan administration, wellbeing solutions, and care navigation. The company serves employers and health plans with data-driven solutions, fostering a mission-driven culture focused on improving health outcomes.