Perform daily audits of RCM accounts to ensure accuracy and compliance with policies.
Review documentation, billing records, and account activity to identify errors and process gaps.
Communicate quality issues and provide constructive feedback to staff and department leaders.
Our partner focuses on revenue cycle management services for healthcare organizations. They foster a remote culture centered on accuracy, accountability, and continuous improvement, with a team dedicated to quality and compliance.
Develop and maintain audit concepts by researching regulatory, coding, or payer policy changes and updating rule documents and code lists.
Perform QA reviews to ensure audit concepts comply with coding standards, payment methodologies, and payer policies prior to deployment.
Collaborate with cross-functional teams including operations, clinical, and client services to support policy execution and drive concept quality.
Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering value and efficiency to health plan clients. Deployed by over 85 health plans representing more than 270 million lives, we are a digital-first, AI-powered platform that reimagines what's possible in healthcare.
Investigate and resolve Coordination of Benefits denials by working with insurance carriers and members.
Conduct outreach to members to collect, verify, and update insurance information, providing clear guidance on benefits.
Maintain accurate member account records by documenting verified insurance details and coverage changes.
The company is a mission-driven healthcare organization focused on improving access to care. The size and culture are not specified, but the environment emphasizes teamwork, continuous improvement, and meaningful impact.
Process medical records requests and manage incoming payer mail with timely and accurate turnaround.
Process billing-team refunds, payer reconsiderations, and manual 837 claim pulls and postings.
Collaborate with the Internal Audit & Compliance Associate to support audit-related documentation and identify process inefficiencies.
Ophelia helps people end their opioid use and restore their quality of life by providing evidence-based treatments for opioid use disorder through a telehealth platform. It is a venture-backed healthcare startup operating in 14 states for almost six years, with a team of physicians, scientists, entrepreneurs, researchers, and White House advisors.