Oversee prior authorization technicians and administrative PA functions.
Analyze data and provide staffing, workflow, and system enhancement recommendations.
Investigate/resolve escalated issues from clients and providers.
Judi Health is an enterprise health technology company providing a suite of solutions for employers and health plans. They have a comprehensive Enterprise Health Platform that consolidates all claim administration-related workflows in one scalable, secure platform.
Lead and manage multi-level Clinical Specialists for clinical support and case coverage.
Develop and deliver clinical education to sales, clinical specialists, and OR staff.
Work cross-functionally with Quality, Regulatory, Marketing, and R&D to develop clinical education.
Calyxo, Inc. is a medical device company that addresses the profound need for improved kidney stone treatment. They are led by executives and investors with a proven track record of commercializing paradigm-shifting devices to meet unmet needs within urology.
Manage a diverse team of over 70 clinical and non-clinical individuals to ensure outstanding care delivery and operational efficiency.
Drive improvements and innovations in healthcare processes by translating operational needs into technical requirements and partnering with product teams.
Foster a collaborative culture, manage budgets, and influence clinical and operational strategy across various organizational levels.
Jobgether is a platform that facilitates job matching between candidates and hiring companies, particularly in the healthcare sector. It uses an AI-powered process for application review and focuses on connecting qualified individuals with relevant roles.
Abstracts and codes physician professional services and diagnosis codes (inpatient, outpatient, diagnostic) using CPT and ICD9 coding.
Trains physicians and staff on documentation, billing, and coding, and provides feedback to ensure compliance and accuracy.
Resolves pre-accounts receivable edits, monitors billing opportunities, and works with Revenue Cycle staff to correct codes and coordinate appeals.
Northwestern Medicine is a leader in the healthcare industry, distinguished by a patient-first approach that cultivates a positive workplace. The organization provides competitive benefits including tuition reimbursement, loan forgiveness, and 401(k) matching, and takes care of its employees across its system.
Reduce the enterprise master patient index (EMPI) through duplicate record reconciliation and respond to provider requested chart corrections.
Assist patients with portal activation and proxy access via Customer Service Management (CRM) and provide phone support for the Portal Help Desk.
Ensure patient safety and data integrity by adhering to healthcare compliance, HIPAA privacy laws, and utilizing health information systems.
CommonSpirit Health operates a network of over 700 care sites across the United States, providing clinical, hospital, home-based, and virtual care services. The organization emphasizes compassion, community health, and innovation in care delivery, valuing employees' commitment to a greater cause within a supportive team environment.
Recruit and contract Medicare-compliant physicians and ancillary healthcare providers within assigned geographies to build a network ensuring care access for seniors.
Clearly communicate contract terms, payment structures, and reimbursement rates to prospective and existing network providers while maintaining up-to-date documentation in tracking systems.
Build and sustain productive, long-term relationships with provider partners, aligning contracting activities with departmental strategy and organizational objectives.
Curana Health is a national leader in value-based senior healthcare, offering on-site primary care, Accountable Care Organizations, and Medicare Advantage plans to senior living communities. The company has over 1,000 clinicians and professionals serving more than 200,000 seniors across 32 states with a collaborative mission to improve health outcomes.
Verifies and collects patient demographic and insurance information through direct data entry into the electronic medical record during scheduling, pre-admission, or admission.
Performs insurance benefit verification, documents coverage details, and secures authorizations for surgical procedures and inpatient stays.
Provides financial education to patients regarding insurance liability and explores alternative payer sources or financial assistance options.
NAH is a healthcare organization focused on patient care and services in a clinical setting. It is a structured entity operating with compliance standards and integrated technology across departments.