Review patient medical records to determine why claims are denied and prepare compelling appeal arguments using clinical evidence and regulatory guidelines.
Search for supporting evidence and analyze insurance denial trends to provide feedback to hospitals and executive leadership.
Ensure compliance with HIPAA regulations and demonstrate excellent written communication skills in crafting appeal letters and hearing testimony.
PAM Health provides specialty healthcare services through over 70 long-term acute care hospitals, rehabilitation hospitals, wound clinics, and outpatient physical therapy locations in 17 states. With a collaborative culture and a focus on compassionate care, the company employs a dedicated team committed to high-quality patient outcomes and professional growth.
Review clinical documentation and assign accurate CPT, ICD-10-CM, and HCPCS codes for diagnoses, procedures, and services rendered.
Monitor outpatient coding work queues and unbilled accounts to support timely filing and claims submission, while resolving coding-related edits.
Collaborate with providers and revenue cycle teams to improve documentation, ensure coding accuracy, and maintain compliance with regulations.
Impact Advisors, LLC is a nationally recognized healthcare management consulting firm delivering Best in KLAS advisory, implementation, and optimization services. We cultivate a caring, fun, honest, and autonomous work environment with a shared mission to create a positive impact.
Review and process prior authorizations for biologics, oncology, and specialty therapies with timely and accurate completion.
Manage clinical documentation, submit and track authorization requests, and resolve issues with insurance providers.
Communicate effectively with patients, clinical staff, and insurance representatives to ensure compliance and workflow efficiency.
IVX Health is a national provider of infusion and injection therapy for individuals managing chronic conditions like Rheumatoid Arthritis, Crohn's Disease, and Multiple Sclerosis. They are a rapidly growing company focused on patient comfort and employee empowerment, with core values of kindness, integrity, and continuous improvement.
Manage referrals and guide participants through the enrollment process with compassion and accuracy.
Provide empathetic communication and support to participants via phone, text, and other channels.
Collaborate with clinical and operational teams to track performance and improve engagement.
The partner company is a healthcare organization that provides participant success services. It offers a supportive, mission-driven culture with a focus on quality and empathy.
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.
Lead the strategic development and optimization of physician and APP compensation programs and contracting processes.
Oversee quality assurance, fair market value assessments, and compliance with regulatory requirements.
Collaborate with executive leaders and cross-functional teams to resolve complex workforce and financial challenges.
The partner company is a healthcare organization that specializes in physician and APP compensation and contracting. It offers a supportive and collaborative work environment focused on employee well-being and professional growth.
Lead site activation strategies and oversee start-up activities across clinical studies.
Manage critical path plans and mitigate risks to ensure timelines are met.
Collaborate with cross-functional teams and clients to improve activation processes.
Our partner is a clinical research organization that supports the delivery of clinical trials. They are a global company with a collaborative culture focused on innovation and operational excellence.
Coordinate reimbursement support activities and ensure timely resolution of patient requests.
Manage case intake, documentation, and tracking to maintain accurate service records.
Monitor workflows, identify improvements, and collaborate with stakeholders to enhance service delivery.
The company is a healthcare partner focused on ensuring patient access to essential services. The culture is inclusive and collaborative, with a remote-first approach and emphasis on purpose.
Lead the execution of national clinical education programs and manage cross-functional teams.
Drive customer success strategies and ensure operational excellence across multiple specialties.
Manage budgets, KPIs, and stakeholder relationships to achieve program objectives.
The partner company is a healthcare technology organization that delivers clinical education and adoption programs to improve patient outcomes. The company operates nationally with a collaborative culture and a focus on customer success.
Lead and manage the clinical team including physicians, APPs, physical therapists, and coaches.
Oversee hiring, staffing, capacity planning, and clinician development.
Own clinical quality, patient experience, and care-delivery operations.
Protera Health is a fast-growing digital health company reimagining musculoskeletal care. Their multidisciplinary virtual care team includes medical providers, physical therapists, health coaches, and other healthcare professionals, and they aim to treat patients as they would their own loved ones.