Verify patient eligibility and analyze Medicaid claim payments to ensure proper reimbursement.
Review UB-04 billing components and prepare initial Medicaid bill packets with supporting documentation.
Conduct timely follow-up with payers, manage authorizations, and appeal denials as needed.
EnableComp provides specialty revenue cycle management solutions for healthcare organizations, using intelligent automation to improve financial sustainability for hospitals and health systems. Recognized as a Top Workplaces recipient and among the Inc. 5000 fastest-growing private companies for eleven years, the company fosters a family-oriented culture focused on employee growth.
Performs clinical evaluations on disability claims to substantiate medical necessity for absence.
Communicates with employees and providers to discuss clinical status and provides follow-up recommendations.
Acts as a clinical resource to claims examiners, ensuring accurate medical terminology and claim decisions.
Sedgwick is the world's leading risk and claims administration partner, helping clients navigate the unexpected with AI-enabled technology and expertise. With over 33,000 colleagues and 10,000 clients across 80 countries, they've been recognized as a Great Place to Work and offer a caring culture.
Schedule, track, and manage appointments while completing required pre-appointment and follow-up communications.
Process and monitor referrals and coordinate authorized care with community healthcare providers.
Maintain accurate patient demographic, insurance, emergency-contact, and administrative information.
International SOS Government Medical Services supports healthcare programs that improve patient care and operational readiness across the U.S. and internationally. Founded in 1984, International SOS operates in over 90 countries, delivering healthcare, medical assistance, emergency response, and workforce support services worldwide.
Accurately assigns ICD-10-CM and CPT codes to professional fee inpatient and outpatient records for reimbursement and data collection.
Reviews medical records for documentation discrepancies and queries physicians for additional information when needed.
Maintains coding quality and productivity expectations, collaborating with Patient Financial Services to resolve edits promptly.
Vail Health is a nonprofit community healthcare system in Colorado's high country, operating a 56-bed hospital with advanced mountain healthcare services. The organization offers 24/7 emergency care, cancer care, surgery, and more, with a focus on community health and a culture of collaboration and excellence.
Proactively monitor patient insurance eligibility and authorization status to prevent therapy interruptions.
Work directly with patients, sales teams, and physicians to obtain updated insurance or clinical documentation.
Serve as primary point of contact for patients, providers, and field partners, answering benefits and authorization questions.
LUX Infusion reimagines infusion care to be more human, supportive, and connected. It is a clinician-led, U.S.-based organization committed to inclusion, diversity, equity, and advancement.
Translate patient medical records into standardized codes for diagnoses and treatments, ensuring accuracy and compliance.
Apply coding principles consistent with government regulations and payer-specific guidelines for Primary Care, Radiology, and Hospitalist charges.
Review ICD, E&M, CPT, and HCPCS codes, query providers on documentation, and educate staff on coding practices.
Dignity Health Medical Foundation is a California nonprofit public benefit corporation providing comprehensive health care services throughout California. It is part of Dignity Health, one of the largest health systems in the nation, with a culture focused on purposeful work and staff development.
Conduct quality assurance and audit planning for the WTC Health Program, reviewing claims and analyzing data to identify trends and issues.
Research federal payer coverage policies and develop program policies and procedures, maintaining the health plan codebook.
Collaborate with clinicians and subject matter experts to support medical management and claims review, ensuring accurate application of medical coding standards.
Advanced Technologies & Laboratories International (ATL) provides expertise in quality assurance, claims processing, medical coding, and audit for the World Trade Center Health Program. The company offers a competitive total compensation package including paid leave, medical, dental, vision, and a 401(k) retirement plan.