Coordinate credentialing, payer enrollment, and recredentialing for clinicians.
Maintain provider data across CAQH, NPPES, PECOS, and payer portals.
Track contracts, follow up with payers, and escalate delays to ensure billing readiness.
Legion Health is a full-stack, AI-native psychiatry network delivering mental health care at scale. It's a fast-paced startup focused on using AI to automate care operations, with a culture of adaptability and process improvement.
Act as the clinical and administrative lead for Cooper 365, handling phone matters, patient check-in/out, and appointment scheduling.
Provide medical assistant support including vital screening, EHR maintenance, document scanning, and ensuring patient paperwork is completed.
Manage referrals, recertifications, prior authorizations, and escalate and resolve patient complaints independently.
Cooper University Health Care is a healthcare provider committed to delivering extraordinary care through clinical innovation and advanced technologies. It offers a comprehensive benefits program and opportunities for professional growth, positioning itself as a top employer in South Jersey.
Understand clients: listen deeply and build trust with older adults who feel lost in the healthcare system.
Educate and empower: help clients understand their Medicare benefits, care options, and community resources.
Solve problems: help seniors access affordable meals, transportation, find specialists, or understand options to stay independent.
EZ Health helps older adults navigate the complex healthcare system, empowering them to get healthier and live better. It is a small, fast-growing startup with a mission-driven culture and a focus on direct, compassionate communication.
Work with ABA/behavioral health providers to collect patient information and communicate authorization decisions
Verify patient eligibility and benefits with insurers and complete prior authorizations via portals or calls
Manage multiple authorizations and collaborate with product team to automate parts of the process
Silna Health is obsessed with optimizing the broken healthcare system by automating prior authorizations and eligibility checks. Backed by Accel and Bain Capital Ventures, they are a fast-growing company working across behavioral health, physical health, ambulatory care, and post-acute care.
Submit and track provider enrollments with Medicare, Medicaid, and major commercial payers.
Maintain and update credentialing databases and payer status logs.
Collaborate with credentialing team and payer representatives to resolve blockers and shorten approval timelines.
Big Leap is a fast-growing, multi-state medical & behavioral clinician group focused on interventional mental health treatments like Spravato & TMS. The company is expanding its remote operations team to support growth.
Reviews payor denials and audits for potential lost revenue and writes comprehensive appeal arguments using clinical criteria.
Functions as a hospital liaison with external third-party payors and works with Physician advisor team to facilitate appeals.
Monitors and reports payor trends to management, ensuring compliance with regulatory and accrediting requirements.
Jefferson Health is a nationally ranked not-for-profit health care system reimagining health care and higher education to create unparalleled value. With more than 65,000 employees, it serves patients through millions of encounters annually at 32 hospital campuses and over 700 outpatient locations in the greater Philadelphia region, Lehigh Valley, and southern New Jersey.
Responsible for case finding, data abstraction, and follow-up of patients with a cancer diagnosis.
Performs clinical data abstraction to capture complete patient history, diagnosis, staging, and treatment information for the cancer registry.
Utilizes cancer data collection principles and assigns codes based on established systems (STORE, SEER, ICD-O3, AJCC Staging 8th Ed) to ensure compliance.
Winship Cancer Institute of Emory University is Georgia's only National Cancer Institute-designated Comprehensive Cancer Center, dedicated to discovering cures for cancer and inspiring hope. As part of Emory University, a leading research university, they foster excellence and attract world-class talent to innovate today and prepare leaders for the future.
Manage client medical payment policies to ensure accuracy and compliance with CMS and payer guidelines.
Conduct periodic reviews and analyses of policy updates, coordinating with Medical Directors and presenting recommendations to clients.
Serve as the primary client liaison, addressing inquiries and maintaining detailed documentation of policy nuances.
Cotiviti is a healthcare data analytics company specializing in payment accuracy and medical policy management. The company fosters a collaborative remote culture and offers competitive benefits to support its team.
Audit outpatient and specialty claims to ensure coding accuracy, clinical validity, and medical necessity.
Utilize advanced coding knowledge and audit tools to identify billing issues and document findings.
Meet productivity and quality standards while recommending process improvements and new claim types.
Cotiviti is a healthcare analytics and auditing company that focuses on improving claims accuracy and reducing costs for clients. They are a mid-to-large sized employer with a culture that emphasizes quality, collaboration, and innovation in healthcare auditing.