Completing collection and A/R follow-up activities for third party payors.
Maintaining quality and productivity requirements as outlined in performance expectations.
Reporting to the Manager/Supervisor of A/R Follow-up.
Piedmont Healthcare is a healthcare system providing medical services across Georgia. The corporate office is a large organization focused on revenue cycle management and administrative support.
Lead statewide perinatal substance use disorder activities within the Oregon Perinatal Collaborative, including coordination, outreach, and promotion of best practices.
Provide quality improvement leadership and coaching to hospitals, clinics, and treatment programs to improve integrated care for pregnant and postpartum people.
Design and monitor evaluation metrics, manage program budget, and report on progress and outcomes.
Oregon Health & Science University is Oregon's only public academic health center, providing patient care, groundbreaking research, and training the next generation of health professionals. As Portland's largest employer, it offers opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington.
Review and analyze Medicare claims sampled by the Department of Justice to determine correct coding and payment based on coverage and utilization.
Conduct in-depth claims analysis to detect fraudulent or abusive billing practices using ICD-10, CPT-4, and CMS guidelines.
Complete summary reports and communicate findings internally while maintaining confidentiality and compliance with DOJ and CMS regulations.
Empower AI provides AI-powered solutions for federal government agencies, helping them transform their workforce and operations. Headquartered in Reston, Va., the company has three decades of experience in Health, Defense, and Civilian missions and is recognized as a 2024 Military Friendly Employer.
Lead strategic growth and operational management of pharmacy benefit and managed care relationships nationwide.
Oversee contract evaluation, negotiation, implementation, and renewal with major healthcare payers.
Analyze reimbursement trends and contract performance to support revenue optimization and business growth.
This company operates in the specialty pharmacy sector, supporting patients with chronic and rare illnesses. It is a mission-driven, rapidly growing environment focused on improving access, care, and outcomes for patients with complex healthcare needs.
Submit medical documentation and billing data to insurance providers
Research and appeal denied or rejected claims, and follow up on unpaid claims
Review insurance payments for accuracy and completeness using billing software
Cardinal Health is a global distributor of pharmaceuticals and medical products, providing performance and data solutions for healthcare facilities. With over 50 years of experience, the company supports an inclusive workplace that values diversity and delivers end-to-end solutions to improve healthcare.
Review and analyze medical record documentation to assign diagnoses and procedure codes for inpatient, outpatient, and professional services.
Ensure compliance with official coding guidelines and ethical standards set by AHIMA.
Work remotely in a full-time, days shift position using ICD-10-CM and CPT/HCPCS coding systems.
Mercy is a Catholic health system founded by the Sisters of Mercy, providing care across hospitals and clinics in the Midwest. It is a large, collaborative organization focused on innovation, technology, and compassion, with a heritage spanning over 195 years.
Manage daily activities virtually to support appropriate patient access to client products.
Educate provider offices on payer requirements, reimbursement processes, and patient support services.
Develop and execute a territory access plan and coordinate with sales, market access, and patient services teams.
Stratis Group is an independent pharmaceutical consulting firm that specializes in commercialization throughout a brand’s lifecycle, focusing on market access, patient services, field reimbursement, and data-driven analytics. The company size is not specified.
Conduct thorough research on attributed patients to understand their healthcare needs and barriers to enrollment.
Perform telephonic outreach to caregivers and healthcare professionals to enroll children and ensure a seamless onboarding experience.
Develop deep knowledge of SSI program and collaborate with Provider Engagement Specialists to support enrollment efforts.
Imagine Pediatrics is a tech-enabled pediatrician-led medical group reimagining care for children with special health care needs. It is a startup with a values-driven culture focused on compassion and innovation.
Review and analyze complete patient medical records to identify all diagnostic and procedural information.\n- Assign accurate diagnostic and procedural codes using encoder software to ensure proper MS-DRG assignment and sequencing.\n- Maintain compliance with coding guidelines and verify medical record completeness for accurate reimbursement.
Henry Ford Health is a leading academic health system providing a comprehensive continuum of care, including primary to complex care, virtual care, and health insurance. With 12 hospitals and hundreds of ambulatory locations across Michigan, it is headquartered in Detroit and committed to innovation and community impact.