The representative manages inbound and outbound calls to provide expert assistance to healthcare providers regarding claims, benefits, and managed care issues. They are responsible for documenting inquiries, researching complex cases, and ensuring timely resolution while maintaining high quality and compliance standards.
The representative is responsible for pre-registering patients, verifying insurance eligibility, and creating financial estimates for upcoming procedures. They also provide financial counseling and ensure patient accounts are cleared prior to the date of service.
Review medical records and assign accurate ICD and CPT diagnosis and procedure codes for radiology services, including CT, ultrasound, and other modalities. Abstract clinical information, resolve documentation gaps, reconcile charges, and ensure coding quality and compliance with applicable guidelines and regulations.
This role focuses on quality assurance for ambulatory physician coding, resolving complex denials, and identifying trends to support revenue cycle integrity. The associate provides guidance to medical staff and coders to ensure accurate clinical documentation and billing code alignment.
The Registered Dietitian manages a complex caseload by providing comprehensive nutritional assessments, developing care plans, and monitoring patient outcomes. They also provide nutrition education to patients and families while collaborating with the interdisciplinary healthcare team.
The specialist is responsible for reviewing, drafting, and negotiating physician contracts while ensuring compliance with company policies and legal requirements. They also manage contract documentation within a database and serve as a resource for internal and external clients regarding contract interpretation.
The Principal Enterprise Cloud Architect leads cross-functional teams to design, implement, and optimize multi-cloud infrastructure across Azure, AWS, and OCI. They provide strategic oversight, drive cloud-based innovation, and ensure scalability, security, and resiliency across the organization's cloud systems.
The Cybersecurity Architect defines and drives the enterprise security strategy, architecture roadmap, and long-term vision across major technology platforms. They serve as a senior advisor to executives, evaluating solution designs and ensuring security is embedded throughout the organization's technology landscape.
Lead the end-to-end design of complex, multi-domain healthcare data solutions using Databricks, AWS, and Azure. Define architectural standards and governance while mentoring engineering teams on compliant, AI-enabled data pipelines.
The RN manages health plan consumer cases by performing pre-service determinations, concurrent reviews, and care coordination to ensure optimal clinical and financial outcomes. They collaborate with internal and external stakeholders to facilitate appropriate care while maintaining accurate documentation in accordance with federal and state regulations.
Analyzes medical records to accurately code diagnostic and procedural information in accordance with national guidelines. Abstracts clinical data into electronic medical records and ensures compliance with regulatory standards.
The Coding Educator develops and coordinates training materials for Health Information Management staff and providers to ensure accurate documentation and coding. They also conduct skill assessments, provide technical support for information systems, and ensure compliance with regulatory standards.
The Registered Dietitian provides comprehensive nutrition assessments, evidence-based education, and personalized care plans for members via telephonic and video visits. They collaborate with an interdisciplinary team to monitor patient progress and contribute to program initiatives and quality improvement activities.
Evaluates medical records to provide clinical and surgical abstraction for complex cardiology professional services. Ensures accurate diagnostic and procedural coding in compliance with national guidelines and reimbursement requirements.
