The Customer Service Representative acts as the primary point of contact for members and providers, handling inquiries regarding benefits, claims, and eligibility. They are responsible for troubleshooting complex issues, documenting interactions, and escalating priority concerns to ensure first-call resolution.
The supervisor monitors daily work queue volumes, manages team performance, and identifies trends for escalation to ensure efficient billing and follow-up processes. They are responsible for coaching team members, solving technical operational problems, and ensuring alignment with Patient Financial Services goals.
The role involves coordinating and implementing research study protocols while managing daily procedural and policy decisions. Additionally, the project manager is responsible for budget oversight, grant writing, and serving as the primary contact for external vendors.
The specialist is responsible for monitoring and improving coding quality, documentation accuracy, and compliance with regulatory guidelines. They will also develop training programs for staff and analyze medical records to ensure coding standards are met.
The HR Support Center Representative II resolves inquiries from employees, managers, and external parties regarding HR policies and processes via phone, email, and chat. They are responsible for documenting all cases in the management system while meeting established service level agreements.
Coordinates patient appointments and screening tests while ensuring medical records are accurately maintained in electronic systems. Provides high-quality customer service by managing high-volume calls and assisting patients and referring providers with scheduling needs.
The Research Manager leads research on medical technologies and products to support coverage decisions and utilization management policies. They manage the Medical Technology Assessment and Prior Authorization committees while collaborating with medical leadership to ensure alignment with clinical and regulatory standards.
The Senior Provider Compensation Analyst is responsible for analyzing, developing, and managing compensation and benefits programs for healthcare providers. This role ensures that compensation models are competitive, compliant with regulations, and aligned with organizational goals.
The Financial Access Specialist manages the financial clearance process for post-acute admissions, including insurance verification and prior authorization management. They collaborate with clinical and financial departments to ensure accurate documentation and timely reimbursement within the Epic system.
The Patient Navigator acts as a liaison between patients, families, and healthcare providers to ensure a seamless and patient-centered care experience. They are responsible for coordinating resources, assisting with care plans, and educating patients on their medical conditions and treatment options.
The Clinical Research Coordinator assists with clinical research studies by recruiting and evaluating patients, collecting data, and performing clinical tests. They also perform data analysis, quality control, and assist in the preparation of study reports and presentations.
The manager is responsible for overseeing revenue cycle financial management activities, including vendor and technology operations, budget strategies, and contract management. They will lead financial analysis, revenue integrity initiatives, and mentor a team of financial analysts and specialists.
The Coding QA Specialist is responsible for auditing medical records to ensure billing accuracy and compliance with regulatory standards. They also collaborate with clinical staff and coders to resolve discrepancies and provide training based on identified performance trends.
The Transition of Care Nurse Care Manager provides episodic care management for patients from inpatient discharge to home, including medication reconciliation and follow-up assessments. They collaborate with primary care physicians and clinical teams to ensure effective transitions and meet billing requirements.
The Credentialing Coordinator I is responsible for processing, reviewing, and maintaining provider and facility credentialing files while ensuring compliance with department and NCQA standards. They also assist with workflow management and provide guidance on the credentialing process during committee meetings.
The Appeals Coordinator manages the end-to-end lifecycle of Medicare member appeals and grievances, ensuring compliance with regulatory and contractual timeframes. They collaborate with internal departments and external agencies to investigate cases, document findings, and provide formal responses.
The Clinical Pharmacist II is responsible for developing and maintaining pharmacy formularies to ensure cost-effective coverage and clinical quality. They will chair the Drug Coverage Committee and lead the implementation of managed care programs such as prior authorization.
The Research Associate will independently plan and execute scientific projects in translational neuroscience, focusing on gene-targeted therapies for cerebrovascular disorders. Responsibilities include operating experimental equipment, analyzing physiological data, preparing scientific publications, and assisting with grant submissions.
The supervisor leads a team focused on Medicaid claims quality, payment accuracy, and adjudication integrity. They are responsible for managing daily inventory, resolving complex claims issues, and collaborating cross-functionally to improve claims outcomes.
The supervisor oversees daily operations of the DSNP utilization management staff, including direct coaching, supervision, and performance evaluation. They are responsible for ensuring accurate clinical reviews, monitoring staff productivity, and developing workflows to meet regulatory and organizational goals.
The Claims Review Specialist is responsible for reviewing and processing medical claims that require manual intervention to ensure accuracy and compliance with clinical guidelines. They must also collaborate with external departments to resolve claims errors and maintain performance goals regarding productivity and accuracy.
The Senior Revenue Analyst is responsible for analyzing, reporting, and optimizing revenue cycle data to support financial objectives. They collaborate with billing teams to address discrepancies, monitor KPIs, and implement process improvements to ensure billing accuracy.
The Utilization Management Nurse analyzes and assesses clinical information to render approval decisions for medical services. They also manage incoming authorization requests and ensure adherence to departmental performance metrics and clinical guidelines.
The Financial Coordinator provides administrative assistance to the finance team by managing research study charge reviews, invoicing, and budget reconciliations. They also perform financial and productivity analyses to support departmental and organizational initiatives.
The Financial Coordinator provides administrative support to the Finance Management team by managing clinical trial budgets, charge reviews, and invoicing. They are responsible for conducting internal reconciliations and analyzing workflows to ensure billing accuracy and compliance.
The Trauma Data Analyst is responsible for developing and maintaining departmental databases and coordinating the submission of pertinent statistics and demographic data. They work closely with leadership and peers to ensure accurate documentation and smooth collaboration across the department.
The Coding Operations Coordinator oversees and coordinates coding operations, focusing on workflow management, operational efficiency, and process optimization. They ensure the timely progression of accounts through the coding lifecycle while collaborating with leadership and revenue cycle teams to implement performance initiatives.
The Finance Operations Lead will optimize data and analytic processes to support payer contracting, contract negotiation, and hospital reimbursement strategies. The role involves leading complex financial analyses, mentoring junior staff, and providing data-driven recommendations to executive leadership.
The Senior Medical Director provides strategic clinical leadership and medical oversight to ensure high-quality, cost-effective care for health plan members. This role involves guiding utilization management programs, leading quality improvement initiatives, and collaborating with cross-functional teams to support value-based care models.
Acts as a liaison between hospitals, insurance companies, and patients to verify coverage and obtain pre-authorizations for medical procedures. Educates patients on insurance benefits and manages the submission of accurate insurance claims.
The role manages the financial aspects of research grants, including budget development and proposal coordination. It ensures strict adherence to institutional and sponsor compliance while facilitating grant applications and financial reporting.
Deliver a structured virtual coaching intervention to educate and support caregivers of cancer patients. Assist caregivers in navigating the healthcare system and building psychosocial coping skills to improve patient outcomes.
The Program Manager serves as the operational hub for the Programs Team, coordinating logistics, managing project plans, and ensuring smooth communication. The role involves managing program data in Salesforce, improving operational workflows, and supporting training and event execution.
The IRB Vice Chair chairs convened IRB meetings and conducts expedited reviews to ensure compliance with federal, state, and local regulations. They lead the Other Events Committee and collaborate with Principal Investigators and leadership to protect human subject research.
The Executive Director executes the physician compensation strategy and manages a team of professionals to oversee provider compensation programs. This includes managing financial, operational, and regulatory aspects while driving process improvements and operational excellence.
Acts as the primary liaison between hospital sites and the Revenue Cycle Operations team to optimize billing, coding, and financial performance. Responsibilities include analyzing performance data, managing issue lists, and executing improvement initiatives to enhance revenue capture.
Leads the editorial strategy and scientific review for departmental publications, press releases, and executive communications for the Chair of Ophthalmology. Manages the end-to-end nomination and application process for over 60 local, national, and international awards annually.
The APP works remotely to manage provider in-basket folders, including patient messages and urgent refills. They collaborate with MA and nursing staff to ensure patient care and coverage during provider absences.
