Oversee the accounts receivable department, managing a team of AR specialists, ensuring timely and accurate billing, claims processing, payment posting, and denial management.
Compensation
Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons. This position is also eligible for a discretionary incentive bonus in accordance with company policies.
Responsibilities
Lead and manage a team of accounts receivable specialists
Develop and implement strategies to optimize the accounts receivable process
Monitor key performance indicators and metrics related to accounts receivable
Oversee billing and claims processing functions
Manage payment posting activities
Requirements
Bachelor's degree in any related field
Nice to have: Certified Professional Coder (CPC)
Nice to have: Certified Revenue Cycle Representative (CRCR)
Senior Contracting Specialist to independently manage contract negotiation, analysis, and documentation for an assigned portfolio of provider clients and facilities, serving as a client-facing point of contact and resource to Contracting Specialists on the team.
Compensation
Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.
This position is also eligible for a discretionary incentive bonus in accordance with company policies.
Responsibilities
Conduct contract negotiation discussions on behalf of clients with payers
Develop negotiation materials including rate benchmarking, reimbursement trend analysis, and financial impact summaries
Identify rate optimization opportunities within the assigned book of business
Review and interpret payer contract language
Maintain accurate, up-to-date documentation of payer contracts, amendments, fee schedules, and client communication logs
Requirements
Bachelor's degree in Healthcare Administration, Business, Finance, or a related field, or equivalent experience
Nice to have: Experience on both the payer and provider sides of contracting
Nice to have: Familiarity with Medicaid, Medicare Advantage, and/or pediatric reimbursement structures
Nice to have: Experience mentoring or guiding junior contracting staff
Nice to have: Experience collaborating with offshore or distributed team members
Provides support to the Provider Network Management team in producing and presenting performance reports, VBC models, care coordination effectiveness and practice efficiencies.
Responsibilities
Produce all quality and performance related reporting establishing opportunities and strategies regularly in preparation for JOC’s.
Interpret claims data and connections to patient outcomes and utilization trends.
Interprets utilization trends, optimizing performance based on state driven quality improvement programs i.e. HEDIS.
Attends meetings with providers to review gaps in care and developing plan of action with the provider to address these gaps in conjunction with PNM and CMO as applicable.
Supports network and quality strategy.
Requirements
Bachelor’s degree in healthcare administration or similar field
An experienced-level role supporting revenue integrity operations through Epic work queue management, hospital billing analysis, charge review, denial resolution, and root cause investigation.
Compensation
The pay range for this role is $60,257.00 - $120,513.00 annually.
Responsibilities
Resolve Epic Hospital Billing work queue errors, claim edits, charge errors, and denial-related issues.
Review and manage charge review workflows, including Medically Unlikely Edits and medical necessity edits.
Analyze hospital claims and account activity using clinical documentation, provider orders, charges, revenue codes, CPT fundamentals, and modifiers.
Research billing requirements across Medicare, Medicaid, and commercial payers.
Read and interpret UB claim forms and apply knowledge of hospital charging and reimbursement methodologies.
Manager of Plan Partnerships overseeing strategic relationships with dental and medical insurance payors to support reimbursement performance, operational efficiency, provider experience, and patient access.
Compensation
$103,000.00-$133,000.00 / Annually
Responsibilities
Manage a portfolio of dental and medical payer relationships.
Develop and maintain productive partnerships with health plan representatives.
Identify opportunities to improve reimbursement, operations, provider experience, and member experience.
Support long-term payer strategies aligned with organizational goals.
Support contract negotiations, fee schedule reviews, amendments, and implementation activities.
Requirements
Bachelor’s Degree in Arts/Sciences (BA/BS) Business, Healthcare Administration, Finance, Public Health, or related field.
Nice to have: Experience within a Dental Support Organization (DSO)
Support payer relationships, analyze reimbursement trends, resolve complex insurance issues, and implement payer contracts across the organization.
Compensation
$58,344 - $78,396 annual salary
Responsibilities
Support payer contract administration, network participation, reimbursement analysis, and implementation of new insurance products and contract changes
Research payer policies, insurance products, reimbursement methodologies, and regulatory changes to identify financial and operational impacts
Monitor Medicare and applicable federal and state payer requirements, including Virginia-specific regulations
Analyze reimbursement rates, fee schedules, and contract provisions to support payer negotiations and organizational decision-making
Coordinate with insurance payers, external billing partners, and internal departments to resolve complex reimbursement and contract-related issues
Requirements
Associate degree or higher in Healthcare Administration, Health Sciences, Accounting, or a related field
Nice to have: Professional certification in healthcare billing, coding, reimbursement, or revenue cycle such as CPC, CRCR, CBCS, CRCS
Supports hospital and clinic revenue cycle operations, including billing, claim submission, payment posting, denial management, appeals, and collections.
Compensation
Hourly wage based on experience.
Responsibilities
Support hospital and clinic revenue cycle processes, including claim submission for all payers, payment posting, denial management, appeals, and collections.
Manage self-pay collections and resolve outstanding account balances.
AR follow-up to review, identify, and resolve discrepancies.
Research and resolve complex credit balance scenarios.
Use Cerner (Oracle) to review account information, document activity, and resolve billing and collection issues.
Provides analytical support for the financial positioning and future growth of assigned area/region, leading financial processes and ensuring regulatory compliance.
Responsibilities
Provides high level of financial expertise through analysis and interpretation of data gathered for decision support
Gathers and challenges assumptions from various multi-disciplinary teams, develops financial proformas, and assists in preparation and presentation of business plans
Leads key financial processes within assigned area or region, coordinating resources and communication and leading process teams
Ensures regulatory compliance in all aspects of the revenue cycle, providing assistance, coordination and education as necessary
Serves as Business Unit CFO, initiating and assisting in identification and implementation of operating improvements and efficiencies
Requirements
Bachelor’s degree in Accounting, Finance or Business Administration or equivalent experience
Nice to have: supervisory/team leadership experience
Nice to have: Master of Business Administration (MBA)
Nice to have: additional related education and/or experience
Supervisor, Accounts ReceivableNewVentra Health, Inc.
Provider Practice Performance AdvisorNewAmerihealth Caritas · Remote, US
Senior Charge Management Coordinator - Revenue IntegrityUVA Health · Remote, US
Mgr, Plan PartnershipsPDS Health · Irvine, US
Managed Care and Reimbursement SpecialistFairfax Radiology Centers (FRC), LLC · Fairfax, US
Business Office SpecialistInfinx · Remote