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Revecore
Revecore
1 001 – 5 000 Darbuotojai
B2BSaaSSveikatos priežiūra
„Revecore“ yra sveikatos priežiūros pajamų susigrąžinimo įmonė, padedanti ligoninėms ir sveikatos priežiūros sistemoms rasti bei susigrąžinti kompensacijas, kurios kitu atveju galėtų likti negautos. Jos „ReClaim™“ platforma sujungia nuosavą dirbtinį intelektą, žalų analizę, darbo eigos automatizavimą ir draudikų taisyklių variklius su klinikine, teisine ir kompensacijų srities patirtimi. Platforma padeda susigrąžinti sudėtingas kompensacijas, įskaitant su veteranais, eismo įvykiais, darbuotojų kompensacijomis ir „Medicaid“ susijusias išmokas, taip pat valdyti atmestas paraiškas, susigrąžinti nepakankamai išmokėtas sumas ir paspartinti gautinų sumų surinkimą. HIPAA reikalavimus atitinkanti ir SOC 2 sertifikuota „Revecore“ infrastruktūra naudoja mašininio mokymosi modelius, išmokytus naudojant šimtus milijonų paraiškų, o įmonė aptarnauja daugiau nei 1 300 ligoninių. Jos komandą sudaro sveikatos priežiūros technologijų, pajamų ciklo operacijų, klinikinių paslaugų, teisės ir kompensacijų sričių specialistai.
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Darbai įmonėje

Director of Diagnosis-Related Group Validation (DRGV)

Lead the launch of Revecore’s Diagnosis-Related Group Validation service for hospitals seeking to recover earned revenue. Shape its operating model, technology, staffing, performance measures, pricing, and go-to-market approach.

USJungtinės ValstijosALAlabamaCTKonektikutasFLFloridaIAAjovaKSKanzasasKYKentukisLALuizianaMEMeinasMAMasačusetsasMIMičiganasMNMinesotaMSMisisipėMOMisūrisNENebraskaNHNaujasis HampšyrasNCŠiaurės KarolinaOHOhajasOKOklahomaPAPensilvanijaRIRod AilandasSCPietų KarolinaSDPietų DakotaTNTenesisTXTeksasasVTVermontasVAVirdžinijaWVVakarų VirdžinijaWIViskonsinasNuotolinisVisas etatasVadovasPrivaloma Kalba: anglųDirektorius

Aprašymas

  • Lead Revecore’s Diagnosis-Related Group Validation service launch and development
  • Establish the operating model, workflows, staffing plan, productivity measures, quality standards, and industry benchmarks
  • Serve as a DRGV, coding, MS-DRG, revenue integrity, and claims subject matter expert
  • Collaborate with Product, Data, AI, Development, and Operations teams to create scalable processes and technology solutions
  • Assess how AI and automation can improve account selection, prioritization, processing, productivity, and service delivery
  • Act as the technical and operational bridge between DRGV specialists and Product and Engineering teams
  • Contribute to software development and address complex coding-table requirements
  • Set performance expectations and metrics while tracking implementation, operational, and financial objectives
  • Provide guidance on pricing, marketing strategy, market positioning, and sales enablement
  • Participate in prospect and client conversations to support sales efforts
  • Work with the BCO team responsible for client service delivery
  • Coordinate execution across a matrixed organization and align stakeholders around the new solution

Reikalavimai

  • Extensive Diagnosis-Related Group Validation expertise supported by hands-on coding experience
  • Expert knowledge of Medicare Severity Diagnosis-Related Group classification and reimbursement methodology
  • Strong knowledge of revenue cycle and revenue integrity, including charge capture, charging patterns, coding, and Clinical Documentation Integrity
  • Experience interpreting payer contracts, reimbursement provisions, and claim adjudication processes
  • Experience designing, leading, or making significant contributions to DRGV programs
  • Experience creating and maintaining complex coding or reimbursement code tables
  • Experience working with Product, Engineering, or software development teams to convert requirements into scalable technology solutions
  • Working knowledge of data, artificial intelligence, and automation applications in DRGV
  • Ability to lead cross-functional initiatives across technical, operational, and commercial teams
  • Strong communication and client engagement abilities
  • Preferred: Experience with Diagnosis-Related Group Downgrades
  • Preferred: Experience at a vendor-side DRGV, payment integrity, revenue integrity, or healthcare revenue cycle organization
  • Preferred: Experience launching or expanding a healthcare service line, product, or operational capability
  • Preferred: Experience with client solutioning, sales enablement, or healthcare industry thought leadership
  • Must live in the United States in one of the specified states
  • Authorization to work in the United States
  • Successful completion of a background check

Privalumai

  • Work remotely from home
  • A quiet, distraction-free home office environment
  • A secure internet connection
  • Home internet service exceeding 20 Mbps download and 10 Mbps upload speeds
  • Workspace suitable for company-provided workstation equipment and related materials
  • Affirmative Action/Equal Opportunity Employer
  • Interview recording and transcription alternatives available upon request

Susiję darbai

FHI 360

Associate Director of Procurement, Administration and Logistics

FHI 360
1 001 – 5 000 Darbuotojai
H1B vizos rėmėjasKonsultavimasMaistas ir gėrimaiSveikatos priežiūra
CDKongas-Kinšasa
120 000 $ – 143 000 $ / metai
Darbas vietojeVisas etatasVyresnysis specialistasPrivaloma Kalba: anglųPrivaloma Kalba: prancūzųPirkimai

Leads procurement, administration, logistics, and operations for FHI 360’s country office in the Democratic Republic of the Congo. Supervises functional leads and maintains compliance with donor, government, and supply chain requirements.

Atidaryti
AlphaSys

Senior Salesforce Data Migration Specialist

AlphaSys
51 – 200 Darbuotojai
KonsultavimasRinkodaraSveikatos priežiūra
AUAustralijaNuotolinisSutartisVyresnysis specialistasVadovasPrivaloma Kalba: anglųDuomenų inžinierius
DebesijaETLSQLSSIS

Lead end-to-end Salesforce data migrations for Australian nonprofits and charities, from strategy and ETL through testing and deployment. The role combines SQL and data engineering expertise with client workshops, team leadership and project delivery.

Atidaryti
Expivia Interaction Marketing Group Inc.

Healthcare Call Center Representative

Expivia Interaction Marketing Group Inc.
201 – 500 Darbuotojai
KonsultavimasLogistikaRinkodara
USJungtinės ValstijosPAPensilvanija
14 $ – 16 $ / valanda
HibridinisVisas etatasVidutinis lygisVyresnysis specialistasPrivaloma Kalba: anglųSkambučių centro atstovas

Assist members with health savings and benefit accounts through phone, chat, and email. The role includes three weeks of paid, in-person training in Erie, Pennsylvania, before moving to a hybrid schedule.

Atidaryti