<p><strong>Position: Senior Financial Analyst – Healthcare </strong></p><p><strong>Location:</strong> Nashville, TN</p><p>We are seeking an experienced Senior Financial Analyst to join client's growing team. Daily responsibilities will be focused on supporting pharmaceutical purchasing and operational performance within a healthcare setting. This individual will play a critical role in shaping data-driven strategies, improving cost efficiency, and partnering with leadership across finance, operations, and clinical teams to drive organizational growth.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Build and refine financial models to project purchasing trends, rebate performance, and contracting outcomes.</li><li>Develop interactive dashboards to visualize spending patterns, utilization metrics, and overall financial results related to pharmaceutical activity.</li><li>Perform scenario analysis and ad-hoc modeling to assess the financial impact of clinical initiatives, treatment changes, and new product implementations.</li><li>Calculate and analyze cost structures and profit margins across network sites using internal cost, rebate, and reimbursement data.</li><li>Establish and manage processes to track, validate, and reconcile pharmaceutical rebate payments with accounting records.</li><li>Partner with operational and supply chain teams to improve purchasing workflows, inventory management, and vendor relationships.</li><li>Deliver insights and recommendations to senior management, translating complex financial data into strategic guidance that strengthens contracting and partnership outcomes.</li></ul><p><br></p>
We are looking for a dedicated Credentialing Specialist to support healthcare operations in Richmond, Virginia. This long-term contract position offers the opportunity to apply your expertise in credentialing processes and compliance within the managed care sector. Join a dynamic team where your skills will ensure smooth workflows and adherence to industry standards.<br><br>Responsibilities:<br>• Oversee credentialing and re-credentialing applications for healthcare providers, ensuring compliance with Medicare, Medicare Advantage, and managed care organization standards.<br>• Manage the end-to-end credentialing process, including verifying provider qualifications, certifications, and licensure.<br>• Maintain accurate and up-to-date records in credentialing databases and systems.<br>• Ensure compliance with regulatory requirements and industry standards throughout credentialing workflows.<br>• Collaborate with healthcare providers and internal teams to address credentialing inquiries and resolve issues promptly.<br>• Conduct thorough audits of credentialing applications and documentation to ensure accuracy and completeness.<br>• Stay informed on changes in healthcare regulations and credentialing requirements to adapt processes as needed.<br>• Provide training and guidance to team members on credentialing procedures and best practices.<br>• Support the implementation of process improvements to enhance efficiency and accuracy in credentialing operations.
We are looking for an experienced Medical Billing/Claims/Collections specialist to join our team on a contract basis. This role is based in Northbrook, Illinois, and offers an excellent opportunity to contribute your expertise in medical billing and claims management within a dynamic healthcare setting. The ideal candidate will bring a strong understanding of medical collections, appeals, and denials processes, ensuring timely and accurate handling of claims.<br><br>Responsibilities:<br>• Manage medical billing operations, including hospital billing and claims processing, to ensure accuracy and compliance.<br>• Handle medical collections and follow up on outstanding claims with payers to secure payments.<br>• Investigate and resolve medical denials by reviewing documentation and initiating appeals as needed.<br>• Collaborate with healthcare providers and insurance companies to address claim-related inquiries and discrepancies.<br>• Utilize Epic software and other electronic medical record systems to maintain and update patient billing information.<br>• Ensure adherence to healthcare billing procedures, statutory requirements, and compliance standards.<br>• Perform research to support claim administration and resolve complex billing issues.<br>• Process payments and reconcile accounts to maintain accurate financial records.<br>• Escalate unresolved issues appropriately to ensure timely resolution.<br>• Provide training and support to staff on billing processes and system functionalities.
<p>We are looking for an <strong><u>experienced Regulatory Legal Specialist</u></strong> to join our team on a contract basis in New York, New York. This role involves supporting regulatory compliance efforts, drafting legal documentation, and collaborating with subject matter experts to ensure adherence to healthcare regulations. <strong><u>The ideal candidate will bring expertise in healthcare law, regulatory affairs, or PBM/TPA operations</u></strong> to help streamline processes and maintain legal accuracy.</p><p><br></p><p>Responsibilities:</p><p>• Track, monitor, and assess the implications of changes to federal and state laws and regulations relevant to the organization.</p><p>• Maintain a centralized repository of regulatory updates and oversee the progress of their implementation.</p><p>• Partner with subject matter experts (SMEs) to confirm implementation plans and timelines.</p><p>• Create regulatory summaries, impact analyses, and internal guidance materials tailored to business needs.</p><p>• Draft and update policies and procedures aligned with regulatory requirements.</p><p>• Participate in cross-functional meetings to foster collaboration, ensure alignment, and uphold accountability across teams.</p>
<p>We are looking for a detail-oriented Medical Billing Specialist to join our team on a contract basis in Fayetteville, North Carolina. In this role, you will be responsible for ensuring accurate billing processes and maintaining compliance with healthcare regulations. This position requires a strong understanding of medical billing practices and excellent organizational skills.</p><p><br></p><p>Responsibilities:</p><p>• Review and process medical claims with accuracy and attention to detail.</p><p>• Verify patient information and insurance coverage to ensure proper billing.</p><p>• Resolve discrepancies and follow up on denied claims to maximize reimbursement.</p><p>• Maintain compliance with state and federal healthcare billing regulations.</p><p>• Collaborate with healthcare providers and administrative staff to streamline billing operations.</p><p>• Generate and analyze billing reports to identify trends and areas for improvement.</p><p>• Handle inquiries from patients and insurance companies regarding billing issues.</p><p>• Stay updated on industry changes and updates to billing codes and procedures.</p><p>• Assist with audits and ensure documentation is complete and accurate.</p><p>• Support the implementation of new billing systems as needed.</p>
<p><br></p><p> </p><p><strong>Job Overview</strong></p><p>Are you passionate about delivering outstanding customer service while playing a key role in patient care? We're looking for a dedicated <strong>Patient Access Facilitator</strong> to join our dynamic team. In this role, you'll handle <strong>front desk responsibilities</strong>, facilitate <strong>patient check-in and check-out</strong>, provide exceptional service to all guests, and assist in ensuring the efficient flow of our healthcare operations.</p><p>This position is ideal for someone who thrives on providing a positive experience for patients, exhibits remarkable organizational skills, and is open to developing new abilities through <strong>cross-training opportunities</strong>.</p><p><br></p><p><strong>Key Responsibilities</strong></p><ul><li>Welcome patients in a friendly and professional manner.</li><li>Manage efficient <strong>check-in and check-out processes</strong> for patients.</li><li>Verify and update patient demographics and insurance information.</li><li>Schedule appointments and maintain accurate records in the system.</li><li>Address patient inquiries, resolve issues, and ensure overall satisfaction.</li><li>Collaborate with internal teams to coordinate patient care.</li><li>Support additional administrative duties as needed.</li></ul><p><br></p><p><br></p>
Job Requirements & Description:<br>• Automotive Tag and Title experience required<br>• Managerial experience required <br>Managerial Job description and responsibilities:<br>• Manage and supervise the daily operations of an Automotive Tag Agency to include <br>walk in dealer customers, walk in customers and dealer customers.<br>• Make sure the employees under your supervision have the complete knowledge of <br>duties and responsibilities to comply with DMV/Agency standards.<br>• Responsible for Interviewing, hiring and training candidates to operate efficiently <br>and effectively per company standards.<br>• Assist title clerks with customer service issues.<br>• Follow all company safety guidelines and policies.<br>• Be available to cover any position at the agency caused by the absence of an <br>employee.<br>• Protect customer private information and secure inventory.<br> 8-5 or 9-6<br>Math Ability:<br>Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, <br>common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw <br>and interpret bar graphs.<br>Reasoning Ability:<br>Ability to apply common sense understanding to carry out instructions furnished in written, <br>oral, or diagram form. Ability to deal with problems involving several concrete variables in <br>standardized situations.<br>Education/Experience:<br>High school diploma or general education degree (GED); and equivalent combination of <br>education and experience.<br>Certificates and Licenses:<br>Ability to pass criminal all candidates required to undergo background check<br> permanent <br>Target start date: ASAP<br> Onsite <br> Management Experience<br>• Customer service knowledge<br>• Ability to multitask<br>• Basic computer knowledge<br>• detail oriented and courteous demeanor<br>• Possess good oral and written communication skills<br>• Attention to detail<br>• Ability to work in a fast-paced environment<br>• Be an active part of a team<br>• Flexible availability, dependability, and punctuality<br>• Time Management<br> Benefits:<br>• Medical<br>• Dental<br>• Vision<br>• 401k - with a Match<br>• Life insurance – paid for by the company<br>• Short Term Disability<br>• Long Term Disability<br>• Paid Holidays<br>• Paid Vacation
We are looking for a skilled Medical Collections Specialist to join our team in Irvine, California. This is a Contract-to-Permanent position, offering an excellent opportunity to grow your career in a dynamic healthcare environment. The ideal candidate will play a vital role in managing accounts receivable, resolving payment discrepancies, and ensuring compliance with industry regulations.<br><br>Responsibilities:<br>• Manage accounts receivable by following up on outstanding payments, payment errors, and claim denials.<br>• Analyze insurance Explanation of Benefits (EOBs) and initiate appeals when necessary to resolve discrepancies.<br>• Maintain detailed documentation of account issues, resolutions, and follow-up actions for patient records.<br>• Prepare and send required documentation via mail or other channels to support claims processing.<br>• Stay informed about commercial and managed care pricing models, as well as relevant rules and regulations.<br>• Ensure compliance with organizational policies and healthcare laws, safeguarding patient confidentiality at all times.<br>• Participate in compliance training sessions and promptly report any concerns or incidents to management.<br>• Utilize systems such as EHR platforms, Epic Software, and IBM AS/400 to ensure efficient claims and collections processes.<br>• Support the team by performing additional tasks as directed by supervisors or management.<br>• Contribute to the overall success of the department by collaborating with colleagues to meet organizational goals.
<p>We are looking for a dedicated Medical Front Desk Specialist to join our clients team on a contract basis in Portland, Oregon. In this role, you will be the first point of contact for patients and play a key role in ensuring smooth operations at the front desk of a medical facility. This position requires exceptional organizational skills, a friendly demeanor, and the ability to manage multiple tasks in a fast-paced environment.</p><p><br></p><p>Responsibilities:</p><p>• Greet and assist patients professionally as they arrive at the medical facility.</p><p>• Schedule patient appointments efficiently and ensure accurate data entry in the system.</p><p>• Manage patient check-in and check-out processes, ensuring all necessary documentation is completed.</p><p>• Handle incoming calls, respond to inquiries, and route calls to the appropriate departments.</p><p>• Maintain and update patient records in compliance with confidentiality and privacy policies.</p><p>• Collaborate with medical staff to coordinate patient care and address scheduling conflicts.</p><p>• Utilize Epic EMR software to manage appointments and patient information.</p><p>• Ensure the reception area is clean, organized, and welcoming for all visitors.</p><p>• Process payments, verify insurance information, and provide billing support as needed.</p><p>• Assist with general administrative tasks to support the smooth operation of the front office.</p>
We are looking for an experienced Senior Commercial Counsel to join our team in Santa Clara, California. In this role, you will provide expert legal guidance for a variety of commercial operations, particularly those involving healthcare specialists and medical devices. This position is ideal for an attorney with a deep understanding of regulatory compliance and contract negotiation in a fast-paced business environment.<br><br>Responsibilities:<br>• Draft, negotiate, and review a diverse range of agreements, including sales, licensing, marketing, procurement, and research collaborations.<br>• Ensure marketing materials and promotional programs align with truth-in-advertising standards, company policies, and applicable legal requirements.<br>• Provide timely and practical legal advice to internal teams on matters related to commercial operations and healthcare-related interactions.<br>• Resolve legal disputes using negotiation and legal expertise, including pre-litigation settlements.<br>• Develop and maintain contract templates, playbooks, and training materials to streamline business processes.<br>• Build a strong understanding of the company’s products, services, and client needs to offer tailored legal counsel.<br>• Monitor and interpret relevant laws impacting sales, marketing, and reimbursement, such as fraud and abuse statutes, FDA regulations, privacy laws, and anti-corruption policies.<br>• Represent the company in external dealings with suppliers and customers to ensure alignment with legal and business objectives.<br>• Manage relationships with outside counsel, including defining project parameters and monitoring budgets.
The Patient Access Coordinator plays a critical role in ensuring a seamless patient experience by handling front-office administrative duties and patient interactions. This position serves as the first point of contact for patients, visitors, and staff, ensuring a detail oriented and welcoming atmosphere at the clinic. The successful candidate will assist with patient registration, scheduling, and financial verification while maintaining strict compliance with HIPAA and other healthcare regulations. <br> Key Responsibilities: Front Desk Management: Greet all individuals (patients, visitors, and staff) who present at the front window and notify the appropriate personnel of any visitor arrivals. Patient Check-In: Complete patient check-ins, collect co-pays, and outstanding balances where applicable. Patient Registration: Verify and update patient information, including personal and financial details. Assign eligibility levels and register new patients as needed with accurate data entry. Consent Assistance: Assist patients with completing patient consent and other necessary forms, if required. Appointment Scheduling: Schedule medical, dental, and behavioral health (BH) patient appointments. Provide clinical summaries to medical and BH patients at the time of exit scheduling. Schedule Coordination: Work closely with the Patient Access Manager and providers to coordinate and maintain daily provider schedules. Patient Confirmation Calls: Make confirmation calls for upcoming appointments, reminding patients to bring necessary items such as co-pays and medication lists. Rescheduling Assistance: Check the bump list daily and reschedule appointments accordingly. HIPAA Compliance: Evaluate records requests for compliance with HIPAA laws and ensure information is released in accordance with applicable regulations. Phone Management: Answer incoming phone calls and relay messages or forward calls as needed. Patient Portal Enrollment: Educate, recruit, and enroll patients in the online portal system. Clerical Tasks: Sort and collate printed materials and notices for distribution purposes. Cross-Training: Cross-train to cover various front office responsibilities to ensure operational flexibility. Committee Participation: Participate in staff committees as assigned by leadership. Travel: Be willing to travel as necessary to meet operational needs across clinic locations. Meetings: Attend mandatory staff and agency meetings. Miscellaneous Duties: Perform additional assigned duties as needed to support operational success.
<p>At Robert Half, we connect exceptional talent with employers across various industries. We are currently seeking a dependable and detail-oriented <strong>Patient Registration Specialist</strong> to assist with overnight operations for a healthcare client in [specific industry/organization type]. This position is crucial in ensuring smooth patient admission services during the 3rd shift, supporting patient care, and maintaining organizational excellence.</p><p><strong>Position Overview:</strong></p><p>As the <strong>Patient Registration Specialist</strong>, you will be the first point of contact for patients during evening and overnight hours. Your primary responsibility will be to manage the patient check-in process seamlessly, ensuring accurate data entry, insurance verification, and delivering excellent customer service in a compassionate manner.</p><p><strong>Responsibilities:</strong></p><ul><li>Welcome and register patients in a professional and courteous manner during overnight hours.</li><li>Collect patient demographic and insurance information and ensure accurate data entry into the system.</li><li>Verify insurance eligibility and manage authorizations as required.</li><li>Safeguard patient information and ensure compliance with HIPAA regulations.</li><li>Address patient inquiries and resolve issues, providing timely and empathetic assistance.</li><li>Handle financial responsibilities, including processing co-pays, payments, and issuing receipts.</li><li>Communicate and collaborate with healthcare staff to ensure a smooth patient experience, especially during shift changes.</li><li>Maintain and organize patient records and ensure all documentation is complete.</li><li>Troubleshoot registration-related issues to minimize delays in patient care.</li></ul><p><strong>Shift Details:</strong></p><ul><li>3rd shift hours</li><li>Must be available for evenings, overnights, and weekends as scheduled. (The specific shift schedule will be established upon hire.)</li></ul><p><br></p>
<p>At Robert Half, we connect exceptional talent with employers across various industries. We are currently seeking a dependable and detail-oriented <strong>Patient Registration Specialist</strong> to assist with overnight operations for a healthcare client in [specific industry/organization type]. This position is crucial in ensuring smooth patient admission services during the 3rd shift, supporting patient care, and maintaining organizational excellence.</p><p><strong>Position Overview:</strong></p><p>As the <strong>Patient Registration Specialist</strong>, you will be the first point of contact for patients during evening and overnight hours. Your primary responsibility will be to manage the patient check-in process seamlessly, ensuring accurate data entry, insurance verification, and delivering excellent customer service in a compassionate manner.</p><p><strong>Responsibilities:</strong></p><ul><li>Welcome and register patients in a professional and courteous manner during overnight hours.</li><li>Collect patient demographic and insurance information and ensure accurate data entry into the system.</li><li>Verify insurance eligibility and manage authorizations as required.</li><li>Safeguard patient information and ensure compliance with HIPAA regulations.</li><li>Address patient inquiries and resolve issues, providing timely and empathetic assistance.</li><li>Handle financial responsibilities, including processing co-pays, payments, and issuing receipts.</li><li>Communicate and collaborate with healthcare staff to ensure a smooth patient experience, especially during shift changes.</li><li>Maintain and organize patient records and ensure all documentation is complete.</li><li>Troubleshoot registration-related issues to minimize delays in patient care.</li></ul><p><strong>Shift Details:</strong></p><ul><li>3rd shift hours</li><li>Must be available for evenings, overnights, and weekends as scheduled. (The specific shift schedule will be established upon hire.)</li></ul><p><br></p>
<p><strong>Senior Project Manager II</strong></p><p><strong>Contract: </strong>15 weeks, Contract to Hire</p><p><strong>Work Arrangement:</strong> Remote</p><p><strong>Work Hours:</strong> Monday through Friday, 8:00 AM – 5:00 PM </p><p><strong>Job Overview:</strong></p><p>We are seeking an experienced <strong>Senior Project Manager II</strong> to lead the implementation of a new contact center team and associated technology across multiple physician practices. In this role, you will work closely with contact center leadership to develop and execute project plans encompassing process mapping, testing, rollout planning, business requirements, and communication strategies. The Senior Project Manager II will coordinate activities across business units, physician practices, and technical teams, ensuring projects are delivered on time, within budget, and to defined specifications.</p><p>This high-visibility role requires strong communication, organizational, and leadership skills, as well as a demonstrated ability to drive transformation and manage stakeholder relationships effectively.</p><p><strong>Key Responsibilities:</strong></p><ul><li>Act as the primary point of accountability for assigned projects.</li><li>Coordinate and manage relationships across multiple stakeholders, including business owners, team members, and service centers.</li><li>Develop strategic documents (e.g., project charters, education and communication plans, detailed project plans) and provide updates/presentations to stakeholders.</li><li>Identify and mitigate project risks, issues, and cross-project dependencies.</li><li>Ensure deliverables are completed throughout the project lifecycle.</li><li>Facilitate decision-making, problem-solving, and the creation of implementation toolkits or migration schedules.</li><li>Mentor and manage project team members as appropriate.</li></ul><p><br></p>
We are looking for a dedicated Front Desk Coordinator to join our healthcare team in Fountain Valley, California. This role requires a friendly and detail-oriented individual who is comfortable managing high foot traffic and thrives in a fast-paced environment. As a Contract-to-Permanent position, this opportunity offers room for growth and development within the organization.<br><br>Responsibilities:<br>• Serve as the first point of contact for patients and visitors, providing a welcoming and organized experience.<br>• Handle incoming and outgoing calls efficiently, ensuring clear communication and resolution of inquiries.<br>• Manage daily administrative tasks, including data entry, organizing files, and scheduling appointments.<br>• Coordinate patient intake processes, ensuring accurate documentation and adherence to healthcare protocols.<br>• Utilize medical terminology knowledge to assist patients and staff with necessary information.<br>• Work collaboratively with healthcare staff to ensure smooth office operations and patient satisfaction.<br>• Maintain a high level of organization in a busy office environment with heavy foot traffic.<br>• Assist with customer service needs, addressing concerns and resolving issues promptly.<br>• Use Microsoft Office applications, including Excel, Outlook, and Word, to complete administrative tasks.<br>• Support the scheduling of interviews and manage timesheets as required.
We are looking for a detail-oriented Medical Billing Specialist to join our team on a long-term contract basis. In this role, you will play a critical part in ensuring accurate and timely processing of medical billing and claims for a healthcare facility in Raeford, North Carolina. This position offers the opportunity to contribute to the smooth financial operations of a trusted healthcare provider.<br><br>Responsibilities:<br>• Prepare, review, and submit medical claims to insurance companies, ensuring accuracy and compliance with regulations.<br>• Follow up on outstanding claims and resolve any issues or discrepancies promptly.<br>• Verify patient insurance coverage and eligibility to facilitate proper billing.<br>• Maintain detailed records of billing activities and ensure confidentiality of sensitive information.<br>• Collaborate with healthcare providers and administrative staff to clarify billing details and address concerns.<br>• Monitor and analyze billing trends to identify opportunities for process improvements.<br>• Respond to patient inquiries regarding billing statements and insurance claims.<br>• Ensure compliance with all relevant healthcare and billing laws, regulations, and guidelines.<br>• Assist in generating financial reports related to billing and collections.
<p>Robert Half is looking for a dedicated Accounting Manager to join our client's team. This role is ideal for someone detail-oriented with extensive experience in financial management, nonprofit accounting, and grant administration within the healthcare sector. </p><p><br></p><p>Responsibilities:</p><ul><li> Lead the preparation and analysis of financial reports, budgets, projections, proformas, revenue and expense accounts, and balance sheet reconciliations.</li><li>Serve as the primary financial liaison for the Foundation, fostering collaboration with its leadership to streamline financial operations.</li><li>Optimize the use of financial software systems to support efficiency and accuracy in day-to-day operations.</li><li>Coordinate funding requests and awards in partnership with the Foundation team, and work closely with the Grant Administration and Management group to ensure clarity regarding external grants.</li><li>Conduct vendor evaluations and oversee annual policy reviews to maintain compliance and drive cost-effectiveness.</li><li>Manage financial aspects of major campaigns, providing support for inquiries related to pledges and contributions.</li></ul><p>For immediate consideration, please contact Steve Fields directly at 919-787-8226.</p>
We are looking for a dedicated Customer Service Representative to join our team in San Antonio, Texas. This is a contract position where you will play a critical role in scheduling patients for preventative health care screenings. The ideal candidate will thrive in a fast-paced environment and demonstrate exceptional communication skills while working independently after training.<br><br>Responsibilities:<br>• Schedule patients for preventative health care screenings, ensuring accuracy and efficiency.<br>• Handle a minimum of 70-80 calls per day to maintain productivity standards.<br>• Utilize computer systems to track and manage scheduling data effectively.<br>• Collaborate with experienced employees during training and transition to working independently.<br>• Maintain professionalism while managing interruptions and prioritizing tasks.<br>• Apply medical knowledge to assist patients and enhance scheduling processes.<br>• Demonstrate familiarity with healthcare systems, including EMR and TRICARE.<br>• Ensure adherence to business casual dress code while engaging with patients and team members.<br>• Provide excellent customer service to address patient inquiries and concerns.<br>• Follow established protocols and guidelines to meet organizational goals.
<p>We are looking for a dedicated Customer Service Representative to join our team in San Antonio, Texas. This is a contract position where you will play a critical role in scheduling patients for preventative health care screenings. The ideal candidate will thrive in a fast-paced environment and demonstrate exceptional communication skills while working independently after training.</p><p><br></p><p>Responsibilities:</p><p>• Schedule patients for preventative health care screenings, ensuring accuracy and efficiency.</p><p>• Handle a minimum of 70-80 calls per day to maintain productivity standards.</p><p>• Utilize computer systems to track and manage scheduling data effectively.</p><p>• Collaborate with experienced employees during training and transition to working independently.</p><p>• Maintain professionalism while managing interruptions and prioritizing tasks.</p><p>• Apply medical knowledge to assist patients and enhance scheduling processes.</p><p>• Demonstrate familiarity with healthcare systems, including EMR and TRICARE.</p><p>• Ensure adherence to business casual dress code while engaging with patients and team members.</p><p>• Provide excellent customer service to address patient inquiries and concerns.</p><p>• Follow established protocols and guidelines to meet organizational goals.</p>
<p>We are looking for a detail-oriented Medical Billing and Payment Posting Specialist to join our team located in the Greater Philadelphia Region. In this fast-paced and rapidly growing environment, you will play a key role in supporting the fee-for-service finance department. This Medical Billing and Payment Posting Specialist role is a contract position that requires strong organizational skills and proficiency with multiple software applications.</p><p><br></p><p>What you get to do every single day:</p><p>• Review and upload claims accurately to ensure proper processing and timely reimbursement.</p><p>• Track claims manually and maintain detailed records for auditing and reporting purposes.</p><p>• Develop and refine standard operating procedures (SOPs) with guidance from leadership.</p><p>• Utilize software tools such as QuickBooks for invoicing and payment management.</p><p>• Handle customer service inquiries related to billing and payments.</p><p>• Navigate and work efficiently across various medical portals and applications, including ModMed, Ability, and Pear.</p><p>• Conduct audits to identify discrepancies and ensure compliance with billing standards.</p><p>• Address medical insurance denials and resolve issues effectively.</p><p>• Process transactions using platforms like Square and maintain accurate financial records.</p><p>• Collaborate with team members to improve processes and support departmental goals.</p>
We are looking for a dedicated Care Coordinator to join our team in Syracuse, New York. In this Contract-to-permanent role, you will provide essential administrative and technical support to the Clinical Supervisor and team members, ensuring seamless operations in the referral and authorization processes. This position offers an opportunity to make a meaningful impact by collaborating with team members and assisting members in accessing the services they need.<br><br>Responsibilities:<br>• Review and accurately input authorization data into a computerized database, including managing expiring authorization reports.<br>• Assist case management with scheduling and coordinating patient services as directed by the clinical team.<br>• Participate in regular meetings with clinical staff to identify opportunities for process improvement and implement recommended changes.<br>• Maintain and manage various reports within organizational systems as assigned.<br>• Perform clerical tasks such as filing, typing, copying, faxing, and taking messages to support team operations.<br>• Actively engage in performance improvement and continuous quality improvement activities.<br>• Communicate regularly with members to ensure their needs are met and collaborate with team members to address any concerns.<br>• Carry out additional duties as assigned by the supervisor to support the team's overall goals.
<p>We are looking for a dedicated Revenue Billing Cycle Manager to oversee and optimize the revenue cycle processes for our healthcare organization in Hilo, Hawaii. This role requires a strategic thinker who can lead teams effectively, analyze financial data, and ensure compliance with industry regulations. If you have a strong background in revenue management and are passionate about improving operational efficiency, we encourage you to apply by calling us at 808-531-8056. Preference will be given to applicants currently residing in Hawaii due to the nature of the job requirements.</p><p><br></p><p>Responsibilities:</p><p>• Lead and manage all aspects of the revenue cycle, including patient registration, coding, claims submission, payer relations, and collections.</p><p>• Supervise and mentor a team of 30 or more staff members, fostering growth and collaboration.</p><p>• Analyze financial data to identify trends and implement strategies for revenue cycle optimization.</p><p>• Ensure compliance with healthcare regulations and standards throughout all billing and financial processes.</p><p>• Collaborate with internal and external stakeholders to address billing issues and improve operational workflows.</p><p>• Utilize advanced software systems like Sunquest, XiFin, and Epic to streamline revenue management operations.</p><p>• Develop and oversee budgets, ensuring efficient allocation of resources.</p><p>• Monitor accounts receivable and auditing processes to maintain financial accuracy and transparency.</p><p>• Implement solutions to resolve denials and improve claims management.</p><p>• Conduct regular performance reviews and provide actionable feedback to enhance team productivity.</p>
<p>We’re seeking an experienced <strong>Infusion Billing and Denials Specialist</strong> to join a growing healthcare organization. This role will play a key part in stabilizing and improving the infusion billing process, managing claim denials, and supporting the transition to an in-house billing model. The ideal candidate brings strong technical expertise, a proactive approach to problem-solving, and experience with healthcare billing systems used in infusion or specialty pharmacy settings.</p><p><br></p><p><strong>Key Responsibilities</strong></p><ul><li>Review, prioritize, and resolve claim denials based on type, urgency, and payer requirements.</li><li>Collaborate with internal teams and third-party vendors to ensure accurate and timely claim submissions.</li><li>Research and resolve billing discrepancies, including coordination with clinical staff for complex or clinical-related denials.</li><li>Track, document, and report denial trends to support process improvement and revenue optimization.</li><li>Assist with billing audits and provide insight on compliance, documentation, and coding accuracy.</li><li>Support the ongoing transition from outsourced billing to an internal model by identifying workflow gaps and recommending improvements.</li><li>Utilize analytics and clearinghouse data to identify patterns in claim rejections and reimbursement delays.</li></ul><p><br></p><p><strong>Systems & Tools</strong></p><p>Experience in the following systems is highly preferred:</p><ul><li><strong>CareTend</strong> (patient accounting)</li><li><strong>eClinicalWorks (ECW)</strong> (clinical documentation)</li><li><strong>Waystar</strong> (clearinghouse)</li><li><strong>PMD</strong> (inpatient billing)</li></ul><p><br></p><p><br></p>
<p>A Senior Software Business Analyst is needed to play a crucial role in connecting business requirements to technical solutions. This role involves engaging with stakeholders to gather and analyze requirements, transforming them into actionable functional specifications. Responsibilities include evaluating existing processes, offering solutions to drive business value, and ensuring project success under tight timelines. The position also includes mentoring junior analysts, leading cross-departmental projects, and fostering innovation. Strong analytical and communication skills, along with a solid understanding of software development life cycles, are essential to succeed in this fast-paced environment.</p><p>The ideal candidate will work closely with development and QA teams to monitor project milestones, provide updates to stakeholders, and address any project risks and challenges. A proactive approach to improving application usability and efficiency will be critical. Focusing on the specialty pharmacy sector, the organization provides end-to-end solutions including hub services, pharmacy network management, group purchasing (GPO) services, cutting-edge technology platforms, and more. With a strong presence as an industry advocate, the focus remains on delivering strategic channel management, advanced products, and tailored services to optimize patient outcomes and improve healthcare delivery.</p><p><br></p><p><strong>** Qualified candidates should have experience with pharmacy insurance, medical insurance, and claims processing **</strong></p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Collect and translate business requirements into detailed functional specifications for new and existing systems.</li><li>Perform gap analyses between current system capabilities and business needs using tools like Confluence, flowcharts, and wireframes to document workflows.</li><li>Create use cases for review during functional testing phases by developers and QA teams.</li><li>Work with IT teams to evaluate project scope and affected systems, providing strategic insights.</li><li>Assess new methodologies for feasibility and implementation efficiency.</li><li>Gain in-depth knowledge of internal software platforms and their underlying functionalities.</li><li>Analyze and optimize existing processes to identify inefficiencies and propose re-engineering solutions.</li><li>Host regular meetings with development teams to resolve obstacles and track progress.</li><li>Provide project status reports to business stakeholders.</li><li>Identify potential risks and escalate issues as required.</li><li>Continuously explore opportunities to improve application functionality, making recommendations for enhancements.</li><li>Maintain compliance with HIPAA regulations and related amendments</li></ul>
<p>Robert Half is seeking an experienced <strong>Contract Manager</strong> for a dynamic <strong>contract-to-hire opportunity</strong> in Princeton, NJ, offering a hybrid work schedule (3 days onsite, 2 days remote). The ideal candidate will bring expertise in <strong>contract lifecycle management</strong>, <strong>cross-functional collaboration</strong>, and <strong>rebate/discount programs</strong> while ensuring compliance and operational excellence.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><p><br></p><p><strong>1. Manage Contract Lifecycle:</strong></p><ul><li>Assist in the drafting, negotiation, execution, and management of payer, specialty pharmacy, and GPO agreements, including rebate, discount, and data-sharing contracts.</li><li>Ensure contracts comply with organizational requirements and regulatory guidelines.</li></ul><p><strong>2. Execute Contract Operations:</strong></p><ul><li>Supervise the setup, validation, and implementation of contract terms in relevant systems.</li><li>Monitor contract performance to ensure adherence to agreed-upon terms.</li></ul><p><strong>3. Validate and Process Rebates:</strong></p><ul><li>Collaborate with Rebate Operations and Finance teams to ensure accurate rebate calculations and timely payments.</li><li>Address discrepancies and ensure compliance with rebate terms.</li></ul><p><strong>4. Foster Cross-Functional Partnerships:</strong></p><ul><li>Build strong working relationships with Legal, Finance, Pricing, Market Access, Trade, and Compliance teams to ensure effective contract alignment and execution.</li><li>Act as a key point of contact to resolve contract-related issues collaboratively.</li></ul><p><strong>5. Manage Contract Systems:</strong></p><ul><li>Utilize and maintain contract management and rebate tools (e.g., Model N, Revitas, Vistex, iContracts) to track contract performance, validation, and intake processes.</li></ul><p><br></p>
