HighFive Healthcare

• Own HighFive's experienced-doctor recruiting channel end to end — sourcing through close. • Build and manage a pipeline of practicing oral surgeons and endodontists. • Develop outreach strategy and relationship cadence for experienced-doctor prospects. • Conduct substantive career and financial conversations — practice economics, the H5 compensation model, associate opportunity scope, and long-term trajectory. • Manage candidates from first outreach through signed employment agreement. • Design and lead practice-visit experiences for experienced-doctor candidates. • Own the compensation conversation using the H5 comp framework and present a specific, data-backed offer narrative. • Prepare term sheets and manage the executive approval workflow for experienced-doctor candidates. • Keep candidate and pipeline records current in Salesforce.

• Investigate, appeal, and resolve denied or rejected claims by insurance payors. • Work with insurance companies to clarify discrepancies and ensure proper reimbursement. • Review and assess Explanation of Benefits (EOBs) at the claim level to determine issues. • Determine root cause of any billing related or claim submission issues to prevent recurrence. • Make corrections to claims based on denials and rebill utilizing standardized process and procedures. • Follow up with unresolved claims through system resources, clearinghouse, payer portal or call to the payor, when necessary. • Assess whether an appeal is required for a claim denial. • Track appeals to ensure timely payment and resolution. • Spot recurring patterns in denials and report them to management for further analysis and action. • Effectively communicate both verbally and in writing with team members, payors, patients, and other relevant parties. • Keep up to date with internal processes, industry standards, and government regulations relevant to denial management to ensure compliance and best practices. • Participate in or take on special projects or additional duties as required by the team or management. • Meet or exceed required accounts per day to meet HighFive and provider’s expectations. • Achieve department goals for net collection rates and the resolution of denied claims, including those successfully paid or overturned.