MD Clarity

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are seeking a Customer Success Engineer with deep healthcare revenue cycle expertise and strong data analysis capabilities to support the ongoing success of our contract management platform. This role focuses on helping healthcare organizations accurately interpret payer contracts, configure reimbursement methodologies, and validate contract performance using customer data. This role sits within the Customer Operations team and works closely with Product and Engineering to ensure that payer contracts, reimbursement rules, and supporting data are correctly configured and validated within the platform. - Interpret complex payer contracts and reimbursement methodologies and translate them into structured system configurations. - Configure managed care contract terms, fee schedules, and reimbursement rules within the contract management platform. - Validate reimbursement calculations and payer payment logic across Medicare, Medicaid, and commercial payers. - Implement custom reporting / current product optimizations to address end-user functional issues. - Conduct root cause analysis and devise solutions for customer workflows. - Use SQL and relational databases to analyze healthcare datasets and validate reimbursement logic. - Investigate and resolve data discrepancies impacting contract configuration or payment calculations. - Partner with engineering teams to troubleshoot escalated technical issues related to data or contract configuration. - Work directly with healthcare customers to resolve contract interpretation questions and reimbursement issues. - Communicate product feedback and recurring customer issues to internal teams to support product improvements. Qualifications - Bachelor’s degree in Healthcare Administration, Business, Information Systems, Data Engineering, Computer Science, Information Technology, or any general Engineering field (e.g. Industrial Engineering) or a related field (or equivalent experience). - 2+ years of experience in healthcare revenue cycle, managed care contracting, payer relations, or contract administration. - 5+ years of experience working with SQL. Requirements - Strong understanding of managed care contracts, payer reimbursement methodologies, and healthcare revenue cycle operations. - Knowledge of reimbursement models including Medicare, Medicaid, TRICARE, commercial payer contracts, and physician payment methodologies. - Proficiency with SQL. - Experience working with healthcare financial or claims datasets. - Strong analytical and problem-solving skills with the ability to conduct root cause analysis. - Strong ability to translate end-user functional issues into potential product enhancements. - Strong organizational skills with high attention to detail. Preferred Qualifications - Experience implementing revenue cycle or contract management technology platforms. - Experience working with healthcare claims or reimbursement modeling. Company Description MD Clarity is a social-impact-driven software company animated by two guiding principles: 1) that patients have a right to know what the financial impact will be on them when getting care; and 2) that doctors, nurses, and physician assistants deserve to be paid fairly by health insurers. Our workflow automation software makes the healthcare experience easier and more transparent for patients and providers, and our products are already used by healthcare organizations that together serve hundreds of thousands of patient visits annually. We’re profitable and recently raised a new round of growth capital to accelerate adoption and scale our impact on the healthcare system. Our fast-growing team combines decades of healthcare technology experience with engineering and business talent from Microsoft, Stanford, Spotify, EY-Parthenon, Harvard, Deloitte, Vanderbilt, Georgetown, UPenn-Wharton, and West Point, among others. We’re distributed among our offices in Seattle and New York City and many fully remote roles. In addition to our shared passion for improving patients’ healthcare experience, we’re united in valuing an inclusive workplace that empowers all with the autonomy, connection to the mission, and flexibility needed to innovate. Must be eligible to work in the U.S. without Sponsorship.

Have you noticed that when you go to the doctor, often no one there can tell you what it will cost? If you think that’s as problematic as we do, join us in our mission to fix it. Position Overview The Revenue Recovery Specialist will play a critical role in ensuring accurate reimbursement and recovering lost revenue for outpatient service providers. This position involves interfacing with insurance carriers, analyzing claims data, and drafting appeals to recover underpaid and denied claims. The ideal candidate must have a strong understanding of outpatient reimbursement methodologies, intermediate Excel skills, and the ability to navigate payer processes independently. Key Responsibilities Claims Research and Analysis - Review claims data in pricing software to identify discrepancies between contracted rates and actual payments. - Research claims variances in outpatient patient accounting systems (e.g., athenahealth, Nextgen) - Deep-dive into payer contracts and manuals to understand “why” a claim has been underpaid or denied. - Review claim details, including coding, billing, and insurance information to verify payer payment discrepancies. Appeals and Follow-Up - Communicate with payer representatives via phone, provider portals, written correspondence, etc. to identify claim status, needed documentation, reasoning for underpayment. - Draft appeals to insurance companies to recover underpaid claims. - Adhere to payer-specific strategies (e.g., escalation, appeal, obtaining audit reports, requesting claim correction, etc.) to resolve accounts expeditiously. Trend Identification and Reporting - Identify trends in workflow and recommend solutions for efficiency improvements. - Prepare monthly recovery reporting for the Client. - Communicate trends during team meetings. Skills and Knowledge - Strong understanding of outpatient reimbursement methodologies (e.g., how Medicare reimbursement works, how to calculate reimbursement using a fee schedule, how payment adjustments work). - Intermediate Excel skills, including pivot tables and large dataset analysis. - Excellent written and verbal communication skills for professional interactions with payer representatives. - Demonstrated ability to work autonomously and communicate findings to teammates. - Persistent problem-solving skills to overcome payer challenges. Education and Experience - Required: Minimum 3–5 years of experience in one or more of the following areas: - Revenue cycle accounts receivable follow-up - Managed care contracting analysis - Insurance company claims or payer relations - Revenue cycle outsourcing recovery - Associate degree preferred; equivalent work experience accepted. More About MD Clarity MD Clarity is a social-impact-driven software company animated by two guiding principles: 1) that patients have a right to know what the financial impact will be on them when getting care; and 2) that doctors, nurses, and physician assistants deserve to be paid fairly by health insurers. Our workflow automation software makes the healthcare experience easier and more transparent for patients and providers, and our products are already used by healthcare organizations that together serve hundreds of thousands of patient visits annually. We’re profitable and recently raised a new round of growth capital to accelerate adoption and scale our impact on the healthcare system. Our fast-growing team combines decades of healthcare technology experience with engineering and business talent from Microsoft, Stanford, Spotify, EY-Parthenon, Harvard, Deloitte, Vanderbilt, Georgetown, UPenn-Wharton, and West Point, among others. We’re distributed among our offices in Seattle and New York City and many fully remote roles. In addition to our shared passion for improving patients’ healthcare experience, we’re united in valuing an inclusive workplace that empowers all with the autonomy, connection to the mission, and flexibility needed to innovate. Must be eligible to work in the U.S. without Sponsorship