• Responsible for efficient & timely billing and collections of hospital outstanding balances • Utilizes the Epic Hospital Billing System to review and monitor accounts • Contacts insurance carriers to confirm payment dates and question claim denials • Performs all Hospital Billing, Follow Up, and Denial activities necessary to obtain payment • Reviews entire account to ensure claims were billed properly • Gathers all necessary documentation for claims reprocessed/adjudicated • Identifies problems in Claims Edit work queue

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Senior Manager, Performance Economics (Service Fund Audit) will support the performance analysis and financial reporting for our Medicare Advantage line of business. The Senior Manager of Performance Economics will perform due-diligence on payer reporting and financial reconciliations. In addition, the position will be responsible for working directly with payer partners and across internal teams to remediate data issues. - Review payer financial reconciliations for accuracy and adherence to agreed-upon methodologies. - Support for the development and deployment of audit procedures applied to payer data sets. - Partner across teams and with payers to resolve data discrepancies. Project manage the contestation process with support from the legal team. - Collaborate with the Service Fund Audit team to support the build of standard operating procedures, timelines, and workflows to clearly document the end-to-end process that will ensure the accuracy of financial reconciliations and eventual payment to practices. - Ensure transparency of Service Fund audit work for field teams and provide timely updates and timelines to senior leaders and market stakeholders. - Serve as the subject matter expert in interpreting payer agreements to ensure accurate calculation of financial reconciliations. - Support projects relating to portfolio management (e.g., practices & contracts) in Medicare Advantage. - Other duties as assigned. Qualifications - Bachelor’s Degree in Healthcare Administration, Business, Public Health, or related field. - 7+ years of experience related to the business of healthcare. Minimum of 3+ years specialization within Medicare Advantage. - 2+ year management experience. - Deep knowledge of value-based care methodologies. - Deep knowledge of Medicare Advantage methodology and economics (contracting, bidding, P&L management, policy). - Advanced ability with Excel / Google sheets and data manipulation skills (e.g., SQL/SAS/R). - Ability to collaborate effectively with cross-functional teams and external partners. - Strong organizational skills with the ability to multitask, prioritize competing demands, and manage time effectively in a fast-paced environment. Preferred Qualifications - Master’s Degree in Healthcare Administration, Business, Public Health, or related field. Benefits - Flexible work schedules and the ability to work remotely are available for many roles. - Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners. - Robust time-off plan (21 days of PTO in your first year). - Two paid volunteer days and 11 paid holidays. - 12 weeks paid parental leave for all new parents. - Six weeks paid sabbatical after six years of service. - Educational Assistant Program and Clinical Employee Reimbursement Program. - 401(k) with up to 4% match. - Stock options. - And much more! Company Description Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.

• Develop and maintain backend services • Collaborate with frontend developers to integrate user-facing elements • Write clean, scalable code • Participate in code reviews and provide mentorship

• Serve as a technical expert in design, development, and deployment of integrations • Manage end-to-end technical lifecycle of integrations • Collaborate with Finance, IT, and external vendors • Ensure compliance with security protocols and audit requirements