Role Description The Payer Reimbursement Specialist is responsible for performing advanced Level 2 audits of payer contract loads, ensuring accuracy, compliance, and proper documentation across all centers. This role serves as a highly skilled technical resource, reviewing contract load accuracy. This position requires a seasoned A/R or reimbursement professional with strong managed care knowledge, exceptional organization, and the ability to work in a fast-moving, evolving environment. - Perform SOX Level 2 audits to validate contract load accuracy. - Review contract rate loads, contract types, MPRs, insurance carrier links, and contract grid updates. - Identify and document discrepancies, coordinate corrections with Managed Care Finance Ops. - Identify where contract grid updates are needed to communicate updates to payer reimbursement analysts, adding notes and ensuring accurate documentation for all audits. - Utilize and maintain tracking systems; monitor audit status and follow-up needs. - Assist in implementing improved tracking and workflow processes, including potential ticketing and intake solutions. - Communicate regularly with Analysts, Managers, and contract loaders to resolve audit findings. - Support special projects and other reimbursement initiatives. - Additional responsibilities assigned as needed. Qualifications - Strong managed care knowledge. - Exceptional organization skills. - Ability to work in a fast-moving, evolving environment. Requirements - Seasoned A/R or reimbursement professional. Company Description

• Submit clean, timely claims with accurate CPT, HCPCS, ICD-10 codes, and modifiers. • Track and resolve denials, rejections, and underpayments with appropriate follow-up and resubmission. • Validate eligibility, authorization, and proper billing pathways for all patient encounters. • Ensure accurate use of telehealth, SDOH, and preventive care codes. • Coordinate with credentialing, partner success, and payer reps to ensure claims compliance. • Perform other duties as assigned. • Review provider documentation and assign accurate codes per ICD-10-CM, CPT, and HEDIS/quality reporting guidelines. • Identify and escalate incomplete documentation or coding gaps; issue coding queries as needed. • Educate providers under the guidance of the Coding Manager to drive documentation improvement. • Support implementation and testing of new documentation macros and encounter note templates. • Maintain and contribute to the internal billing rules matrix (payer, state, provider type, modifiers). • Collaborate with the Data & Analytics team to track claim trends, documentation compliance, and A/R performance. • Partner with Revenue Cycle and Clinical Ops to align workflows with payer requirements and business goals. • Support provider training, macro updates, and compliance education efforts.

Role Description The Global Logistics Specialist supports the execution of global logistics operations, ensuring the efficient and compliant movement of goods across domestic and international networks. This role partners with internal teams, carriers, and third-party providers to deliver reliable, cost-effective transportation solutions while maintaining high service levels and adherence to trade regulations. - Coordinate end-to-end domestic and international shipments, including freight forwarding, customs clearance, and final delivery - Serve as a primary point of contact for internal teams, carriers, freight forwarders, and customs brokers - Partner with suppliers, warehouses, and logistics providers to schedule and monitor shipments - Ensure compliance with international trade regulations, customs requirements, and company policies - Prepare, review, and validate shipping documentation (commercial invoices, bills of lading, certificates of origin, etc.) - Monitor shipments using tracking tools and provide proactive updates and exception management - Identify and resolve delays, discrepancies, and service issues to minimize disruption - Maintain accurate shipment records and support reporting on performance and exceptions - Provide accurate and timely freight quotes, including duties, taxes, and accessorial costs - Analyze shipment requirements and recommend efficient, cost-effective logistics solutions - Other job duties as assigned Qualifications - Minimum Required: - 2+ years of experience in logistics, transportation, or supply chain operations - 2+ years of customer service or client-facing experience - Proficiency in Microsoft Excel and Word - Familiarity with parcel and freight tracking systems - Strong attention to detail and ability to work in a fast-paced environment - Preferred: - 3+ years of related logistics experience - Knowledge of U.S. export laws - Experience with software programs relevant to logistics operations Requirements - Strong communication skills with the ability to convey information clearly and professionally - High attention to detail and accuracy - Strong time management and organizational skills - Customer-focused mindset with a proactive approach to problem-solving - Ability to manage multiple priorities and meet deadlines - Ability to collaborate across cross-functional teams and external partners Benefits - Medical, Dental, and Vision Insurance - 401(k) - Paid company holidays - Paid time off - Paid parental and caregiver leave - Plus more! See benefits here for additional details.

Role Description This role manages an arbitration case load including evaluation of provider disputes and appropriate client payment offers. This position is responsible for successful analysis and resolution of the most complex escalated issues. The incumbent will coordinate efforts with the team and leadership to bring matters to efficient and successful outcomes. The incumbent's primary responsibility will be to oversee and manage the intake, processing and coordination of all materials and information relating to the Independent Dispute Resolution ("IDR") as regulated by Federal or State law. Duties - Assume primary responsibility for determining appropriate amount of client plan arbitration offers. - Draft briefs and offers persuasively documented arguments supporting client positions in arbitration packages pursuant to federal regulations. - Conduct due diligence (e.g. online research, portal and application research) to assist with the analysis and preparation of arbitration packages. - Work with other departments to develop or obtain information necessary for the submission of IDR packages. - Review and analyze clinical information along with documents submitted by providers of moderate to high complexity. - Meet federal filing deadlines and turnaround times. - Respond timely to all electronic, written and verbal communications, log information derived from written and verbal communication; maintain detailed and accurate records. - Outreach to clients for data needed for arbitration packages. - Maintain department productivity and quality standards. - Sensitivity to privacy in accordance with HIPAA guidelines. - Collaborate, coordinate, and communicate across disciplines and departments. - Ensure compliance with HIPAA regulations and requirements. - Demonstrate Company's Core Competencies and values held within. - The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. Job Scope Keep the needs of external and internal customers as a priority when making decisions and taking action. Operate independently under limited supervision. Has decision making authority to determine the appropriate amount of clients' offers and drafting of briefs. Works across customers, beneficiaries, providers, and supplemental payors while maintaining positive relationships. Compensation The salary range for this position is $19-21 per hour. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity. Qualifications - Minimum high school diploma or equivalent (GED) and four (4) years' experience in healthcare operations. Bachelor's degree in a related field is preferred. - Excellent organizational, analytical and independent decision-making skills. - Demonstrated problem solving skills with the ability to manage multiple priorities and meet associated timelines. - Ability to anticipate needs and solve problems proactively in a fast paced, rapidly changing environment. - Sound business judgement. - Ability to learn quickly and work independently within time constraints. - Adept knowledge of Microsoft Word, Excel and Outlook. - Logical, clear and concise written and verbal communication skills. - Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone. Benefits - Medical, dental and vision coverage with low deductible & copay. - Life insurance. - Short and long-term disability. - Paid Parental Leave. - 401(k) + match. - Employee Stock Purchase Plan. - Generous Paid Time Off – accrued based on years of service. - 10 paid company holidays. - Tuition reimbursement. - Flexible Spending Account. - Employee Assistance Program. - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits. EEO Statement Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. Application Deadline We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.