Role Description The Billing Denial Specialist is responsible for proactively reviewing, researching, and resolving insurance claim denials to ensure timely reimbursement and minimize revenue loss for the Practice. This role plays a critical part in the revenue cycle by identifying denial trends, filing appeals, correcting claim issues, and working denials through to resolution. The ideal candidate is highly organized, detail-oriented, dependable, and able to work independently with minimal supervision. This individual must be a self-starter who takes initiative, remains proactive, and does not require constant direction to manage responsibilities effectively. This is a fully remote position. Only qualified applicants currently residing in Florida will be considered for employment. Key Responsibilities - Review denial reports daily and actively work all assigned insurance claim denials to resolution. - Research denied, underpaid, and rejected claims to determine root cause and appropriate corrective action. - Submit corrected claims, reconsiderations, and appeals in a timely manner. - Communicate with insurance carriers regarding claim status, appeals, and reimbursement issues. - Identify denial trends and escalate recurring payer or workflow issues to leadership. - Maintain accurate and detailed documentation of all follow-up activities within the practice management system. - Work collaboratively with billing, coding, authorizations, scheduling, and clinical teams to resolve claim issues. - Ensure compliance with payer guidelines, billing regulations, and practice policies. - Prioritize workload effectively to meet productivity and aging goals. - Follow through on unresolved claims until final determination or payment is received. - Assist with special revenue cycle projects and additional duties as assigned. - Other duties as assigned. This job description is not designed to cover or contain a comprehensive list of activities, duties, or responsibilities that are required of the employee. They may change, or new ones may be assigned at any time with or without notice. Qualifications - Minimum of 3 years of medical billing and denial management experience preferred. - Experience working with commercial insurance, Medicare, Medicaid, and managed care payers. - Strong understanding of medical billing, claims processing, EOBs, appeals, and denial resolution. - Knowledge of CPT, ICD-10, and HCPCS coding preferred. - Experience with EMR and practice management systems preferred. - Proficiency with Microsoft Office and payer portals. - Ability to manage multiple priorities and meet deadlines. - Knowledge of HIPAA regulations and ability to maintain confidentiality. - Strong analytical and problem-solving skills. - Excellent attention to detail and organizational skills. - Self-motivated, proactive, and dependable. - Strong written and verbal communication skills. - Ability to identify opportunities for process improvement and workflow efficiency. - Professional, positive, and team-oriented attitude. Benefits - 100% employer-paid medical insurance for employees. - 401(k) with company match and employer-funded profit sharing. - Four-day work week (Monday – Thursday), supporting strong work/life balance. - Paid holidays and Paid Time Off (PTO). - A collaborative, team-oriented culture with strong support and a shared commitment to exceptional patient care.

Role Description Ready to take your career to the next level? Join our team as a Billing Analyst I and make an impact from anywhere! - Audit bills with precision and efficiency - Ensure compliance with Broadspire standards, state & national regulations - Help maintain accuracy and cost control Benefits - Remote Flexibility – Work from anywhere in the U.S. - Excellent Crawford Benefits programs that empower financial, physical, and mental wellness - Generous Employee Referral Bonus Program - Multiple Employee Discounts Company Description Because a claim is more than a number — it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community – one claim at a time. - Employees are empowered to grow, emboldened to act and inspired to innovate. - Industry-leading team pioneers new solutions for the industries and customers we serve. - We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. - Proudly operate as One Crawford: united in purpose, vision and values. - Total compensation plans provide each of our employees with far more than just a great salary. - Pay and incentive plans that recognize performance excellence. - Benefit programs that empower financial, physical, and mental wellness. - Training programs that promote continuous learning and career progression while enhancing job performance. - Sustainability programs that give back to the communities in which we live and work. - A culture of respect, collaboration, entrepreneurial spirit and inclusion.

Role Description A Payment Integrity Validation Specialist is an integral part of a dynamic team, aiding in the facilitation of coordination of benefits. Validation Specialists utilize access to insurance eligibility and claims payment information as well as outreach to insurance carriers to ensure member records are accurate. This role builds a foundation of knowledge that supports future advancement. What you’ll do - Verifies medical insurance eligibility data. - Accurately documents data gathered. - Meets daily production quotas. - Follows specific timeframes to complete tasks. - Uses multiple computer systems to work efficiently. - Provides excellent customer service. Qualifications - High School diploma, GED, or equivalent combination of education. - Experience with health insurance is preferred, but not required. - Excellent oral and written communication skills, including on the phone, are required. - Ability to work well independently or in a team environment. - Very strong attention to detail and organizational skills. - Word and Excel proficiency required. - Experience in the healthcare field is helpful, but not required. Requirements What Success Looks Like… After 3 months - You will have a strong understanding of the role. - You begin building relationships and collaborating with peers. - You develop effective time and priorities management. - You receive initial feedback about your performance and are using it to improve. - You’ve gained confidence in your abilities and are starting to feel more comfortable in your role. After 1 year - You have mastered the tasks and responsibilities of the position, executing them with confidence and efficiency. - You have established a strong network of internal relationships and are recognized as a key collaborator. - You’ve been entrusted with greater responsibility indicating the company’s confidence in your abilities. - You see opportunities for career progression and personal development. Benefits - PTO, Paid Holidays, and Volunteer Days. - Eligibility for health, vision and dental coverage, 401(k) plan participation with company match, and flexible spending accounts. - Tuition Reimbursement. - Eligibility for company-paid benefits including life insurance, short-term disability, and parental leave. - Remote and hybrid work options. Pay range $23.00/hour. This is a non-exempt position. Equal Employment Opportunity at Machinify We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know.

Role Description The Enrollment Specialist will be the primary contact for the Enrollment Department for Privia independent providers and responsible for all aspects of managing the payer enrollment process. - Enrolls providers new to Privia with all commercial health plans specific to the market. - Enrolls providers new to Privia with both Medicaid and Medicare. - Updates and maintains provider enrollment status in credentialing system, CredentialStream. - Reviews data in provider record, specifically taxonomy, license, and specialty and ensures it is correct prior to submitting applications. - Performs follow up with health plans according to designated timeline, until Provider is PAR. - Escalates known issues to manager for assistance. - Collaborates with credentialing team regularly to ensure that there is an awareness of all new providers who are onboarding. - Attends RCM and payer calls as needed as well as any other internal stakeholder meeting that may involve their market, as needed. - Other duties as assigned. Qualifications - 2+ years’ experience in payer enrollment function required. - Experience with RCM - enrollment claim resolution preferred. - Experience working in various payer portals required. - Verity CredentialStream or other credentialing software experience preferred. - Medicare/Medicaid payer experience required. - Demonstrated skills in problem solving and analysis and resolution. - Must be able to function independently, possess demonstrated flexibility in multiple project management. - Must comply with HIPAA rules and regulations. Requirements - The salary range for this role is $50,000.00-$55,000.00 in base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). - This role is also eligible for an annual bonus targeted at 10%. - The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Interpersonal Skills & Attributes - An individual with the ability to communicate appropriately and effectively with providers; including sensitive and confidential information. - An individual who is passionate about playing a key role in changing the current healthcare environment. - High level of attention to detail with exceptional organizational skills. - Exercise independent judgment. - Ability to problem solve and explore all options and to use available resources to find new and effective solutions. Technical Requirements - In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. - This should be acquired prior to the start of your employment. - The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/ . - Work with your internet provider if you have questions about your connection. - Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.