Role Description The ITS Team Lead is responsible for the overall coordination and leadership of department initiatives and projects, including the efforts of other project team personnel. This role provides procedural guidance and assumes responsibility for achieving desired results in conjunction with the ITS Manager and Leadership. Key responsibilities include: - Guiding a team of analysts and/or programmers in the planning and development (and/or support) of automated and manual systems. - Evaluating requests for systems development and enhancement and their respective resource requirements. - Developing project milestones and deliverables in conjunction with team members and management. - Conducting needs analysis studies, including evaluation of the current environment. - Participating with users and team members to define and document current and future business needs. - Assisting management in assessing feasibility and cost benefits studies. - Documenting specific design specifications and participating in the design of production and conversion plans. - Developing test data and/or designs of test protocols. - Developing implementation plans and supporting the implementation process. - Assisting in the development of user and ITS procedure manuals. - Monitoring progress against plans and providing management reports as required. - Assisting technical team and management in the development of plans for maintenance and development of assigned systems. - Analyzing and evaluating outside software and assisting in preparation of recommendations for acquisition. - Participating in determining the nature and scope of project activities and processes to be developed or modified. - Arranging test data and coordinating test processing for newly developed systems. - Establishing and evaluating program efficiency by analyzing performance and determining the accuracy of results. - Participating in the development of formal cost estimates, time, and personnel to develop and/or modify systems. - Participating in the development of formal statements of expected performance of new or modified systems. - Performing job-related duties in conformance with ITS standards. - Supporting the "I Am Yale-New Haven" service excellence program. - Performing other job-related duties as required. Qualifications - Bachelor's degree in Computer Science or related required. - With a Bachelor's degree, 3 to 5 years of experience in a variety of programming and analytical activities; at least four (4) years of analytical experience in an online, real-time, and database environment. - In lieu of a Bachelor's degree in an IT-related field: 8 years of progressive, related work experience, at least 4 of which are related to analytical experience. - Experience in a healthcare environment preferred. Requirements - Ability to work independently and meet deadlines with minimal supervision. - Ability to deal with simultaneous tasks, communicate effectively, problem solve, and develop creative solutions to complex problems. - Demonstrated ability to work well under tight time constraints and manage time effectively. - Strong organizational, problem-solving, and listening skills. - Attention to detail, innovative thinking, and ability to inspire others. - High level of customer service skills and ability to participate as a strong collaborative team player. - Capability of taking a leadership role in managing end-user relationships. - Customer Focus: Independently leads efforts and maintains ongoing engagement with customers. - Problem Solving: Facilitates basic problem-solving discussions and encourages members to see problems as improvement opportunities. - Innovation: Creates an environment that encourages a questioning attitude and adapts agile principles. - Adaptability: Accountable for executing the strategic plan and participating in initiative development. Benefits - Must be willing to travel to all YNHHS delivery networks and practice locations for support needs. - 24x7 on-call rotation support.

Role Description - Conduct internal audits of services prior to claim submission to identify errors, inconsistencies, or missing information. - Research discrepancies by reviewing documentation, scheduling data, authorizations, and payer requirements. - Communicate with providers and internal team members to clarify services delivered and ensure claims reflect accurate clinical activity. - Make necessary corrections or adjustments within the practice management system to finalize clean claims. - Apply payer-specific and state-specific billing rules to ensure compliance and prevent denials. - Demonstrate an understanding of underlying billing rules and regulatory intent to appropriately resolve new or uncommon scenarios. - Review Explanation of Benefits (EOBs), Electronic Remittance Advice (ERA), and bank deposit information to accurately post payer payments. - Reconcile posted payments against deposit totals and identify discrepancies or underpayments. - Flag potential payer issues, trends, or inconsistencies for escalation. - Maintain accurate financial records within the billing system. - Generate and correct patient invoices as needed. - Follow up with patients or responsible parties regarding outstanding balances. - Document outreach attempts and payment arrangements. - Support timely resolution of patient balances to improve overall accounts receivable performance. Qualifications - Bachelor’s degree (BA/BS) highly preferred. - Previous experience in medical billing, claims auditing, revenue cycle management, accounts receivable, payment posting, or healthcare administration required. - Strong understanding of claim auditing and claim-cleaning processes required. - Ability to review documentation, authorizations, scheduling records, and payer requirements to identify claim discrepancies. - Experience reviewing EOBs and ERAs preferred. - Strong attention to detail and analytical skills required. - Strong communication and problem-solving abilities required. - Ability to interpret payer-specific and state-specific billing guidelines. - Experience working with billing software or practice management systems preferred. - Ability to manage multiple tasks and deadlines in a fast-paced environment. - Ability to work independently in a remote environment. - Reliable internet connection and a suitable home office setup. Requirements - Experience with ABA billing codes and authorization structures preferred. - Multi-state or multi-payer billing experience preferred. - Experience posting payments and reconciling deposits preferred. - Familiarity with denial prevention and claims auditing workflows preferred. - Experience using medical billing software and practice management systems preferred. - Experience working with US healthcare insurance payers and reimbursement processes preferred. - Comfortable working U.S. hours. Benefits - Remote work from home. Company Description Fraud Disclaimer: ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.

Title: Medical Claims Billing & Case Management Specialist Location: Remote United States Job Description: The Sr. AR & Case Management Specialist (Sr. AR Manager) is responsible for complete, accurate and timely processing of all designated claims, reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming SalesForce cases and providing information as requested or properly authorized. The Senior AR Manager will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues and the team resolving the cases is a key element in this role. Additionally, the Senior AR Manager is responsible for overseeing functions within Accounts Receivable in accordance with compliant best practices, such as Claims Worklists, Zero Pay, Unapplied, and Denials, to ensure that all are reviewed, reconciled and resolved in a timely matter. The Senior AR Manager will also serve as an subject matter expert and point of escalation on one of our internal sub-teams. - Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; writing rules where appropriate to stop errors from occurring. - Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives. - Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques. - Serves as an escalation point, and escalates issues to the appropriate party. - Suggest and run point on policy updates as needed. - Work directly with practice consultants and/or physicians via Salesforce to ensure optimal revenue cycle functionality - Focused on driving toward achievement of department's daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals. - Other duties as assigned - High School Graduate. - 5+ years experience in a physician medical billing office or equivalent claims experience - Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims - Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas) preferred - Experience working with athenaOne suite of tools preferred - Experience using Salesforce for case management preferred - Must provide accessibility to private, quiet work space with high-speed internet to effectively work remotely (if a remote worker) - Experience with VA payers & providers preferred - Must comply with HIPAA rules and regulations - Excellent written and verbal communication The hourly range for this role is $23/hr to $25/hr in hourly 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. All your information will be kept confidential according to EEO guidelines. Technical Requirements (for remote workers only, not applicable for onsite/in office work): 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/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. 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. Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.

Title: Prior Authorization Specialist Location: Lone Tree, Colorado Job Description: Change people’s lives and love what you do! Cochlear is the most recognized brand in hearing health care. Prior Authorization Specialist (Internal title: Reimbursement Operations PreClaim Specialist) Position Spotlight: - In-person comprehensive role-based training provided - Fixed 8-hour shift schedule within business hours 8:00 a.m. – 5:00 p.m. Mountain Time, Monday through Friday; possible Saturday shift depending on business needs - Hybrid work model once training is completed and cleared by your supervisor About the role Change people’s lives and love what you do at Cochlear—the most recognized brand in hearing health care—helping people hear and be heard around the world, while being part of one of Denver Business Journal’s 2026 Best Places to Work honorees in Denver! In this role, you will be based in our Americas head office based in Lone Tree, CO. This role requires full in-person attendance during the initial training period and transitions to a hybrid work model based on performance, as assessed by your supervisor. If you bring experience in full-cycle prior authorization submissions and are eager to further develop your skills and advance your career, this is a fantastic opportunity to join the Reimbursement Operations team at the global leader in implantable hearing devices! Your success in this role is measured by your ability to facilitate all pre-claim activity for reimbursement orders while providing exceptional service to internal and external customers. Work collaboratively with your peers within a region setting where you will develop subject matter expertise, as well as with internal stakeholders in Billing and Collections, Customer Experience and other operations teams to provide the most efficient order process for our recipients. Key Responsibilities - Verify eligibility, investigate insurance benefits and validate coverage; calculate and collect recipient out of pocket estimates based on their deductible, coinsurance and out of pocket maximum - Navigate and utilize operational resources while managing orders following date and urgency prioritization workflow - Collect documentation based on payor requirements and medical professional preferred method - Evaluate medical documentation for accuracy, requirements and validity and submit to insurance for prior authorization when required - Communicate professionally, effectively and clearly with customers to ensure understanding and meet the customer need; engage with cross functional business partners to support reimbursement processes, orders and customers - Secure in network exceptions and negotiate one-time agreements with insurance payors in which Cochlear is non-participating Key Requirements To add value to Cochlear in this role you'll be able to meet and demonstrate the following knowledge, skills and abilities in your application and at interview: - Bachelors or Equivalent Work Experience - 2-3 years of experience ideally working with health insurance, including but not limited to: - Insurance Verification - Prior Authorization - Coordination of Benefits - Out of Pocket cost estimate calculations - Proven ability to work collaboratively and positively in a team environment to build strong, professional relationships - Excellent computer skills (preferably in Microsoft Office) and experience utilizing common office resources (phone, fax, copier and email). - Excellent verbal and written communication skills Salary and Benefits In addition to the opportunity to develop your knowledge and grow professionally, we offer competitive wages and benefits. - Target Salary Range/Rate: $23.50 - $26.00 per hour based upon experience, as well as an annual bonus opportunity of 5% of base salary. Compensation offered to candidate may vary based on work experience, education and/or skill level. - Benefit package includes medical, dental, vision, life and disability insurance as well as 401(K) matching with immediate vesting, Paid Time Off, tuition reimbursement, maternity and paternity leave, Employee Stock Purchase Plan and pet insurance. Who are we? Human needs have always been our inspiration, ever since Professor Graeme Clark set out to create the first multi-channel cochlear implant because he saw his father struggle with hearing loss. We always start with people in mind – thinking about their needs. For this reason, our products, services and support will continue to evolve and improve. We are by our customers’ side through the entire hearing journey, so they can experience a life full of hearing. Our employees tell us that the number one reason they enjoy working for Cochlear is the opportunity to make a difference to people’s lives and working in an organization where they can be part of bringing the mission to life each day. Physical & Mental Demands The physical and mental demands described below are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the individual is regularly required to be in a stationary (seated/standing) position; utilize business technology for work product delivery, communicate orally and in writing with others internal or external to the organization, utilize problem solving/critical thinking skills to discern and convey information. May be asked to occasionally transport/move up to 30 pounds, depending on the position. Specific vision abilities required by this job include ability to adjust focus. The individual is regularly required to utilize comprehension, critical thinking, communication, problem solving, organization reasoning, relating to others and discernment of items such as product specifications, procedures and processes to customers (whether internal or external). Influence, organization/classification of information and planning are also required. The work environment is a home/office environment and are representative of those an individual encounters while performing the essential functions of this job. Cochlear Americas is an Equal Opportunity Employer. We will provide reasonable accommodations for qualified individuals with disabilities. If you require accommodation with completing the online application.