Role Description Responsible for maintaining low denial rates and optimizing reimbursement across the enterprise by ensuring high coding standards and effective denial management practices. Leads and supports initiatives to improve coding accuracy, reimbursement outcomes, and appeal turnaround times. - Perform in-depth analysis of denial trends, including Epic system edits, coding validation, Charge Description Master (CDM) processes, authorization trends, and payer denials. - Identify opportunities for performance improvement and implement strategies to enhance revenue cycle outcomes. - Educate departments on appropriate charging, billing, and coding practices to ensure regulatory compliance. - Collaborate with Managed Care, Compliance, and operational teams to resolve complex issues with departments and payers, driving sustainable improvements in reimbursement and denial prevention. Qualifications - High School Diploma or GED required. - One (1) of the following coding certifications required: CPC, COC, RHIT, RHIA, or CCS. - One (1) to two (2) years of coding experience required. - One (1) to two (2) years of denial management and/or insurance-related experience required. Requirements - Manage and resolve clinical denials through claim corrections, resubmissions, authorization verification, payer reprocessing, reconsiderations, and appeals. - Analyze denial trends and identify opportunities to improve coding accuracy, documentation quality, reimbursement outcomes, and denial prevention efforts. - Research and resolve denials related to authorization, medical necessity, coding, billing, non-covered services, and payer policy requirements. - Prepare and submit detailed appeals and reconsiderations supported by medical record documentation, coding guidelines, and payer requirements. - Apply ICD-10-CM, CPT, HCPCS, NCCI, CMS, and payer-specific guidelines to review, validate, and correct coding and billing issues. - Review and adjust charges, diagnosis coding, procedure coding, modifiers, and billing information to ensure regulatory compliance and reimbursement accuracy. - Collaborate with Managed Care, Revenue Cycle, Compliance, Coding, and operational departments to resolve complex denial and reimbursement issues. - Monitor payer communications, policy updates, reimbursement changes, and authorization requirements to identify risks and improve reimbursement performance. - Track, trend, and report denial activity, root causes, and reimbursement opportunities while providing recommendations for process improvement. - Participate in audits, compliance reviews, denial prevention initiatives, and revenue integrity activities to improve financial performance. - Meet established productivity and quality standards while managing multiple payer work queues, including Medicare, Medicaid, government, and commercial payers. - Educate departments on denial prevention strategies, coding accuracy, charge capture, documentation improvement, and reimbursement best practices. Benefits - Work Style: Remote - Location Requirement: Must reside in an approved state (FL, GA, PA, NC, SC, TN, or TX) - FTE: Full-Time (1.0 FTE)

• Understand each customer’s workflows, KPIs, and constraints. • Translate business needs into clear, testable requirements. • Distinguish between regulatory requirements, customer must-haves, and nice-to-haves. • Develop a detailed knowledge of our product to map requirements to existing features, upcoming roadmap items, and needed customizations. • Explain the value of solutions in terms of data quality, regulatory compliance, and operational efficiency. • Define how GridUnity and customer systems exchange data. • Map fields, identify transformations, and validate data. • Guide configuration of GridUnity products and ensure customer IT environments are ready. • Partner with Project Managers and the CX team to plan and run User Acceptance Testing. • Track issues, support defect triage, and manage readiness checklists. • Coordinate cutover activities with customers and internal teams. • Work with BAs to document requirements and compare them to market best practices and product capabilities. • Create clear source-to-target data mappings, confirm data ownership and quality rules, and review historical data to reduce risk. • Identify future integration opportunities. • Contribute to Statements of Work and scoping workshops. • Act as the technical liaison during sales and early project phases. • Support or deliver product demos and training. Ensure clean handoffs to customer administrators and support teams.

Role Description Review Mortgage loan files to ensure accuracy of information and verify the presence of all required documents. Documents may include credit, title, appraisals, credit documents, property valuation, loan-to-value ratios, and debt carried. Manual Frontline Underwriting experience is required to perform this job. Qualifications - College Degree or equivalent work-related experience, and High School Diploma or equivalency required - At least 3 years of recent experience in conventional and government underwriting and Quality Assurance/Quality Control function in the mortgage banking industry - Experience in quality assurance services in a multiple client environment a plus - A strong working knowledge of calculating and verifying income & assets, and evaluating credit reports, purchase contracts, appraisals, title commitments, and other loan pertinent documentation - In depth working knowledge of AUS systems, including Loan Prospector and Desktop Underwriter - Must have manual underwriting experience, as well as automated - Must have held previous signing authority - At least an Intermediate level user of Microsoft Office Suite, with an emphasis on Word and Excel - Strong written communication skills - Ability to handle multiple tasks and prioritize workloads - Knowledge of all conventional and government underwriting guidelines for agencies Requirements - Audit a minimum of 8 files per day relating to credit, collateral, and capacity AND maintain a 98% rate of accuracy - Analyze calculations and verifications of income & assets, and evaluations of credit reports, purchase contracts, appraisals, title commitments, and other loan pertinent documentation - Enter review results into company’s proprietary software - Stay current on all agency, state and federal guidelines, and participate in on-going training as industry evolves - Review internal audit results, and discuss feedback with team lead/manager for response - Work well with others including mentoring new hires or junior level analysts as needed - Manage time efficiently and prioritize workloads to meet strict deadlines while handling multiple tasks - Be flexible in the work environment - Conduct all activities and interactions in a professional manner - Complete company/client introductory training during orientation period - Adhere to the company’s policy and procedures. - Other duties as assigned by manager Company Description

Oversee and support a team of clinicians, ensure quality ABA programming, collaborate with families to drive outcomes, and provide supervision and clinical guidance while embracing innovative approaches in behavior analysis.