Role Description Work remotely while using your denial management expertise to make a direct impact on healthcare operations. - Work Style: Remote - Location Requirement: Must reside in Florida or Georgia - FTE: Full-Time (1.0 FTE) Responsible for reviewing technical denial claims and submitting reconsiderations and appeals to ensure accurate and timely reimbursement. Optimizes financial performance within the revenue cycle by maintaining low denial rates and maximizing recovery across the enterprise. - Conducts root cause analysis of denied payments through comprehensive review of patient encounters, payer contracts, historical denial trends, and appeal outcomes. - Maintains strong relationships with third-party payers, responding to inquiries, disputes, and correspondence. - Collaborates with Enterprise Technical Denial Assistance leadership and Managed Care to escalate and resolve complex denial issues while ensuring compliance with state and federal regulations. - Serves as a subject matter expert in denial management, partnering with revenue cycle teams to implement best practices that improve reimbursement and reduce organizational write-offs. Qualifications - High School Diploma or GED required - Minimum of four (4) years of experience in billing, insurance follow-up, collections, or denial management within a hospital or clinical setting Requirements - Identify, prioritize, and resolve denied claims, including initiating timely appeals and reconsiderations - Interpret and apply payer contract terms to ensure accurate claim resolution and reimbursement - Conduct internal and external correspondence clearly, professionally, and in compliance with organizational standards - Review and take appropriate action on EOBs, denial letters, appeal determinations, and documentation requests in a timely manner - Meet productivity and accuracy standards, including working an average of 60 accounts per day with a 98% accuracy rate - Manage and work multiple payer workqueues, including Medicare, Medicaid, government, commercial, and Medicare Advantage plans - Research and resolve denials related to eligibility, registration, billing errors, missing information, and documentation requests - Initiate and follow up on appeals to prevent timely filing denials and ensure optimal reimbursement outcomes - Evaluate accounts and drive resolution using tools such as remittance advice, denial codes, and payer communications - Identify payer-specific denial trends and escalate findings to leadership with actionable insights for root cause analysis - Collaborate with revenue cycle teams across the enterprise to recommend process improvements and prevent future denials - Review payer policies and communications to identify risks to reimbursement and stay current on regulatory and industry best practices - Proactively identify and resolve at-risk A/R to minimize revenue loss and ensure compliance with contractual deadlines Company Description

• The Analyst will record documents in the ERP, perform month-end closings, calculate and remit direct and indirect taxes; • Analysis of indirect taxes and ERP master data; • Filing of tax obligations (EFD CONTRIBUTIONS / SPED FISCAL / MIT / DCTFweb / REINF / GIA / DIRF / SCANC / SIMP, etc.); • Research tax legislation and provide updates to clients as necessary; • Resolve outstanding tax issues to enable issuance of federal, municipal and state tax certificates.

• Prestar Suporte de Nível I via telefone, chat e presencialmente. Orientar os usuários de forma clara sobre o uso dos módulos, características e dúvidas operacionais do sistema. • Atender aos chamados de suporte, realizando as parametrizações e ajustes de configuração no sistema, garantindo a conclusão das demandas dentro dos prazos estipulados, gerenciar o próprio tempo e priorizar a fila de chamados de forma eficaz. • Realizar a análise e diagnóstico inicial de incidentes de produção. Em casos de problemas de Nível II, efetuar o escalonamento imediato para o suporte técnico remoto, e acompanhar, homologar e validar a entrada da solução em produção. • Aplicar conhecimentos básicos em SQL, JavaScript, HTML e CSS para criar formulários dinâmicos, otimizar processos internos e desenvolver relatórios gerenciais (BI) para apoiar a tomada de decisão. • Mentalidade digital, curiosidade por novas tecnologias e interesse em entender como a Inteligência Artificial pode transformar processos, experiências e resultados.

Role Description cFocus Software seeks a Vulnerability Analyst to join our program supporting the National Institutes of Health (NIH). This position is fully remote. This position requires a Public Trust or the ability to obtain a public trust clearance. - Direct vulnerability scanning activities across NIH enterprise systems. - Develop enterprise vulnerability management strategies. - Establish vulnerability assessment priorities based upon risk. - Continuously improve enterprise vulnerability management capabilities. - Analyze enterprise vulnerability scan results. - Perform vulnerability prioritization using risk-based methodologies. - Identify critical vulnerabilities requiring immediate remediation. - Evaluate exploitability and business impact. - Conduct root cause analysis. - Validate corrective actions. - Track vulnerability trends and recurring issues. - Coordinating remediation efforts with System Owners. - Tracking remediation progress. - Monitoring SLA compliance. - Escalating critical vulnerabilities within required timeframes. - Validating remediation completion. - Supporting risk acceptance processes. - Reducing enterprise cybersecurity risk. - Monitoring aging vulnerabilities. Qualifications - Public Trust Clearance - B.S. Computer Science, Information Technology, or a related field - 7+ years with vulnerability assessments or vulnerability management programs. - Experience managing enterprise vulnerability scanning solutions. - Experience with penetration testing efforts. - Experience supporting Federal cybersecurity programs. - Experience with RMF, FISMA, and NIST guidance. - Experience developing executive cybersecurity reports. - Ability to obtain and maintain NIH suitability/background investigation.