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Cura is growing and we are always interested in meeting talented individuals who are passionate about revenue cycle and the recovery of underpayments.  We operate as an extension of our client's business office and therefore fulfill many roles in the revenue cycle. 

From data management and contract modeling to underpayment analysis and collections follow-up, if you are passionate about the healthcare revenue cycle, possess an analytical problem solving mindset and enjoy an energetic team environment we would like to hear from you.

We are currently seeking applicants for the roles listed below.  For consideration, please forward your resume referencing position of interest along with a brief summary of why you are interested in joining the Cura team to talent@curarcm.com.

Current Openings:

Audit Specialist

Denial Audit Specialist

Collections Specialist

Denial Management Specialist

Senior Programmer Analyst

Manager, Denial Management Services

Clinical Appeals Specialist

Data Programming Analyst

Audit Specialist

 

Position Summary:  Primarily responsible for the thorough review of managed care and other insurance contracts; comparison of such contracts against healthcare claims to identify underpayments stemming from contractual variances, denials, and billing/coding issues. 

 

Essential Duties and Responsibilities:

  • Maintain a professional attitude and approach with payers, colleagues, and clients 

  • Review and interpret customer’s managed care contracts, government-based, worker’s compensation and other payer contracts and fee schedules to ensure accurate calculations per the terms of the agreement

  • Model contract terms, rates and fee schedules in contract management software to evaluate accuracy of insurance payments

  • Assist in improving and developing internal software and solutions

  • Examine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentation 

  • Contact insurance companies to explain and resolve underpayments and arrange for payment or adjustment processing on behalf of client 

  • Document information in appropriate Cura and client systems

  • Prepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and payment posting 

  • Monitor periodic changes in recognized coding schemes (ICD, CPT, DRG, etc.) to anticipate contract language, calculation and reimbursement changes 

  • Develop reports and communicate project status to internal and client team members

  • Performs other duties as assigned 

 

Essential Skills and Experience:

  • Minimum 2 years of experience working in the hospital reimbursement space (patient accounts, revenue cycle, managed care, payment review, etc)

  • Basic understanding of Medicare, Medicaid and third-party reimbursement guidelines

  • Experience working with ICD-10, DRG, CPT-4 and/or HCPCS coding systems

  • Knowledge of UB04s

  • Strong quantitative and analytical skills

  • Technically savvy with ability to manage large sets of data

  • Ability to identify trends and perform root cause analysis

  • Excellent time management and problem-solving skills

  • Excellent communication skills, both written and verbal; ability to explain complex issues with ease

  • Demonstrates computer proficiency including working knowledge of MS Office Suite, particularly Excel 

  • BS/BA Business or Health Administration preferred, other majors considered

Denial Audit Specialist

 

Position Summary:  Primarily responsible for review, follow up and denial management activities related to the collection of underpaid and denied hospital claims. Researches and resolves account issues including identifying root cause of denials, thorough review of managed care and other insurance contracts, identifying information needed to appeal and correctly process claims; generally working to identify and resolve issues to collect payment as expediently as possible. We are seeking a candidate with denial and appeal experience and familiarity with managed care contract terms and reimbursement methodologies to fill this position. 

 

Essential Duties and Responsibilities:

  • Maintain a professional attitude and approach with payers and clients

  • Evaluates and identifies recovery opportunities 

  • Performs all appeals and denial recovery procedures needed to appropriately and accurately resolve technically denied claims

  • Prepare and submit correspondence such as online inquiries, appeals, and letters for payment processing

  • Processes and resolves rejections and denials received from payers

  • Follow up on claims in a timely fashion as outlined in departmental policies and procedures 

  • Utilize online payer portals as appropriate to submit appeals

  • Document information in appropriate internal and client systems

  • Maintain regular contact with necessary parties regarding claims status 

  • Comply with federal and state laws, company and department policies and procedures 

  • Performs other duties as assigned

 

Essential Skills and Experience:

  • Minimum 5 years of experience working in a hospital patient accounts/revenue cycle, managed care, or related setting 

  • Experience working denials and appeals to resolution 

  • Basic understanding for Medicare, Medicaid and third-party reimbursement guidelines

  • Experience working with ICD-9, ICD-10, CPT-4 and/or HCPCS coding systems

  • Basic knowledge of UB04s and CMS1500s

  • Experience performing account resolution with third party payers 

  • Accounts receivable collections from payers 

  • Experience accessing and submitting documentation through payer portals

  • Ability to effectively identify and communicate payer trends 

  • Organization and documentation skills to ensure timely follow-up and accurate record keeping 

  • Strong customer service orientation

  • Team player

  • Demonstrates computer proficiency including working knowledge of MS Excel and Word

  • High School diploma or equivalent

Collections Specialist

 

Position Summary:  Primarily responsible for the thorough review of managed care and other insurance contracts, comparison of such contracts against healthcare claims to identify underpayments and thorough follow-up and collection of underpaid healthcare claims. 

 

Essential Duties and Responsibilities:

  • Maintain a professional attitude and approach with payers and clients 

  • Review insurance contracts to gain thorough understanding of payment methodologies 

  • Examine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentation 

  • Contact insurance companies to explain and resolve underpayments and arrange for payment or adjustment processing on behalf of client

  • Follow up on claims in a timely fashion as outlined in departmental policies and procedures

  • Document information in appropriate internal and client systems

  • Prepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and payment posting

  • Maintain regular contact with necessary parties regarding claims status 

  • Comply with federal and state laws, company and department policies and procedures

  • Performs other duties as assigned

 

Essential Skills and Experience:

  • Minimum 2 years of experience working in a hospital patient accounts/revenue cycle, managed care,
    or related setting 

  • Basic understanding for Medicare, Medicaid and third party reimbursement guidelines

  • Experience working with ICD-9, ICD-10, CPT-4 and/or HCPCS coding systems

  • Basic knowledge of UB04s and CMS1500s

  • Experience performing account resolution with third party payers 

  • Accounts receivable collections from payers 

  • Ability to effectively identify and communicate payer trends 

  • Experience working denials/appeals to resolution preferred

  • Organization and documentation skills to ensure timely follow-up and accurate record keeping 

  • Strong customer service orientation

  • Team player

  • Demonstrates computer proficiency including working knowledge of MS Excel and Word

  • High School diploma or equivalent

Denial Management Specialist

 

Position Summary:  Primarily responsible for review, follow up and denial management activities related to the collection of denied hospital claims. Researches and resolves account issues including identifying root cause of denials, thorough review of managed care and other insurance contracts, identifying information needed to appeal and correctly process claims; generally working through issues to collect payment as expediently as possible. 

 

Essential Duties and Responsibilities:

  • Maintain a professional attitude and approach with payers and clients 

  • Performs all appeals and denial recovery procedures needed to appropriately and accurately resolve technically denied claims

  • Evaluates, identifies, and coordinates with Clinical staff

  • Prepare and submit correspondence such as online inquiries, appeals, and letters for payment processing

  • Processes and resolves rejections and denials received from payers

  • Follow up on claims in a timely fashion as outlined in departmental policies and procedures 

  • Utilize online payer portals as appropriate to submit appeals

  • Document information in appropriate internal and client systems

  • Maintain regular contact with necessary parties regarding claims status 

  • Comply with federal and state laws, company and department policies and procedures 

  • Performs other duties as assigned

 

Essential Skills and Experience:

  • Minimum 5 years of experience working in a hospital patient accounts/revenue cycle, managed care, or related setting 

  • Experience working denials and appeals to resolution 

  • Basic understanding for Medicare, Medicaid and third party reimbursement guidelines

  • Experience working with ICD-9, ICD-10, CPT-4 and/or HCPCS coding systems

  • Basic knowledge of UB04s and CMS1500s

  • Experience performing account resolution with third party payers 

  • Accounts receivable collections from payers 

  • Experience accessing and submitting documentation through payer portals

  • Ability to effectively identify and communicate payer trends 

  • Organization and documentation skills to ensure timely follow-up and accurate record keeping 

  • Strong customer service orientation

  • Team player

  • Demonstrates computer proficiency including working knowledge of MS Excel and Word

  • High School diploma or equivalent

Senior Programmer Analyst

 

Position Summary:  Primarily responsible for the development and delivery of technology solutions to support the business objective of identifying and recovering underpayments. Collaborates with cross-functional team members throughout process to ensure objectives are met. 

 

Essential Duties and Responsibilities:

  • Develop, maintain, and operate all logic-driven and data exchange platforms required to complete Cura’s products

  • Assist in development, maintenance, and operation (as necessary) of all proprietary products and workflow tools used by Cura’s employees

  • Assist in achieving operational objectives by maintaining current IT systems, evaluating, and installing new technology, contributing information and recommendations to strategic plans and reviews, and preparing and completing action plans

  • Review, analyze and research instrumentation and business data to identify or isolate performance, functional or data defects

  • Provide mentorship and guidance to other members of the software development team, when necessary

  • Serve as a contact with third party technology partners, when necessary

  • Provide periodic technology support for other team members

  • Take appropriate precautions to ensure security and integrity of all data, which may be commercially sensitive and/or contain Protected Health Information

 

Essential Skills and Experience:

  • Minimum 8 years of experience in designing and developing medium- to large-scale software

  • Minimum 8 years of .NET development - C#, ASP.NET MVC, Visual Studio, Entity Framework & SQL Server

  • Minimum 3 years of EDI experience, including 270/271, 276/277, 278, 837/835 transactions

  • Expertise in refactoring existing applications for performance, maintainability and scalability

  • Familiarity with healthcare industry, business process automation, model driven development, or CodeSmith a plus

Manager, Denial Management Services

 

Position Summary:  Primarily responsible for the supervision of large retrospective and ongoing denial resolution projects related to accounts from governmental and third-party payers for hospitals/health systems.  Manages daily activities and inventory related to appeal functions, ensuring processes are performed accurately, efficiently, and effectively to meet recovery targets, staff performance, project planning and client engagement. The successful candidate works independently under the guidance of the Senior Director; has a thorough understanding of hospital revenue cycle, including billing, coding, collections, prevailing reimbursement methodologies, governmental and third-party payer requirements; experience owning client and project P&L’s; experience hiring and managing staff and productivity metrics; technically and data savvy; excellent communication skills; excellent client engagement skills. 

 

Essential Duties and Responsibilities:

  • Manage denial resolution projects for multiple hospital/health system clients 

  • Budget and manage P&L for projects, including directing scope, resource planning and tracking productivity

  • Hire and mentor team of expert staff that performs account level clinical and technical appeals and account resolutions

  • Work closely with staff to prioritize and disseminate worklists to triage, appeal and follow up for ongoing account resolution, leveraging automation and best practice methodologies

  • Responsible for payment posting, invoicing and return reporting

  • Analyze trends in insurance denials and work to effectively resolve, including bulk projects with counterparts at payers

  • Own client engagement process with appropriate members of hospital revenue cycle, including implementation, meetings (onsite and virtual), and reporting processes

  • Responsible for reports and communicating project status to internal and client team members

  • Travel occasionally as required

  • Performs other duties as assigned

 

Essential Skills and Experience:

  • Minimum 6 years of experience working in a hospital acute care setting/revenue cycle, reimbursement, managed care, related consulting, or other related setting (physician and ambulatory experience does not qualify)  

  • Minimum 3 years of experience managing team and P&L

  • Expert understanding of governmental and third-party payer authorization, claim submission and reimbursement guidelines 

  • Extensive experience working in hospital patient account systems and payer portals

  • Strong knowledge of with ICD-10, CPT-4 and/or HCPCS coding systems

  • Exceptional communication skills (oral and written)

  • Strong quantitative and analytical skills

  • Technically savvy with ability to manage large sets of data; proficiency in SQL preferred

  • Polished and professional with excellent client engagement and presentation skills

  • Highly skilled and experienced in the industry with strong revenue cycle management subject matter expertise

  • Excellent time management and problem-solving skills

  • Reliable, responsible, self-directed, goal-oriented and flexible 

  • BS/BA required; Business or Health Administration preferred; other majors considered

Clinical Appeals Specialist

 

Position Summary:  Primarily responsible for thorough review of claim denials from managed care and other insurance carriers and denial management activities related to the collection of denied hospital claims. Handle verbal and/or written appeals requiring clinical input or interpretation, as well as identify coding or clinical documentation issues and work to correct and overturn denials. 

 

Essential Duties and Responsibilities:

  • Review and perform retrospective reviews, investigates and appeals all clinical level denials such as not medically necessary inpatient stays or levels of care, authorization or other denial issues

  • Audit Medical Records to retrieve clinical information for appeal, prepare appeal correspondence

  • Utilize online payor portals

  • Review and process correspondence including approvals and denials/adjustments, demand letters and results from various levels of appeals

  • Working with team to monitor, track, trend and coordinate denial resolution with payers

  • Communicates with all parties in a professional manner to alert of specific problem issues

  • Performs other duties as assigned

 

Essential Skills and Experience:

  • Licensed as an RN or LPN (must possess and maintain a current state nursing license)

  • Bachelor’s degree desirable, but equivalent job experience will be considered

  • At least 3 years of experience as a Case Manager or equivalent is desired

  • At least 1 year experience with medical necessity appeals at all levels is preferred

  • Experience using standardized clinical guidelines; InterQual experience preferred

  • Working knowledge of the revenue cycle

  • Knowledge of medical terminology and/or insurance claim filing experience

  • Detail oriented, analytical and ability to problem solve

  • Excellent written and oral communication skills

  • Demonstrates computer proficiency including working knowledge of MS Excel and Word

Data Programming Analyst

Position Summary:  Primarily responsible for targeted data analysis of hospital claims data and developing and tracking reporting metrics for operations as well as development and programming tasks to increase operational efficiency, including working with internal stakeholders. 

 

Essential Duties and Responsibilities:

  • Analyze and review hospital claims data, 837/835 data, and other data sources

  • Perform comprehensive data analysis on targeted data sets with the end result of creating work items for the operations team 

  • Develop and track reports using queries and report templates, modifying these queries as required, and communicating project status to internal team members

  • Undertake ad hoc analysis for internal distribution

  • Work cross-functionally with IT on development initiatives

  • Ability to balance day-to-day demands and long-term project initiatives

  • Perform other duties as assigned

  • Role will report directly to Director, Underpayment Recovery Services

 

Essential Skills and Experience:

  • Experience working in data analysis, building queries and analytical reports

  • Some experience in software development using a C based language

  • Proficiency with computer systems, data management concepts and database structures

  • Strong SQL skills to manage large sets of data, identify trends and perform root cause analysis

  • Strong Excel skills

  • Strong analytical and creative problem-solving skills with the ability to “think outside the box”

  • Experience working with healthcare data