Top Tech Jobs & Startup Jobs in Denver & Boulder, CO

Perform line-by-line reviews of high-dollar facility itemized bills and claims (UB-04), identify billing/coding errors, validate codes (CPT, HCPCS, ICD-10, MS-DRG), compare charges to contracts and policies, document findings and recommended adjustments, refine audit processes, provide SME guidance and training, and collaborate cross-functionally to remediate payment integrity issues.

The WFM Specialist will optimize scheduling and staffing to meet business requirements, monitor service levels, and communicate adjustments to stakeholders.

Support end-to-end member data and payer eligibility to ensure accurate claims processing. Conduct payer/provider outreach for overpaid claims, make outbound provider calls, document recovery activities, escalate disputes, and assist leadership with scoping and prioritization.

Manage and negotiate contracts with hospitals and large ancillary providers to build a high-performing network. Analyze provider performance and financial data, support national network strategy, ensure regulatory compliance, collaborate with provider services, and meet SLAs and cost-saving objectives.

Perform end-to-end claims coding audits and repayment quality reviews using CPT/HCPCS/ICD-10 guidelines; document findings, create reference guides, support provider communications, train teammates, and drive process improvements for payment integrity.

Partner with cross-functional teams to analyze large healthcare datasets, build models and dashboards, and surface insights to reduce medical waste. Scope, run, and present analyses, monitor performance metrics, and support initiatives to improve financial and utilization outcomes.

Support SIU anti-fraud initiatives by auditing medical records and claims, performing quality checks of coding reviews, interpreting dashboards, documenting findings, educating providers and teams, and recommending process improvements to ensure compliance and operational targets.

The Sales Executive will drive sales by identifying and qualifying leads, educate prospects on ICHRA, and set up meetings for enrollment.

The Provider Network Associate supports provider network accessibility and quality through recruitment, engagement, and collaboration with internal and external partners.

The Manager, Network Recruitment will supervise associate recruiters, drive recruitment strategies, coach team members, and ensure efficient execution of recruitment tasks while managing provider relationships and compliance.