Jobs at MedRisk

Processes and applies incoming payments, reconciles accounts receivable balances, investigates discrepancies, communicates with customers and internal teams, maintains documentation and reports, and supports month-end closing. The role requires basic accounting knowledge, Excel proficiency, strong attention to detail, and clear communication. Insurance billing experience and familiarity with ERP systems such as SAP or Oracle are preferred.

Evaluates workers’ compensation treatment requests for medical necessity, appropriateness, and regulatory compliance. Applies evidence-based guidelines, performs prospective, concurrent, retrospective, and appeal reviews, gathers clinical information, communicates determinations with providers, and refers cases for physician review. Maintains productivity, turnaround-time, confidentiality, and quality standards while managing utilization review processes independently.

Leads the enterprise architecture practice and owns the organization’s three- to five-year technology vision, strategy, governance, and roadmaps. Advises executives and the board on technology investments, risk, architecture, and major partnerships. Oversees architecture standards, cross-domain decision-making, technology evaluations, due diligence, and platform strategy. Mentors architects across application, data, infrastructure, security, and enterprise domains while advancing organizational architecture maturity, scalability, compliance, security, and cost efficiency.

Manages software configuration, release planning, migration, deployment, version control, build processes, audits, and change control. Coordinates with business analysts and quality assurance teams to ensure software changes meet organizational and customer requirements. Develops procedures, supports source-code repository workflows, deploys applications across environments, analyzes IT issues, and prepares recommendations and audit documentation. The role requires strong configuration management, software lifecycle, documentation, communication, data analysis, and problem-solving skills.

Owns the strategy, roadmap, requirements, delivery, governance, and adoption of data and analytics products built on Snowflake and delivered through Power BI. Partners with engineering, analytics, governance, and business stakeholders to prioritize backlogs, define data models, validate quality, coordinate dashboard releases, manage UAT, and improve data product performance, accessibility, and self-service analytics adoption.

Plans and delivers complex technical initiatives involving systems implementations, integrations, data, infrastructure, databases, and cloud platforms. Translates technical requirements into project plans, manages risks and dependencies, applies PMO governance, and reports progress to leadership. Owns the Microsoft enterprise relationship, supports FinOps enablement, and advises other project teams on technical considerations. Coordinates engineering, IT, finance, vendors, and business stakeholders throughout project delivery.

Leads large-scale workers’ compensation bill review operations, overseeing service delivery, client satisfaction, workforce planning, process optimization, budgets, and business growth. Manages multiple leadership layers and operational teams while establishing performance goals, monitoring service metrics, driving automation and AI initiatives, and partnering with technology, product, quality, compliance, sales, and clients. Requires extensive healthcare, claims, payment integrity, or medical bill review leadership experience.

Researches complex billing, claims, and reimbursement issues to support accurate revenue collection. The analyst identifies trends, reports workflow opportunities, proposes process improvements, documents resolutions, meets productivity standards, and protects patient account confidentiality under HIPAA guidelines.

Provides inbound phone support to providers and collection staff regarding claim status. Explains billing processes and timing, coordinates with internal departments to resolve inquiries, meets customer service and quality standards, maintains agent availability goals, follows procedures, identifies system or process issues, and completes assigned tasks.

The Client Solutions Manager oversees project management for client projects, coordinating with business and tech teams while ensuring effective communication and deliverables adherence. Responsibilities include gathering requirements, managing workflows, and maintaining project timelines.

The job description only identifies a Director of Network Development position and provides no details about responsibilities, qualifications, technologies, compensation, travel, or work authorization.

Analyze and resolve billing, claims, and reimbursement issues to ensure accurate, timely revenue receipt. Identify trends, report patterns to management, propose workflow improvements, document resolutions, meet production standards, and maintain HIPAA confidentiality for patient accounts.