Jobs at Trend Health Partners

Lead the design and development of scalable document-processing systems for healthcare workflows. Build Go services and AWS Step Functions pipelines, solve large-scale PDF processing challenges, implement observability, optimize PostgreSQL/RDS performance, and support OpenSearch indexing. Provide architectural direction, mentor engineers, translate ambiguous requirements into shipped solutions, and ensure reliable handling of sensitive PHI under HIPAA requirements.

Oversees multiple strategic, interrelated projects and coordinates resources, dependencies, budgets, risks, and priorities across cross-functional teams. Establishes program governance, roadmaps, metrics, reporting, and operating cadences; communicates progress and recommendations to senior leadership. Leads organization-wide initiatives, change management, stakeholder alignment, and adoption activities while mentoring project managers and improving delivery processes, tools, and standards.

Analyzes healthcare claims, provider, pharmacy, and enrollment data to identify trends, improve data quality, optimize workflows, reduce costs, and support business decisions. Translates business needs into requirements, develops complex SQL queries, validates data, recommends process improvements, coordinates projects, and serves as a liaison among operations, research and development, IT, and external partners. Also mentors team members and communicates technical findings to nontechnical stakeholders.

Researches and analyzes healthcare claims to identify, validate, and recover overpayments for commercial insurers and state healthcare programs. Reviews contracts, payment policies, claims systems, algorithms, and regulatory guidance; resolves disputed overpayments; develops and documents new recovery opportunities; and collaborates with management, clients, providers, and team members to ensure accurate, timely claim analysis and continuous process improvement.

Reviews hospital claims, remittances, EOBs, and payer correspondence to identify underpayments and incorrect adjudications. Interprets contracts and reimbursement methodologies, initiates corrected claims, prepares appeals, follows up with payers, and tracks recoveries. Identifies systemic payment trends, documents cases, collaborates with clients and internal teams, and meets accuracy, recovery, and turnaround KPIs.

Analyzes and recovers healthcare claim overpayments by validating claims, reviewing disputes, researching payer policies, and coordinating adjustments, refunds, and offsets with providers. The role interprets medical, pharmacy, provider, and enrollment data to identify recovery trends and opportunities, supports algorithm development and production documentation, monitors performance, and collaborates with payers, providers, management, and team members.