Teams at Claim Health

Own exception handling across healthcare revenue cycle workflows, including intake, eligibility, authorizations, claims, denials, appeals, and billing. Audit automation outputs for accuracy and compliance, investigate revenue issues, document root causes, configure rules, and identify automation opportunities. Partner with product and engineering teams to improve platform workflows while managing time-sensitive cases across payers, states, agencies, and EMRs.

Own clinical quality for an AI-driven home health and hospice documentation platform. Audit charts, validate documentation, identify automation errors, develop SOPs, partner with engineering to improve automation logic, support implementations, and track quality metrics to improve accuracy and reduce exceptions at scale.

Review and audit automated prior authorization workflows, identify failure points, translate payer rules into scalable automation with product/engineering, build SOPs, partner with clients to configure workflows, and track authorization performance metrics to drive improvements.