About Alaffia & Our Mission

The U.S. healthcare system suffers from over $300B in improper payments each year due to fraud, waste, abuse, and processing errors. We’re on a mission to change that. To best prevent inaccurate payments, we’ve assembled a team of experienced technologists and industry-leading healthcare domain experts. The Alaffia team has alumni ranging from Amazon, Goldman Sachs, the Centers for Medicare and Medicaid Services, and other leading healthcare and financial institutions. We’re also backed by industry-leading venture capital firms!

Location: Remote

About the Role & What You’ll Be Doing

Alaffia’s core goal is to provide cutting-edge Payment Integrity Services to our clients and fostering those relationship is a top priority. As such, we’re looking for a detail-oriented individual who loves collaboration and thrives in a client/provider facing role. You will work alongside our Payment Integrity Solutions and Engineering teams to deliver cutting-edge hospital bill & claims editing solutions to our clients. Servicing as the main point of contact, you will break down complex edits by creating an understandable reporting package that will be shared with clients and healthcare facilities. In this role, you’ll have the opportunity to drive real social and economic change by tackling fraud, waste and abuse in the healthcare industry.

Your Responsibilities

• Work cross-functionally as the primary liaison between our healthcare payer clients, healthcare facilities, and our internal teams

• Understand client scope of work and serve as the client advocate when working with internal teams to ensure that client needs are understood and satisfied

• Lead new client onboarding, training and implementation, ensuring a smooth client experience from claim receipt, claim review, and delivery of claim analysis reports

• Triage client support requests and tickets and ensure all issues are resolved in a timely manner, closing the loop amongst all necessary stakeholders

• Collaborate with our Payment Integrity team to understand and effectively communicate analysis results to all necessary stakeholders

• Contact healthcare facilities to request documentation, explain our payment integrity analyses, and resolve complex claim-related issues

What We’re Looking For

• Bachelor’s degree preferred or relevant healthcare industry experience

• 3+ years of professional experience in hospital bill reviews, claims negotiation, and provider relations

• Deep understanding of health insurance, medical billing and coding, and payment integrity

• Excellent presentation, oral and written communication skills

• Experience working with CRM databases (Salesforce)

• Must be detail-oriented and flexible to work in a fast-paced, dynamic environment

• Nice to haves:

• Prior experience working at a healthcare company or plan administrator

• Prior experience with self funded health plans

• Prior experience in contract negotiations

Our Culture

At Alaffia, we fundamentally believe that the whole is more valuable than the sum of its individual parts. Further to that point, we believe a diverse team of individuals with various backgrounds, ideologies, and types of training generates the most value. Our people are entrepreneurial by nature, problem solvers, and are passionate about what they do — both inside and outside of the office.

If you want to work alongside driven people on a mission to make a major impact at the core of U.S. healthcare by implementing the latest in cutting-edge technologies, then we’d like to meet you!

What Else Do You Get Working With Us?

• Competitive base salary

• Fully covered healthcare benefits

• Unlimited PTO

• Work in a flat organizational structure — direct access to Leadership