Health Admins

Accounting Manager

• Lead and manage the consolidated month-end close process across all legal entities, ensuring accuracy, timeliness, and alignment with GAAP.
• Ensure Health Admins maintains a state of continuous audit readiness and full compliance with applicable accounting standards and regulatory requirements.
• Serve as the accounting subject-matter expert across the M&A lifecycle — from target evaluation through post-close integration.
• Act as the accounting representative in systems integration and ERP projects, ensuring financial data integrity is preserved and accounting workflows are properly configured.
• Coordinate multi-entity, multi-jurisdiction tax compliance, working with external advisors to ensure timely and accurate filings.
• Oversee Finance's role as an operating function in the billing, collections, and escrow management lifecycle.
• Maintain complete, accurate, and client-ready accounting records for all TPA customers administered by Health Admins.
• Build, manage, and develop an accounting team capable of supporting the company's growth trajectory.

Senior Accounting Manager

Claims Specialist

• Review and process medical claims submitted by members or providers promptly and accurately.
• Verify the accuracy and completeness of claim information, including patient demographics, diagnoses, procedures, and billing codes when available.
• Ensure compliance with insurance policies and industry standards.
• Investigate and resolve any discrepancies or issues related to claim submissions.
• Conduct comprehensive medical claims audits to identify errors, discrepancies, or fraudulent activities.
• Analyze claim documentation, including medical records and billing statements, to ensure adherence to coding guidelines and reimbursement policies.
• Research complex medical billing and coding issues to support claims processing and audit activities.
• Interpret coding guidelines, reimbursement policies, and legal requirements to determine appropriate claim adjudication.
• Provide recommendations for improving claims submission procedures and enhancing reimbursement accuracy.
• Serve as members' primary point of contact regarding claims inquiries and resolution.
• Respond promptly to customer inquiries and concerns with professionalism and empathy.
• Collaborate with cross-functional teams to address customer issues and ensure timely resolution.

Claims Processor

Engineering Manager

• Own the engineering team: manage daily scrums, lead weekly team meetings, and set direction on priorities, blockers, and technical approach
• Define and drive the organization's AI and technology strategy, including platform selection, architecture patterns, and build-vs-buy decisions
• Design and own AI/ML architecture across cloud platforms (AWS Bedrock, Google Vertex AI), establishing standards for RAG implementations, agent orchestration, and model selection
• Contribute directly to production codebases; this is a hands-on role, not management from a distance
• Architect agentic systems using modern patterns: MCP (Model Context Protocol), tool-use, function calling, and multi-step orchestration frameworks
• Own the full data quality pipeline upstream of RAG: document ingestion architecture, parsing strategies, chunking methodology, and continuous iteration based on retrieval performance
• Define and implement observability strategy, evaluation frameworks, production metrics, drift detection, and quality monitoring for deployed AI systems
• Own cost optimization: model selection tradeoffs, token economics, usage monitoring, and budget forecasting at enterprise scale
• Hire, mentor, and develop engineers; build a high-performing team culture that balances speed with code quality and system longevity
• Establish and refine engineering processes: CI/CD pipelines, git workflow standards, SDLC documentation, code review practices, and onboarding programs
• Develop AI-assisted development workflows and tooling that create a multiplying effect on team productivity
• Define guardrails, compliance patterns, and scalability strategies for AI systems handling PHI
• Collaborate with Operations, Compliance/Legal, and business stakeholders to identify, prioritize, and deliver AI use cases
• Ensure all engineering and AI implementations comply with HIPAA and organizational data governance requirements
• Report to the CTO on team performance, technical direction, and strategic roadmap

VP of Engineering

Accountant

• Ownership Mapping & Process Documentation
• Policy-to-System Translation & Change Management
• Cross-System Reconciliation & Analysis
• Payment Integrity & Leak Detection
• Revenue Validation
• Escrow Operations & Governance
• Decline Management & Payment Resolution
• System Change Review & IT Guardrails
• New Client Financial Onboarding
• Exception Management & Escalation

Revenue Accountant

Data Analyst

• Ownership Mapping & Process Documentation
• Document and maintain clear accountability for every step of the payment lifecycle, from initiation through bank reconciliation.
• Map and formally document who is accountable for each segment of the payment journey across all systems and teams.
• Identify gaps where no named owner exists and work with the Operations and Finance to resolve ambiguity.
• Policy-to-System Translation & Change Management
• Translate complex financial rules into actionable system requirements and serve as the communication bridge between Finance, Operations, and IT.
• Partner with the Financial Controller to document governing policies (contribution-to-coverage eligibility, escrow governance, revenue recognition, exception authority, delinquency and reinstatement rules) and convert each into clear If/Then logic.
• Own the validation loop: when a process or system change is deployed, verify it operates as designed through structured testing and parallel runs.
• When it breaks, diagnose the root cause and re-validate.
• Serve as the primary change communication point.
• Cross-System Reconciliation & Analysis
• Execute monthly reconciliation processes across all financial systems, investigate variances, and produce analytical reporting.
• Payment Integrity & Leak Detection
• Proactively audit financial systems to identify payment failures and billing anomalies that create financial exposure.
• Develop and maintain dashboards or reporting views that surface payment integrity risks on a weekly cadence.
• Revenue Validation
• Ensure administrative fee draws are calculated against settled, stable payment data and flag variances before they flow into financial reporting.
• Escrow Operations & Governance
• Execute day-to-day escrow account operations while maintaining fiduciary controls and proper segregation of duties.
• Decline Management & Payment Resolution
• Own the full decline lifecycle as a structured, data-driven process—from detection through resolution.

Financial Data Analyst

Financial Planning and Analysis

Financial Systems & Operations Specialist

Sales

• Develop and execute a strategic sales plan to grow Health Admins' self-funded solution offerings nationally, with territory defined by existing and developing broker relationships.
• Build, cultivate, and maintain strong relationships with brokers and benefits consultants across the country to generate new business opportunities.
• Serve as a trusted advisor to brokers and prospective employer clients, educating them on the value of Health Admins' self-funded plans and Smart Healthcare Platform.
• Manage the full sales cycle from prospecting and proposal development through negotiation and close.
• Collaborate with internal teams — including underwriting, operations, account management, and marketing — to deliver tailored solutions that meet client needs.
• Monitor market trends, competitor activity, and regulatory changes within the self-funded space to identify opportunities and refine go-to-market strategies.
• Represent Health Admins at industry conferences, broker events, and networking functions.
• Track and report on pipeline activity, sales forecasts, and performance metrics to senior leadership.
• Contribute to the development of sales collateral, presentations, and RFP responses.