Netsmart

QA Engineer

• Oversee Coding & OASIS staff competency to ensure accuracy, consistency, and compliance with guidelines.
• Develop and deliver new-hire orientation and ongoing training, including client-specific processes and updates.
• Conduct Quality Assurance (QA) reviews, document findings, identify trends, and collaborate closely with QARs performing day‑to‑day QA.
• Serve as the expert resource for complex Coding & OASIS questions and maintain updated knowledge resources.
• Partner with managers, clients, and internal teams to support client onboarding, quality discussions, and process alignment.
• Work collaboratively with both stateside and offshore (India-based) review teams to support training, quality standards, and workflow consistency.
• Test and provide feedback on McBee Clinical Review platform functionality.
• Communicate quality concerns to all appropriate stakeholders and support resolution actions.

QA Specialist

Account Executive

• Identify and participate in strategic sales pursuits for assigned clients to meet and exceed annual quota
• Forecast accurately and close business on time
• Conduct initial evaluation of prospective clients; identify and prioritize client’s business needs
• Suggest appropriate solutions to match those needs
• Understand and position new and existing solutions for growth within our current client base
• Actively participate in demand generation campaigns to create pipeline
• Generate, manage and grow new business by prospecting for new clients in person and via the telephone
• Cultivate regular direct contact with all prospective new clients
• Work with technical and marketing support staff to qualify and complete RFPs

Senior RCM Sales Executive

Consultant

• Provide technical and product support for sales teams including solution presentations, proposal responses and follow up for current and prospective clients
• Present scripted and unscripted solution presentations to large and small groups; demonstrating knowledge of solution's features and functionalities and effective facilitation of discussion and questions
• Develop and apply knowledge of industry intelligence and trends relevant to specific audiences
• Coach others to clearly articulate and promote Netsmart’s competitive advantages during solution demonstrations
• Promote Netsmart solutions at industry events, trade shows, client meetings and Netsmart’s annual health conference meeting
• Review responses as a part of bid submissions or requests for proposals (RFPs); contribute clinical, financial and local workflow expertise as applicable, and share key RFP feedback with solution presenters
• Maintain appropriate knowledge base for industries served to facilitate ongoing product development and product offerings to market

Solution Consultant

Solutions Engineer

• Provide expertise during client engagement to deliver workflow and solution design
• Responsible for guiding clients through current workflows, upgrades, system changes, enhancements, and ongoing system maintenance
• Act as a primary consultant for the client’s solution troubleshooting, consultation, and knowledge transfer

Business Solution Architect – Consulting

Accounts Receivable

• Responsible for researching and resolving outstanding balances by following up on claim status, working denials, and filing appeals.
• Manage the end-to-end A/R workflow including billing, payment posting, adjustments, reconciliation, claim follow-up, and resolution.
• Ensure timely and accurate submission of claims across commercial, Medicare, Medicaid, and managed care payers.
• Reconcile payments, remittances (ERA/EOB), and correct posting discrepancies when applicable.
• Conduct detailed review of denied or underpaid claims to determine root causes and corrective actions.
• Prepare and submit persuasive appeal letters supported by documentation and regulatory guidelines.
• Track and analyze denial patterns, escalating systemic issues to leadership and recommending process improvements.
• Collaborate with payers to clarify claim decisions, request reconsiderations, and resolve administrative or coding-related barriers.
• Communicate with insurance carriers via phone, email, fax, and portal correspondence to resolve outstanding issues.
• Maintain professional, timely communication with internal teams and clients regarding claim status, trends, and financial impacts.
• Build strong relationships with payer representatives to improve overall reimbursement efficiency.
• Apply current federal and state regulations that impact reimbursement, including Medicare/Medicaid guidelines.
• Review and resolve EDI rejections, claim edits, and submission errors.
• Utilize automation tools, RPA workflows, and AI-enabled processes to streamline follow-up and improve productivity.
• Maintain accurate documentation and meet or exceed established productivity and quality benchmarks.

Accounts Receivable Specialist

• Responsible for researching and resolving outstanding balances by following up on claim status
• Manage the end-to-end A/R workflow including billing, payment posting, adjustments, reconciliation, claim follow-up, and resolution
• Ensure timely and accurate submission of claims across commercial, Medicare, Medicaid, and managed care payers
• Conduct detailed review of denied or underpaid claims to determine root causes and corrective actions
• Communicate with insurance carriers via phone, email, fax, and portal correspondence to resolve outstanding issues

RCM Accounts Receivable Specialist

Data Analyst

• Analyze complex data using advanced statistical techniques to inform Health Pivots reporting and product enhancements.
• Identify and leverage new tools, processes, and methodologies to strengthen Health Pivots data models and analytic workflows.
• Acquire, clean, and manage datasets from multiple sources to support Health Pivots platform accuracy and performance.
• Identify trends, patterns, and anomalies that improve Health Pivots’ ability to deliver actionable market and organizational intelligence.
• Build compelling dashboards and visualizations that help clients understand and apply Health Pivots insights.
• Troubleshoot data quality issues, identify root causes, and implement improvements to elevate Health Pivots data integrity.
• Collaborate with business stakeholders to prioritize analytics needs specific to Health Pivots initiatives.
• Support ongoing process improvement efforts to increase the value, efficiency, and scalability of Health Pivots analytics.

Senior Data Analyst – HealthPivots

• Collaborate with clients to configure software solutions in pre-production and production environments
• Complete complex system configuration and assist with testing as necessary; ensure proper configuration management and change control processes
• Gather and document business requirements based upon client requirements and known system functionality
• Lead design sessions to uncover interdependencies and design decision impacts using recommended practices
• Responsible for training, coaching, guiding and mentoring Application Analysts and Consultants
• Identify, resolve and report solution status, risks, and issues to client and Netsmart leadership; analyze data to determine configuration readiness
• Develop client relationships and navigate through conflict and complex relationship situations to achieve business objectives
• Identify and execute process improvement opportunities and efficiencies
• Identify and generate documentation for best practices in methodology