Theoria Medical

Manager

• Oversee the processing of initial payer applications for health professionals, ensuring compliance with national accreditation standards and state/federal regulations.
• Maintain and manage payer credentialing databases and electronic records, ensuring accuracy, confidentiality, and audit readiness.
• Liaison with medical staff leadership, payers, licensure boards, and regulatory agencies to resolve credentialing issues promptly.
• Supervise payer credentialing staff by coordinating workloads, providing training, monitoring performance, and ensuring quality outcomes.
• Conduct regular audits of payer credentialing processes to identify gaps, implement corrective actions, and drive continuous improvement.

Payer Credentialing Manager

Financial Planning and Analysis

• Lead enterprise-wide reporting initiatives that drive strategic decision-making and business transformation.
• Partner closely with executive leadership and cross-functional stakeholders to deliver actionable insights.
• Establish reporting standards and support organizational performance objectives.
• Translate complex data into meaningful business recommendations.
• Influence business outcomes through data-driven insights.

Financial Planning & Analysis Manager

Project Manager

• Organize and manage files for Compliance and Legal Departments.
• Perform administrative duties as assigned.
• Conduct legal research related to healthcare compliance, healthcare payer requirements, clinician licensing, and other applicable state and federal laws.
• Assist with the preparation of contract templates, policies and procedures, investigation summaries, legal memoranda and other documents.
• Creating presentations and documents utilizing appropriate technology with exceptional attention to correct grammar, spelling, and formatting.
• Communicate effectively and professionally with company personnel and third parties, including regulatory representatives.
• Assist with compliance investigations and other legal matters as assigned.
• Create and Conduct trainings with company personnel on various legal and compliance topics as assigned.
• Provide day-to-day assistance to Compliance and Legal departments as needed and as assigned by leadership, attorneys and compliance department.
• Assist with dispute resolution and litigation matters as assigned.

Legal Project Manager

Procurement

• Develop and execute targeted sourcing strategies for active and passive candidates.
• Utilize recruitment tools on platforms like LinkedIn Recruiter, Greenhouse, Practice Match and Doc Café.
• Conduct comprehensive market research to map talent pools and target competitive companies.
• Capitalizing on prior sourcing experience to add a creative flair to attract talent when needed.
• Craft high-converting, personalized outreach campaigns to engage cold leads.
• Act as the primary, high-charisma ambassador of our employer brand via written communications.
• Follow-ups with active and passive candidates.
• Populate and organize Greenhouse (ATS).
• Deliver talent pipelines to champion company initiatives.
• Schedule interviews for the recruiters.

Sourcing Specialist, Healthcare

Recruitment

• Serve as the dedicated point of contact for applicants, building a deep knowledge of Theoria Medical's values and mission.
• Drive applicant engagement through proactive outreach and timely follow-ups that increase offer acceptance.
• Lead outbound recruiting efforts to our highest priority prospects, via personalized emails and calls.
• Manage and respond to applicant questions in a timely, professional manner.
• Track and analyze key recruiting metrics to improve hiring strategy and outcomes.
• Collaborate with talent acquisition team, sourcers and hiring managers to create feedback loops that improve candidate experience
• Make process improvements based on feedback from providers and internal stakeholders to improve the overall recruiting experience, both qualitatively and quantitatively

Provider Recruiter

• Lead and manage the revenue cycle operations, including but not limited to billing, holds/credentialing, denials, collections, and accounts receivable management.
• Assist in developing and implementing KPIs and policies and procedures to ensure accurate and timely submission of claims, reduce denials, and increase collections.
• Analyze trends impacting charges, coding, collection, and accounts receivable and take appropriate action to realign staff, third party vendors and revise policies and procedures.
• Identify and resolve revenue cycle issues, including coding and billing errors, incomplete or inaccurate patient information, insurance prioritization and other issues that may impact revenue.
• Monitor and analyze revenue cycle metrics, including accounts receivable aging, claim submission, payment turnaround times, and denial rates.
• Analyze billing and claims for accuracy and completeness; follow up with RCM teams and third party vendors on work queues, pending claims and unpaid AR.
• Spearhead the resolution of rejected or underpaid claims by conducting targeted appeals and payer negotiations.
• Analyze and manage overpayments from payers as well as implementing policies to reduce denials and refunds.
• Work with credentialing, billing and coding staff to ensure compliance with regulatory requirements, including HIPAA and other federal and state regulations.
• Develop and maintain strong relationships with RCM Directors, HR, Clinical Operations and Credentialing departments to ensure a smooth revenue cycle operation.
• Review and respond to various payor correspondence
• Communicate with patients and clients

Payer Credentialing Manager

Financial Planning & Analysis Manager

Legal Project Manager

Sourcing Specialist, Healthcare

Provider Recruiter

Manager, Revenue Cycle Management