Trend Health Partners

Auditor

• Independently audit clinical documentation to ensure consistent with billed services in a production environment
• Apply clinical and industry guidelines, payer P&P, and use of in-depth knowledge that supports medically necessity of services rendered
• Develop relationships with medical providers and health plans to confirm adherence to P&P, guidelines, and continuum of care.
• Continually keep abreast of technology changes, regulatory issues, and medical practice through ongoing training and self-directed research and share with others, accordingly
• Share ideas that offer process improvements and share with team for education.

Nurse Auditor I

Claims Specialist

• Assist client in identifying, validating, and recovering claim overpayments.
• Validate claims to ensure the accuracy of algorithms and that no refund has previously been posted to the client’s system(s).
• Review and resolve disputed overpayments from client/provider.
• Participate in knowledge sharing to brainstorm and resolve claim issues or seek clarifications.
• Identify new overpayment opportunities and trends by reviewing and researching areas such as CMS and Medicaid claims processing policies.
• Interpret and analyze medical and pharmacy claims data as well as provider and enrollment data.
• Assist Management with concept approval information needed for client approval on specific trends.
• Complete step by step instructions for each algorithm moved to production.
• Always represent TREND and our clients in a professional manner.
• Cooperate with team members to meet goals and complete tasks in an efficient and effective manner.
• Provide feedback to Management regarding inventory levels, algorithm effectiveness/productivity, and new trends/ideas.
• Collaborate with TREND Management to identify new opportunities, areas of improvement, and innovate potential solutions.
• Escalate to the manager any situation outside the employee’s control that could adversely impact the business relationship.
• Train and assist new analysts as needed while maintaining high quality and production results.
• Assist with Quality Review process.
• Ensure staff is appropriately resolving day-to-day problems in a timely and successful manner.

Claims Analyst III

AI Engineer

• Design, develop, test, and ship production‑grade software across backend services and front‑end applications.
• Build and operate cloud‑native solutions in AWS with a focus on reliability, scalability, and performance.
• Develop and maintain backend services primarily in .NET/C#.
• Contribute to Angular front‑end development, including component design and API integration.
• Implement and support CQRS patterns, separating command and query responsibilities where appropriate.
• Design and work with event‑sourced systems, including events, projections/read models, and system evolution over time.
• Use MongoDB and OpenSearch to support application persistence, projections, and search capabilities.
• Leverage AI-assisted coding tools (including Copilot CLI, Claude Code, Codex) to accelerate feature delivery, refactor and improve existing code, generate and improve tests, and support documentation.
• Actively develop and manage agent-driven coding workflows, where multiple AI agents are used to build, test, and iterate on features in parallel.
• Continuously refine code through AI feedback loops, using iterative prompting, validation, and improvement cycles.
• Validate and audit AI-generated code for accuracy, security, and maintainability, applying strong engineering judgment and testing discipline.
• Collaborate closely with Product, QA, and fellow engineers to deliver high‑quality outcomes.
• Participate in code reviews and contribute to engineering standards and best practices.
• Mentor and support other engineers as needed through pairing, feedback, and knowledge sharing.

Senior AI Full Stack Engineer

Risk

• Support data governance initiatives related to data quality, standardization, and documentation
• Assist in validating and profiling datasets to identify data quality issues and inconsistencies
• Help maintain data definitions, data dictionaries, and metadata documentation
• Partner with team members to understand business requirements and support basic data mapping efforts
• Execute predefined data quality checks and assist in resolving data discrepancies
• Support data migration and integration activities through documentation and validation tasks
• Use SQL to query and validate data under guidance from senior team members
• Collaborate with cross-functional stakeholders to ensure adherence to data governance standards
• Document processes, workflows, and data-related procedures clearly and accurately
• Contribute to continuous improvement efforts to strengthen data governance processes

Data Governance Analyst I

Data Engineer

• Design, develop, and maintain optimal data pipelines and workflows.
• Provide technical guidance on architecture design and collaborate with Data Engineers for implementation.
• Work with stakeholders to assist with data-related technical issues and support their data infrastructure needs.
• Perform data integration, transformation, and cleaning to create insightful and actionable data for the business.
• Translate business requirements into technical specifications and finished products.
• Participate in code reviews and contribute to team knowledge sharing.
• Lead the development and maintenance of documentation for data engineering processes and systems.
• Create ad-hoc reports requested by internal and external partners.
• Work as a team to support and troubleshoot errors for 100+ data pipelines.
• Work closely with the application development team to update data and data structures.
• Provide analysis, recommendations, and feedback to business process owners, leadership team, and the Information Technology department.
• Propose automated solutions to repeated development tasks.

Data Engineer II

Business Intelligence Developer

• Manage internal business applications used to manage operational workflows.
• Oversee the scheduling and coordination of tasks, jobs, and tactics within internal business applications.
• Coordinate and maintain client and user accounts in business applications, ensuring all information is current and accurate.
• Monitor and manage jobs and workflows within business applications to ensure efficient operation and timely completion of tasks.
• Monitor and maintain scheduled reports in Looker, Power BI.
• Develop and implement tactics within business applications to streamline processes and improve efficiency.
• Manage the SFTP Portal. Create, update, and maintain accounts for internal logins and clients.
• Import and export data through business applications, performing data cleansing as required.
• Learn and become proficient with business applications (jobs, tasks, scripts, development).
• Supply IT with requirements/procedures for data pulls and data preparation.
• QA automated reports created by IT.
• Analyze disparate types of data to identify trends within data.
• Identify process improvement opportunities and implement creative solutions to improve efficiency.
• Ensure continuous communication with clients on the status of reporting requests.
• Verification of client requested data and dissemination coordination with other team members.
• Achieve individual productivity and quality goals.
• Communicate to Management any issue(s) that would impede the accuracy.

BI Engineer I

SDET

• validating the quality, reliability, and safety of AI powered systems across TREND's platform
• AI Testing & Validation
• Design and execute test strategies for AI/ML models, including functional, regression, and scenario-based testing
• Validate accuracy, consistency, and reliability of AI-generated outputs
• Develop test cases for edge cases, model drift, and unexpected behavior scenarios
• Evaluate model performance against defined success criteria and business requirements
• Test agent-driven workflows and validate interactions between AI agents, APIs, and downstream systems
• Identify failure points in end-to-end AI workflows and recommend improvements
• Validate training, validation, and test datasets for completeness, accuracy, and bias risks
• Perform data validation testing across pipelines to ensure integrity of inputs and outputs
• Partner with Data Engineering to detect anomalies
• Build and maintain automated test frameworks for AI-enabled systems
• Integrate testing into CI/CD pipelines to enable continuous validation
• Help define and validate guardrails for AI systems

AI Test Engineer II

• Review medical records and associated claim information to validate accuracy of DRG assignments and/or Itemized Billing
• Utilize coding guidelines to perform DRG validation
• Validate principal diagnosis, secondary diagnoses, sequencing of diagnoses, discharge statuses and procedures utilizing the medical record
• Apply CPT and ICD-10 guidelines
• Validate itemized bill payments utilizing the UB-04, the itemized bill and industry/client coding guidelines
• Provide appeal responses for claims utilizing industry standards and company/client policies
• Maintain certifications and continuing education requirements

Coder, DRG Auditor I

• Acquire knowledge of the client’s claims adjudication system(s), member and provider contracts, and client claim payment policies and procedures.
• Assist client in identifying, validating, and recovering claim overpayments.
• Validate claims to ensure the accuracy of algorithms and that no refund has previously been posted to the client’s system(s)
• Review and resolve disputed overpayments from client/provider.
• Identify new overpayment opportunities by reviewing and researching areas such as CMS and Medicaid claims processing policies, adjustments by client’s internal unit/other vendors, client’s claims processing policies/system(s), provider, and member contracts.

Claims Analyst I

Analyst

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Credit Balance Analyst I

Project Manager

• Support payer-facing revenue integrity projects from initiation through delivery.
• Accurate invoicing support.
• Receivables processing and payer inventory workflows.
• Client reporting and special projects involving invoicing or payment workflows.
• Identify opportunities for process improvements.