Trend Health Partners

Auditor

• review medical records and associated claim information to validate accuracy of DRG assignments and/or medical necessity for inpatient level of care
• Utilize coding guidelines and clinical guidelines to perform DRG validation
• Validate principal diagnosis, secondary diagnoses, sequencing of diagnoses, discharge statuses and procedures utilizing the medical record
• Evaluate short stay claims for medical necessity of an inpatient level of care
• Apply CPT and ICD-10 guidelines
• Apply policies, procedures, guidelines and regulations developed by Centers for Medicare and Medicaid Services (CMS), commercial payers, InterQual, MCG, and Trend Health Partners
• Provide appeal responses for claims of the above types utilizing industry standards and company/client policies
• Assist with new concept development
• Assist with claim selection criteria
• Assist with itemized bill review as needed
• Maintain licensures, certifications and continuing education requirements
• May require client communication to support findings

Nurse Coder, DRG Auditor I

Full-stack Engineer

• Design, develop, and test features for both the CAVO UI (SPA built in Angular) and backend APIs using Node.js and Go.
• Write maintainable, scalable, and well-tested TypeScript and Go code.
• Contribute to document ingestion and processing workflows involving distributed microservices (Lambdas, ECS, SQS).
• Collaborate with the engineering team to improve the performance and resilience of background processing flows (e.g., OCR, classification, medical data extraction).
• Integrate with internal services such as CAVO EDI, Ingest, and Document Flow.
• Participate in code reviews, design discussions, and sprint planning sessions.
• Write technical documentation and contribute to architecture discussions.
• Troubleshoot issues and work with our Cloud team to ensure observability and uptime.
• Collaborate with QA to define test strategies and support automated testing.
• Uphold security and compliance best practices in healthcare software development

Software Engineer II, CAVO

Analyst

• 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, adjustments by client’s internal unit/other vendors, client’s claims processing policies/system(s), provider, and member contracts.
• Interpret and analyze medical and pharmacy claims data as well as provider and enrollment data to accurately assess and demonstrate key insights into trends and opportunities and follow concept development process.
• 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 trend /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

People Operations

• supporting day-to-day People & Culture operations
• employee lifecycle administration
• data integrity
• compliance
• employee support
• coordinate employee engagement initiatives, including planning and promoting internal events

People Operations Generalist I

Data Engineer

• Support the design, development, and maintenance of data pipelines and workflows
• Assist in the data integration and transformation processes using Python, T-SQL, SSMS, and Databricks
• Collaborate with other Data Engineers to understand the technical aspects of the stack and the architecture design
• Work with large and complex healthcare data sets to identify business needs and provide data-driven solutions
• Help in translating business requirements into technical specifications
• Participate in code reviews and contribute to team knowledge sharing
• Assist in the development and maintenance of documentation for data engineering processes and systems
• Create ad-hoc reports requested by internal and external partners
• 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 I

TREND Health Partners, tech-enabled payment integrity company. Our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare.
Joining TREND Health Partners means becoming a part of a dynamic growing organization that promotes a collaborative and innovative work environment.
Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more.

The Coding Auditor’s primary responsibility is to analyze data from claim denials, identify opportunities for prioritizing claim reviews, and focus on target DRG’s to ensure appropriate review and coding sequence.

Coding Auditor

TREND Health Partners is a tech-enabled payment integrity company. Our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows.
Joining TREND Health Partners means becoming part of a dynamic, growing organization that promotes a collaborative and innovative work environment. Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more.

The Provider Services Analyst I’s primary responsibility is to determine denials from remittance /explanation of benefits, trend root cause, and take appropriate steps for resolution by crafting detailed appeal letters and contacting insurance payers for resolution. This individual must be self-motivated and be able to work independently and within a team structure. Ensures legal compliance by following guidelines, account contract, and the company's business plan.

Provider Services Analyst I

Frontend Engineer

• TREND Health Partners is a tech-enabled payment integrity company focused on payer-provider collaboration and waste reduction
• Develop and maintain high-quality front end components that are modular, reusable, and performant
• Collaborate with product managers, designers, and backend engineers to create seamless user experiences
• Optimize application performance, manage complex state, and use appropriate data structures
• Ensure technical feasibility of UI/UX designs and write unit/integration tests using frameworks like Jasmine or Karma
• Debug and resolve technical issues and participate in agile ceremonies
• Mentor junior developers and document key components and workflows to support onboarding

Front End Engineer II

• Assist providers in identifying, reviewing, and validating patient accounts in a credit balance state
• Manage accounts receivables to ensure timely collection of identified Client overpayments
• Prioritize workload to meet deadlines and goals using guidelines set out by manager
• Achieve individual productivity and quality standards
• Professionally and proactively build relationships and maintain contact with the appropriate personnel at Providers
• Respond to all provider and Client requests in a timely manner
• Escalate to manager any situation outside the employee’s control that could adversely impact the business relationship
• Always represent TREND and our clients in a professional manner
• Cooperate with team members to meet goals and complete tasks