Backend Engineer

• Establish and maintain active monitoring of ANSI X12 277CA claim acknowledgment transactions to confirm payers have received submitted claims
• Implement a tracking and escalation process for claims that have not received 277CA acknowledgment within defined payer-specific windows
• Partner with the Front End Revenue Cycle Manager and Engineering to ensure clean claim submission and minimize rejection rates at the clearinghouse level
• Maintain working knowledge of clearinghouse workflows and claim status tracking capabilities
• Own the Athena Health AR aging report — ensuring it accurately reflects payment status and is actively worked on a defined cadence
• Establish AR follow-up workflows by payer and aging bucket, with defined SLAs and escalation paths for each tier
• Drive systematic reduction of the over-180-day AR balance through targeted payer follow-up, appeals, and collections activity
• Coordinate with Finance and the Manager/Director of Operational Effectiveness to ensure AR balances in Athena are accurately reflected in Zuora and NetSuite through a defined reconciliation process
• Identify and escalate AR balances where the insurance collection path has been exhausted and the employer guarantee of payment clause may apply
• Build and manage a structured denial work queue in Athena Health with assigned ownership, defined SLAs, and a clear resubmission process for each denial reason code
• Analyze denial trends by payer, reason code, and service line to identify root causes and implement upstream controls to prevent recurrence
• Prioritize denial resolution based on dollar value and timely filing window expiration — ensuring high-value, near-deadline denials are worked first
• Establish appeals workflows for payer-specific appeal processes, including supporting documentation requirements and submission timelines
• Monitor denial overturn rates by payer and reason code, and use outcomes data to refine appeal strategies
• Partner with the Front End Revenue Cycle Manager to address eligibility-driven denials at the root — denials reflecting coverage terminations that should have been caught upstream
• Manage the collections process for both claims-billed payer populations
• Establish payer-specific follow-up protocols including call queues, correspondence templates, and escalation timelines
• Coordinate with Client Success on employer group collections, including communication protocols and escalation to the employer guarantee of payment process when appropriate
• Monitor and report on cash collection rates by payer against contracted PMPM rates, identifying and investigating variances
• Recruit, onboard, and develop back-end RCM staff including AR follow-up specialists, denial management analysts, and collectors
• Establish competency requirements, training programs, and performance expectations for all back-end positions — with particular emphasis on experienced denial management and collections hires
• Conduct regular AR review sessions with staff to ensure accounts are being worked effectively and escalations are appropriate
• Build a culture of accountability, data-driven decision making, and continuous improvement within the back-end team

Senior Manager, Back End Revenue Cycle

• Guidehouse has an exciting opportunity for a Microsoft Dynamics Architect to support our client's Case Management system.
• As an Architect, you will work with the technical team to design and deliver the case management solution within a given time, identify risks and mitigate the risk during the design phase.
• You will be responsible for high-quality projects.
• You will work with the client, PM, and BA and streamline the communication between teams.
• Gather technical requirements and propose solutions based on client’s architectural and business needs.
• Drive Dynamics CRM implementations through all project phases, including discovery, definition, build, test, and deploy.
• Lead data-centric discussions with the client through discovery meetings.
• Translate concepts into user flows, wireframes, system diagrams, and prototypes.
• Develop integrations and customizations to Dynamics CRM.
• Design and lead the system architecture process to create, define specifications for, and implement customizations for any custom code or data migration requirements.
• Present tailored demonstrations of the technology solution.
• Work with technology and business groups to define project specifications.
• Develop technical solution designs and implementation plans and take full ownership of the Dynamics 365 solution.
• Interact with both prospective and current customers during product demos/evaluations.
• Enhance efficiency of development, testing and release process; develop tools and frameworks to ensure robust and high-quality delivery of Dynamics 365 Implementations.
• Document technical risks and issues, and actively work to avoid, mitigate, resolve risks and technical debt.
• Relay of the solution design to the development team and provide technical guidance during development of the solution to the development team.
• Travel to multiple customer locations for demos and meetings when required.

Microsoft Dynamics 365 Technical Architect

• leads important projects in design, development, implementation and management of databases
• develops database architectures to address business requirements, ensuring system scalability, security, performance and reliability
• designs database applications such as interfaces, data transfer mechanisms and data partitions to enable efficient access of the generic database structure
• creates plans for architecture updates and integrates new systems with existing warehouse structure to refine performance/functionality
• influences department’s strategy and makes decisions on moderately complex to complex issues regarding technical approach for project components

Senior Database Engineer

• Designs, develops, and implements data integration packages for the organization
• Performs a wide variety of database programming assignments and research/troubleshooting in T-SQL
• Troubleshoots and maintains existing ETL packages
• Becomes a subject matter expert in the organization’s SSIS packages
• Creates new Extraction, Transformation, and Loading (ETL) packages to achieve data integration
• Tests and debugs code using departmental standards and protocols prior to elevation
• Acts as a subject matter expert in the existing ETL packages used to load Actimize
• Makes recommendations and implement improvements to the packages
• Reviews database design and code written by other developers, identifies issues, and discusses efficiencies
• Troubleshoots ETL issues as they arise by evaluating the ETL packages, source data, and destination systems
• Develops, updates, and maintains ETL specifications and documentation used to develop data migration mappings and transformations
• Performs other duties as assigned.

AVP Database Developer II

• Build high-performance applications: Design, develop, and maintain scalable software that powers the Opendorse platform.
• Own backend services: Write clean, testable code in .NET to deliver reliable APIs and business logic.
• Craft modern interfaces: Use React and TypeScript to build engaging, responsive UIs that deliver a great user experience.
• Leverage AI development tools: Use AI-assisted workflows to accelerate development, improve quality, reduce repetitive work, and help shape how our engineering team builds software.
• Move data with confidence: Work with SQL Server to store, query, and manage data efficiently.
• Focus on quality: Write unit and integration tests to ensure our systems are resilient and maintainable.
• Collaborate to deliver: Work closely with product, design, and engineering teammates to ship features that matter.
• Drive technical growth: Contribute to architectural decisions, code quality initiatives, and performance improvements across the stack.

Full-Stack Software Engineer – .NET, React

• Writing secure, correct, efficient, clear and supportable “production ready” code that meets internal standards and industry best practice.
• Enhance and extend our existing products, including device management, microservices, and WPF (Windows Presentation Foundation) applications to deliver seamless experiences to our customers.
• Design and build APIs that integrate with internal and external services and contribute to overall system functionality.
• Clarifying and communicating engineering requirements for new products, features, quality improvements, or design changes.
• Track progress, update stakeholders, communicate with peers and broader team through stand-ups, regular updates on work items.
• Implement industry-standard security practices to safeguard both customer and internal data.
• Ensure thorough testing of code, participate in code reviews, and proactively resolve bugs and performance bottlenecks.

Software Engineer, Backend

• Lead the design and implementation of scalable data platforms and pipelines using PySpark, Spark, and Python
• Drive adoption and best practices for Palantir Foundry (data pipelines, ontology, workflows, and operational applications)
• Architect and optimize high-performance data processing solutions for large-scale datasets
• Provide technical leadership and mentorship to data engineers, ensuring code quality and best practices
• Collaborate with cross-functional teams (business, analytics, data science) to translate requirements into scalable solutions
• Design robust data models, ETL/ELT frameworks, and data integration strategies
• Ensure data quality, governance, security, and compliance across enterprise data platforms
• Lead performance tuning, troubleshooting, and optimization of data pipelines
• Drive CI/CD implementation, code reviews, and release management
• Stay current with emerging data engineering technologies and recommend improvements

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