Healthcare Operations Implementation Specialist

Engage Health Solutions is a nationally recognized healthcare consulting firm specializing in Medicare audit defense, revenue integrity, and appeals strategy. We serve a growing base of physician groups, wound care providers, and specialty practices navigating complex federal reimbursement and compliance environments.

We are seeking a Healthcare Operations Implementation Specialist to serve as the operational backbone for client engagements. This role is responsible for guiding newly onboarded clients through the implementation process, tracking progress as clients move through the Medicare administrative appeals process, and ensuring all workflows, deadlines, and deliverables stay on course. This is a high-accountability position that requires intellectual rigor, exceptional attention to detail, and the ability to quickly learn complex regulatory and procedural frameworks.

This is not a passive coordination role. The right candidate will take genuine ownership of client progress, proactively identify issues, and communicate clearly across internal clinical, legal, and operational teams. If you are highly organized, a fast learner, and thrive in a detail-intensive professional environment, this role offers significant growth opportunity within a rapidly expanding national firm., Client Implementation & Onboarding

• Lead onboarding workflows for new clients, coordinating documentation collection, system setup, and introductory communications.
• Serve as the primary day-to-day point of contact for assigned clients throughout the implementation and appeals lifecycle.
• Ensure clients understand process milestones, required actions, and expected timelines at each phase of engagement.
• Coordinate activities across internal clinical, audit, data, and appeals specialists to keep client engagements on track.

Appeals Process Tracking & Workflow Management

• Track and monitor client status across all levels of the Medicare administrative appeals process, including redeterminations, QIC reviews, ALJ hearings, and MAC-level proceedings.
• Maintain accurate, up-to-date records of deadlines, open items, deliverables, and milestone completions within Jira and internal tracking systems.
• Escalate at-risk timelines proactively and coordinate with leadership to resolve bottlenecks before they become missed deadlines.
• Manage the secure transfer of files, clinical documentation, and correspondence between clients and internal teams.

Communication & Reporting

• Draft clear, professional client updates, status summaries, and follow-up communications.
• Schedule and coordinate client calls, prepare meeting agendas, and distribute action items and recaps.
• Ensure internal teams receive complete and accurate information needed to perform audits, appeal drafting, and analyses.

Account Management & Client Relationship Support

• Maintain ongoing awareness of each client's account status, outstanding needs, and satisfaction level.
• Identify opportunities to expand services to existing clients and communicate them to leadership.
• Support client retention through consistent follow-through, responsiveness, and professionalism.

• Bachelor's degree in healthcare administration, business, public health, life sciences, or a related field - required.
• Exceptional attention to detail; demonstrated ability to manage complex, multi-step workflows without errors.
• Strong written and verbal communication skills, including the ability to communicate professionally with physicians, administrators, and executives.
• Proven ability to learn quickly, take direction, and independently execute in a fast-paced environment.
• High proficiency with Microsoft Office Suite (Word, Excel, Outlook) and comfort with workflow or project tracking tools.
• Must be local to the Wilkes-Barre / Scranton area and able to work in-office full time. Remote work is not available for this position.
• Ability to handle sensitive client and regulatory information with discretion, confidentiality, and professionalism.

Preferred Qualifications

• Experience in healthcare, revenue cycle management, medical compliance, Medicare billing, or audit operations.
• Familiarity with the Medicare administrative appeals process or federal reimbursement frameworks.
• Experience with Jira, project management platforms, or client success / CRM environments.
• Paralegal background or experience in a legal, regulatory, or compliance support role.
• Exposure to clinical documentation, ICD-10 coding, CPT coding, or medical records review.

• Base salary $50,000 - $75,000, commensurate with qualifications and experience.
• Eligible for performance-based bonus.
• Health, dental, and vision insurance.
• Paid time off and paid holidays.
• Professional development opportunities within a growing national firm.
• Direct exposure to Medicare regulatory strategy, federal appeals practice, and healthcare compliance - a career-differentiating environment for the right candidate.