Cost Control Specialist

Cost Control Specialist

About CrowdHealth

CrowdHealth is helping Members live boldly—without the fear and stress of traditional healthcare bills. No doctor networks. No huge monthly premiums. No annual deductibles. No surprises. We're a community-powered alternative to health insurance, enabling individuals to access and fund healthcare with transparency, simplicity, and control.

Purpose

To help CrowdHealth Members access high-quality, fairly priced medical care by identifying fair market rates, negotiating costs, and managing complex healthcare cases—ensuring Members and the Community are protected from overbilling and financial surprises.

Scope

As a Cost Control Specialist, you are responsible for ensuring that medical care accessed by Members is appropriately priced and aligned with CrowdHealth’s standards of value and fairness. You will work closely with Care Advocates, Crowdfunding Specialists, external negotiation partners, provider partners and Crowd Members to identify affordable care options, manage complex cases, and resolve disputes. Your responsibilities include:

• Supporting cost evaluations and benchmarking for care recommendations
  
  
• Engaging in provider communications on behalf of members to secure fair pricing ahead of surgeries
  
  
• Managing bundled cash-pay pricing and Single Case Agreements (SCAs) by working directly with providers and external negotiation partners
  
  
• Overseeing negotiations and post-negotiation cases for high-cost care
  
  
• Coordinating, managing and resolving complex or escalated Member situations
  
  
• Collaborating cross-functionally with team members to create seamless experiences for Members
  
  

This is a full-time remote position reporting to the Director of Crowdfunding.

Expected Outcome

CrowdHealth Members receive high-quality care at fair prices with minimal financial stress—resulting in:

• Reduced healthcare costs
  
  
• Higher Community confidence in pricing standards
  
  
• Increased Member satisfaction with care recommendations and financial transparency
  
  
• Seamless collaboration across internal teams to manage complex care cases
  
  

Responsibilities

Fair Market Pricing & Cost Benchmarking

• Maintain a strong working knowledge of medical care cost databases, tools, and benchmarking platforms.
  
  
• Support Care Advocates in identifying fairly priced providers and facilities.
  
  
• Help determine the fair market value of medical procedures and services.
  
  

Case Management for High-Cost Procedures

• Proactively research and “shop” for high-value providers and facilities for elective, high-dollar surgery to secure favorable cash-pay rates
  
  
• Contact provider offices directly to negotiate transparent pricing, verify their willingness to work with the CrowdHealth model, and build long-term relationships
  
  
• Support members through the entire care journey, including scheduling procedures, facilitating medical records transfers, and ensuring all pre-surgery requirements are met.
  
  
• Manage SCAs and bundled cash-pay pricing for complex or high-cost procedures (e.g. surgeries).
  
  
• Drive Cross-functional Alignment amongst the following teams to ensure excellent member experience:
  
  
  
  • Care Advocates for Member communication and navigation
    
    
  • Crowdfunding Specialists to manage funding timelines and approvals
    
    
  • External partners and platforms to research pricing, identify provider options, and structure the case
    
    
• Handle disputes and escalated complaints related to care pricing or negotiation outcomes
  
  
• Maintain meticulous records of payment terms, deposit requirements, and final settlement data to ensure seamless crowdfunding and audit readiness
  
  

Post-Negotiation Management

• Engage Members after bill negotiations to explain outcomes and expectations.
  
  
• Send and manage required documentation (e.g., HIPAA releases, ACH forms).
  
  
• Draft Case Summaries and other materials for review by external negotiation partners.
  
  
• Coordinate with Crowdfunding Specialists to initiate funding once a negotiated resolution is reached.
  
  

Complex Case Oversight & Escalation

• Help de-escalate emotionally heightened Member situations.
  
  
• Escalate complex or unresolved cases to leadership as needed.
  
  
• Maintain communication with Members and external partners throughout the resolution process.
  
  

Qualifications

• Background in healthcare services, pricing, or billing strongly preferred
  
  
• Experience with healthcare cost benchmarking tools and negotiation platforms
  
  
• Familiarity with Single Case Agreements and cash-pay pricing models
  
  
• Passion for helping individuals navigate the healthcare system and avoid excessive medical costs
  
  

Skills & Competencies

• Healthcare pricing expertise: Able to assess cost fairness and identify high-value care options
  
  
• Clinical literacy: Strong command of CPT/HCPCS codes and medical terminology to ensure accurate cost benchmarking and procedure identification
  
  
• Logistical coordination: Experience managing the “administrative plumbing” of healthcare (medical records transfer, scheduling, and HIPAA-compliant data transfer)
  
  
• Provider communication: Comfortable and persuasive in professional dialogue with surgical centers and hospital administrators
  
  
  
• Negotiation & resolution skills: Comfortable managing sensitive, high-stakes financial cases
  
  
  
• Clear communication: Able to explain complex cost-related topics to Members in plain terms
  
  
  
• Calm under pressure: Skilled at de-escalating tense situations and providing confident support
  
  

• Strong organization & Data integrity: Detail-oriented and capable of tracking case progress across multiple stakeholders; exceptional attention to detail in tracking financial transactions and payment milestones
  
  
  
• Collaborative mindset: Works well with both internal team members and external partners
  
  
  
• Technical fluency: Proficient in Excel, and able to use care pricing databases and internal case management tools
  
  

Job Type: Full-time

Salary: $75,000 per year
Benefits:

• Unlimited paid time off
• 3 months parental leave
• Equity

Schedule: Monday to Friday normal business hours
Location: Remote

‍Email resume and cover letter to the Director of Crowdfunding, Jami Carswell, at jcarswell@joincrowdhealth.com.

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