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Optima Dermatology

Dermatology and cosmetic skin care services

Payor Reimbursement & Claims Remediation Specialist

Full-TimeUpdated on 10/23/2026
No salary listed
Senior
Bachelor's
Portsmouth, NH, USA
HybridHybrid role based at 111 New Hampshire Ave., Portsmouth, NH.
Medical, Clinical & VeterinaryClinical Support & Patient Administration

About the job

Requirements
  • A high school diploma or equivalent is required.
  • At least 5 years of experience in Revenue Cycle Management, payor operations, claims analysis, or related healthcare reimbursement roles.
  • Demonstrated experience analyzing reimbursement and payment data, including expected-versus-actual payment and fee schedule variance analysis.
  • Working experience using Power BI or a comparable business intelligence tool to run reports and extract data, including slicers and filters.
  • Knowledge of claims adjudication and reimbursement methodologies.
  • Knowledge of contracted fee schedules, payor contract terms, and expected reimbursement modeling.
  • Knowledge of payor policies, payment logic, and operational workflows.
  • Knowledge of credentialing and enrollment impacts on claims processing.
  • Knowledge of CPT, HCPCS, and ICD-10 coding concepts as they relate to claims adjudication.
  • Knowledge of Explanation of Benefits (EOBs) and payor remittance processes.
  • Strong analytical and problem-solving skills to identify systemic issues, incorrect-payment patterns, and root causes.
  • Working proficiency in Power BI as a user, including running existing reports, applying slicers and filters, exporting data for analysis, and preparing clean data files for external use.
  • Ability to translate complex payment data into clear reporting packages for payors.
  • Ability to communicate effectively with payor leadership and internal stakeholders, including the Revenue Cycle Director.
  • Ability to manage multiple projects simultaneously and prioritize work based on financial and operational impact.
  • Strong follow-through and attention to detail.
  • Ability to work independently in a complex, fast-paced environment.
  • A bachelor's degree in healthcare administration, business, finance, data analytics, or a related field is strongly preferred, or an equivalent combination of education and experience.
  • Ability to follow HIPAA guidelines and complete annual training requirements.
Responsibilities
  • Run established Power BI reports and use slicers, filters, and standard functions to extract data for analysis of payor payment performance.
  • Analyze payor adherence to contracted fee schedules by comparing expected reimbursement with actual payment and identifying variances.
  • Identify patterns of incorrect payment, including systematic underpayments, fee schedule load errors, bundling and downcoding trends, and policy-driven payment reductions.
  • Quantify the financial impact of identified payment issues to prioritize remediation by recovery value and operational urgency.
  • Create reporting packages and data files for payors to open and process remediation projects, including impacted claim listings, expected-versus-paid detail, and supporting documentation.
  • Identify and manage systemic, project-level payor issues affecting claims adjudication, payment accuracy, and reimbursement timeliness.
  • Lead payor remediation efforts to resolve underpayments, recurring denials, credentialing-related processing errors, and incorrect policy application.
  • Coordinate retrospective claims reprocessing and repayment for impacted claims and accounts.
  • Track remediation efforts from identification through resolution, ensuring accountability and follow-through.
  • Serve as the primary operational point of contact with payor claims, provider operations, contracting, and credentialing departments for systemic claims issues.
  • Communicate directly with payor operational leaders to prioritize issues and drive resolution.
  • Prepare and present payor issue summaries, root-cause findings, and data-supported remediation requests.
  • Escalate complex or stalled issues in partnership with the Revenue Cycle Director as appropriate.
  • Partner with billing and credentialing leaders to remediate payor-related claims, contracting, adjudication, and credentialing issues.
  • Partner with FP&A to review systemic payor issues identified through claims-to-contract and expected-versus-actual payment analysis.
  • Receive escalated, project-level payor issues from Accounts Receivable leadership involving adjudication errors, credentialing gaps, or payor policy interpretation.
  • Collaborate with credentialing, billing, compliance, contracting, and Accounts Receivable teams to align remediation efforts and operational corrections.
  • Translate payor resolutions into forward-looking claims-processing and billing guidance to prevent recurrence.
  • Provide data, reporting, and analysis to the Revenue Cycle Director to support decision making and departmental priorities.
  • Support revenue cycle analysis activities by providing data and ad hoc reporting on request.
  • Maintain documentation and visibility into active payor remediation projects, including scope, status, and financial impact.
  • Communicate progress, risks, and outcomes to the Revenue Cycle Director and other key internal stakeholders.
  • Support continuous improvement initiatives related to payor performance and claims accuracy.
  • Maintain accurate documentation of payor communications, remediation activities, and outcomes.
  • Respond promptly to emails, tasks, and requests related to payor projects.
  • Maintain working knowledge of the practice management system, electronic medical record, billing workflows, and reporting tools, including Power BI.
  • Participate in revenue cycle projects and departmental initiatives as assigned.
  • Follow department standard operating procedures and use assigned systems and tools as intended.
  • Perform other duties as assigned by the Revenue Cycle Director.

About the company

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Optima Dermatology

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Optima Dermatology provides medical and cosmetic skin care services through a network of dermatology experts. Its offerings include medical dermatology (treating conditions such as eczema and acne), dermatologic surgery, and cosmetic procedures, all delivered under one roof. The company uses advanced technology and highly skilled providers to diagnose and treat skin conditions and to perform aesthetic treatments, with patient consultations and procedures that cover the full care spectrum. What sets Optima Dermatology apart is its combination of top providers, access to the latest skin-care technologies, and a patient-centric approach focused on personalized, friendly care and long-term relationships. The company's goal is to deliver high-quality, convenient, and compassionate care that meets a wide range of skin needs, from medical treatment to cosmetic enhancements, driving ongoing patient satisfaction and referrals.

Company Size

51-200

Company Stage

Debt Financing

Total Funding

N/A

Headquarters

Portsmouth, New Hampshire

Founded

2018

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Simplify Jobs

Simplify's Take

What believers are saying

  • July 2026 Nashua opening extended Optima to nine New England locations.
  • January 2026 Concord launch added twelfth total location, showing continued expansion.
  • Optima hired Christopher Mancuso and Maria Petkova in 2026, widening capacity and access.

What critics are saying

  • 2025 Indiana FLSA lawsuits from Todd Troxell and Carrie Kastler signal labor exposure.
  • Indeed reviews in 2026 cite short staffing, poor management, and weak training.
  • High physician dependence means one resignation or reimbursement shock quickly damages local access.

What makes Optima Dermatology unique

  • Alpine Investors-backed, multi-state dermatology platform across New England, Ohio, and Indiana.
  • Mohs surgery, medical, surgical, cosmetic, and pathology services under one roof.
  • Recruiting Castle Connolly dermatologists like Andrew Werchniak and Daniel Stewart strengthens credibility.

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Benefits

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Disability Insurance

Growth & Insights and Company News

6 month growth

25%

1 year growth

25%

2 year growth

25%
Greater Nashua Chamber of Commerce
Jul 13th, 2026
Optima Dermatology expands its services in Nashua, NH.

Optima Dermatology expands its services in Nashua, NH. July 13, 2026 New Practice Opening in July 2026 NASHUA, NH - In July 2026, Optima Dermatology will open the doors to another practice in New Hampshire at 169 Daniel Webster Highway, Suite 300, in Nashua. The opening of the Nashua practice marks Optima Dermatology's ninth New England location, with others in Stratham, NH, Portsmouth, NH, Bedford, NH, Manchester, NH, Salem, NH, Concord, NH, Scarborough, ME, and York, ME. Expanding access to expert dermatology services is core to Optima Dermatology's mission, and this newest location demonstrates its commitment to increasing accessibility across the region. The practice is conveniently located for individuals in Nashua, Hudson, Merrimack, Hollis, Brookline, Litchfield, Milford, Amherst, and nearby Massachusetts cities, including Tyngsboro, Dunstable, and Pepperell. Board-certified dermatologist Christopher Mancuso, DO, is leading the Nashua team and will begin seeing patients in July 2026. Dr. Mancuso has been providing industry-leading dermatology services to patients for more than 10 years, specializing in medical and surgical dermatology care for a range of skin conditions, including acne, psoriasis, eczema, skin cancer, and more. Dr. Mancuso earned his Doctor of Osteopathic Medicine at Lake Erie College of Osteopathic Medicine and completed his residency and internship training in dermatology at St. Barnabas Hospital in New York. Patients can expect the highest quality of care and personalized treatment from Dr. Mancuso and his team, in keeping with Optima Dermatology's mission to treat every patient the way we would treat our family and friends. "The opening of the Nashua practice is meaningful to Optima's continued expansion across the region, as well as for my own commitment to serving patients," said Dr. Mancuso. "It's rewarding to be part of such a dedicated dermatology provider and the crucial widening of access throughout New England." Dr. Mancuso and the entire Nashua Optima Dermatology team look forward to partnering with the local medical community and strive to take a collaborative approach with a seamless referral process. If you are a healthcare provider interested in learning more about Optima Dermatology, please contact our medical community team at [email protected]. Dr. Mancuso is accepting new patients in July 2026 following the opening of the Nashua practice. Please call 603-441-3223 or schedule an appointment online through the Nashua practice web page. The Patient Support Team is available Monday through Friday from 6:30 am to 5:30 pm. For more information, please visit https://optimadermatology.com/. About Optima Dermatology Optima Dermatology is revolutionizing skin care. Our mission centers on creating greater access to expert dermatology care and delivering an unparalleled patient experience. With a focus on excellence and innovation, our world-class team is highly engaged, mission-driven, and inspired to set the new standard in dermatology. Our guiding principle is to treat each and every patient as we would want our friends and family to be treated, and we are committed to being your trusted experts in all aspects of skin care.

Optima Dermatology
Jun 15th, 2026
Board-Certified Physician Assistant Kieran Lombard, PA-C, joins Optima's Scarborough, ME practice.

Board-Certified Physician Assistant Kieran Lombard, PA-C, joins Optima's Scarborough, ME practice. Lombard is eager to provide expert medical dermatology services to patients of all ages. Optima Dermatology is excited to welcome board-certified Physician Assistant Kieran Lombard, PA-C, to its Scarborough, ME practice. Kieran has been providing dermatology services to patients in New England since 2020 and treats a variety of skin conditions, including acne, eczema, psoriasis, and skin cancer. Kieran received his Bachelor of Health Sciences from Western New England University, graduating cum laude, and later received his Master of Physician Assistant Studies from Massachusetts College of Pharmacy & Health Sciences. After numerous years providing dermatology services to patients in New England, Kieran is excited to bring his expertise and passion to Optima's Scarborough practice in Maine. Delivering the care patients expect and deserve. Kieran is committed to helping every patient with an individualized treatment plan. His personal experiences with acne allow him to understand what patients need and expect, and meet them with a personalized and compassionate approach that mirrors Optima's mission of treating patients the way Optimadermatology would treat its own family and friends. Optimadermatology recently had the opportunity to learn more about Kieran, his approach, and the path that led him to become a board-certified physician assistant. What made you decide to pursue a career in dermatology? What did the path to get there look like for you? My path to dermatology started as a patient. I struggled with severe acne growing up and spent a lot of time seeing a dermatologist. One of the physician assistants I saw made a big impression on me and offered to let me shadow him in clinic, which was my first real exposure to the field. I found that I really enjoyed the mix of medicine and patient care involved in dermatology. I had already decided to pursue a career as a physician assistant, but this helped guide the direction of my journey, and I went on to graduate school to earn my PA master's degree. While in school, I completed a rotation in dermatology, solidifying the love I had for the specialty; the medicine, the procedures, and especially the relationships you build with patients over time. What is your favorite aspect of being a board-certified physician assistant? My favorite aspect of being a board-certified physician assistant is the combination of a broad medical foundation and the autonomy I have in dermatology. PA training gave me experience across all major areas of medicine, which allows me to approach patient care with a well-rounded perspective. In dermatology, I can spend time with patients and practice in a way that aligns with my values, while still having the support of a collaborative team and supervising physicians. I truly enjoy that balance of independence and teamwork. What is your approach to treating your patients? My approach to treating patients is centered on education and shared decision-making. I aim to provide patients with clear information about their condition and the available treatment options so they can make informed choices about their care. By discussing the benefits and considerations of each option, patients can decide what matters most to them and what best fits their goals. My role is to guide them through that process and support the decision that works best for them. What is your number one tip when it comes to taking care of your skin? I think my number one tip is 'less is more'. It's easy to get lost in the sea of products claiming to make your skin better, but unless there is a true underlying disorder, the best thing you can do for your skin is wear a good sunscreen, use bland soaps, moisturize, and get your yearly skin check. What is one thing you want your patients to know about you? The one thing I want my patients to know about me is that I understand what it's like to be on the other side of the exam room. Having struggled with severe acne myself, I know how frustrating and personal skin issues can feel. That experience helps me approach patients with empathy and understanding. I strive to maintain professionalism while creating a comfortable, approachable environment where patients feel heard, supported, and confident in the care they're receiving. What do you like to do when you are not in the office treating patients? Outside the office, I try to stay active and enjoy a variety of outdoor pursuits. I play ice hockey and mountain bike whenever I can, and I love spending time outdoors or doing any kind of athletics. I also help manage a small family farm and pursue photography as a side project, which lets me combine creativity with being outside. What to Expect From Dermatological Care Delivered by Kieran and His Team Patients visiting Optima Dermatology with Kieran and his team will receive the highest-quality care, backed by decades of advanced training and experience. Kieran is currently accepting new patients at its Scarborough, ME location. Request an appointment online or call Optimadermatology at (855) 277 - 9689.

Optima Dermatology
Jun 8th, 2026
Christopher Mancuso, DO, joins Optima Dermatology's Nashua, NH practice.

Christopher Mancuso, DO, joins Optima Dermatology's Nashua, NH practice. Dr. Mancuso brings more than a decade of expert dermatology experience to the Nashua area. Optima Dermatology is excited to welcome board-certified dermatologist Christopher Mancuso, DO, to its Nashua, NH practice. Dr. Mancuso has been providing dermatology services to patients for more than 10 years, specializing in medical and surgical dermatology care for a range of skin conditions, including acne, psoriasis, eczema, skin cancer, and more. Dr. Mancuso earned his Doctor of Osteopathic Medicine at Lake Erie College of Osteopathic Medicine and completed his residency and internship training in dermatology at St. Barnabas Hospital in New York. He is passionate about clinical research and helping every patient find relief for their unique situation with individualized, cutting-edge treatments. Passionate Care Delivered by passionate experts. Dr. Mancuso is excited to deliver personalized and comprehensive care to patients in the Nashua area, especially for often complex skin issues that require dedicated treatment plans and an understanding ally. His approach to care is aligned with Optima's mission of treating patients the way Optimadermatology would treat its own family and friends. Optimadermatology recently had the opportunity to learn more about Dr. Mancuso, his approach, and the path that led him to become a board-certified dermatologist. What made you decide to pursue a career in dermatology? What did the path to get there look like for you? In high school, I took a class in anatomy and physiology and realized how interesting the human body is. I happened to also be seeing a dermatologist to treat my severe acne. I was so appreciative for the confidence they were able to restore in me, and I knew that I wanted to do the same for others like me. What is your favorite aspect of being a board-certified dermatologist? I love that Optimadermatology treat so many varied medical conditions, from acne to skin cancer to rare cutaneous manifestations of internal diseases like Crohn's disease. Being able to perform surgeries like skin cancer excisions and using devices like blue light allow me to have a more hands-on approach to care. What is your approach to treating your patients? I try to communicate clearly and thoroughly explain the diagnosis, treatment, and possible side effects. The best way for me to instill confidence in my patients is to explain my exact thought process. What is your top tip for taking care of your skin? The biggest thing is sun protection, including avoiding direct sunlight, wearing sunscreen, and covering up with clothing. What is one thing you want your patients to know about you? I treat all of my patients with respect, and I hope they see me as a friendly advisor and partner in their healthcare. What do you like to do when you are not in the office treating patients? I enjoy spending time with my wife and 3 young sons. I like outdoor activities like hiking and running, but I am a bit of a sci-fi and Lord of the Rings nerd as well. What to Expect From Dermatological Care Delivered by Dr. Mancuso and His Team Patients visiting with Dr. Mancuso and his team at Optima Dermatology will receive the highest quality care backed by decades of advanced training and experience. Dr. Mancuso is currently accepting new patients at its Nashua, NH location. Request an appointment online or call Optimadermatology at (603) 441-3223.

Optima Dermatology
Mar 17th, 2026
Dr. Andrew Werchniak, MD, joins Optima Dermatology's Concord, NH practice.

Dr. Andrew Werchniak, MD, joins Optima Dermatology's Concord, NH practice. March 2026 Dr. Werchniak brings more than two decades of experience in medical Dermatology and Skin Cancer treatment. Optima Dermatology is excited to welcome board-certified dermatologist Andrew Werchniak, MD, to its Concord, NH practice. Dr. Werchniak has been providing dermatology services to patients since 2004, specializing in medical dermatology and skin cancer treatment. Dr. Werchniak received the Castle Connolly Top Doctors Award in 2019, 2020, and 2025. He earned these numerous recognitions through a deep commitment to skin cancer treatment and prevention, which he has made the cornerstone of his career. In addition to serving as Medical Director of Dana-Farber/Brigham and Women's Cancer Center's Skin Cancer Screening program, Dr. Werchniak founded and served as program director of the hospital's Center for Cutaneous Oncology. This hands-on program allows fellows to work alongside dermatologists, surgeons, and oncologists to gain experience diagnosing and treating complex skin cancers, including melanoma, cutaneous lymphomas, and Merkel cell carcinoma. In the Harvard Combined Dermatology Residency Program, Dr. Werchniak served as Associate Director for Medicine/Dermatology Residency. He completed his residency in dermatology at the Geisel School of Medicine at Dartmouth and received his Doctor of Medicine from the University of Virginia School of Medicine in Charlottesville. With his deep experience and passion for serving patients in New Hampshire, Dr. Werchniak is excited to join Optima Dermatology and deliver dermatology care to individuals in the Concord area. Optimadermatology recently had the opportunity to learn more about Dr. Werchniak, his approach, and the path that led him to become a board-certified dermatologist. What made you decide to pursue a career in dermatology? What did the path to getting there look like for you? I was attracted to dermatology for several reasons. Many rare and exotic skin conditions can arise, and I found these interesting - there is often a lot of detective work involved in determining what is going on! My background is in engineering, and the problem-solving aspect of dermatology was particularly enticing. Dermatology has a nice blend of both thinking and doing (lots of procedures regularly), and the variety helps keep things fresh. Finally, most of the conditions that Optimadermatology encounter can be either cured outright or well-controlled with an array of techniques and medications, which differs from many other areas of medicine. What is your favorite aspect of being a board-certified dermatologist? Helping people understand what they can do to have the healthiest skin possible. What is your approach to treating your patients? I view my job as a team effort. I provide patients with the information and tools necessary to manage their condition and help them understand what to expect should they choose to follow one approach versus another. Most situations in medicine do not have a single obvious treatment path; rather, there are different reasonable options that involve trade-offs. Depending on the diagnosis, what might be a good choice for one individual may not be the optimal choice for someone else. Many factors are at play - age, life circumstances, co-morbidities, and preferences. What is your number one tip when it comes to taking care of your skin? That's easy: wear sunscreen daily! Sunscreen will help minimize many detrimental skin changes that occur as Optimadermatology age. What is one thing you want your patients to know about you? I want my patients to know I want them to do well, and I will do whatever I can to help them have the healthiest skin possible! What do you like to do when you are not in the office treating patients? Anything outdoors! I enjoy hiking, kayaking, snowshoeing - you name it. Anything that gets me outside and allows me to wander around in nature. What to Expect From Dermatological Care Delivered by Dr. Werchniak and His Team Patients visiting with Dr. Werchniak and his team at Optima Dermatology will receive the highest quality care backed by decades of advanced training and experience. Dr. Werchniak is currently accepting new patients at its Concord, NH location. Request an appointment online or call Optimadermatology at (603) 609-9344.

Optima Dermatology
Jan 6th, 2026
Optima Dermatology Welcomes Maria Petkova, NP-C

Optima Dermatology welcomes Maria Petkova, NP-C. Maria Offers Her Expertise as a Board-Certified Nurse Practitioner to Patients of All Ages Board-Certified Nurse Practitioner Maria Petkova, NP-C, has joined Optima's Salem and Bedford, NH practices, bringing industry-leading medical and dermatological experience to patients of all ages. She treats a variety of skin conditions, including acne, eczema, psoriasis, skin cancer, and more. Before entering the dermatology field, Maria worked as a registered nurse in oncology and pediatric intensive care. She went on to earn her Master of Science in Nursing, graduating with Summa Cum Laude honors with an emphasis on Family Medicine. She also holds a Bachelor of Science in Nutrition and Dietetics from Simmons University in Boston. Maria's background and clinical interests focus on women's and pediatric health, along with a strong foundation in oncology research. She has participated in multiple research studies at the Harvard School of Public Health and helped develop numerous cutaneous and non-cutaneous oncology clinical trials at the Novartis Institute for Biomedical Research. She maintains an active membership with the Society of Dermatology Nurse Practitioners, the Dermatology Nurses Association, and the American Association of Nurse Practitioners. With her new role at Optima Dermatology, Maria looks forward to providing industry-leading dermatology care to patients of all ages in the southern New Hampshire area. Because of her diverse experience in nutrition, academic and clinical research, oncology, ICU, and pediatrics, Maria is able to deliver care in a highly personalized and compassionate way, which aligns with Optima's mission to treat every patient as Optimadermatology would its family and friends. Optimadermatology recently had the opportunity to learn more about Maria, her approach, and the path that led her to become a board-certified nurse practitioner. What made you decide to pursue a career in dermatology? What did the path to get there look like for you? After spending several years working in inpatient oncology and ICU, I wanted to shift into a specialty where I could build more long-term relationships with my patients and be part of their ongoing care. My path into dermatology was shaped by the incredible mentorship I received early on. I had the opportunity to train with an exceptional dermatologist whose knowledge, passion, and genuine enthusiasm for the field were contagious. He was one of the best teachers I've ever had, and I know I wouldn't be where I am today without his guidance and support. That experience solidified my love for dermatology and the meaningful connections it allows me to make with patients. What is your favorite aspect of being a board-certified nurse practitioner? My favorite part of being a Nurse Practitioner is the ability to draw on my diverse clinical background to support my patients. My experience in nutrition, academic and clinical research, oncology, ICU, and pediatrics gives me a broad perspective that I use every day to create individualized care plans. I believe the compassion you gain as a nurse while being present with patients and families during some of their most difficult moments is something unique that NPs carry forward into advanced practice. It allows me to approach each patient with empathy and a commitment to improving their quality of life. My approach to patient care is to treat every individual the way I would want my own family to be treated. Having been a patient myself and having supported close family and friends through their own medical experiences, I understand how frightening, uncomfortable, and at times overwhelming healthcare can feel. Because of that, I prioritize building a trusting and respectful relationship with each patient. I want patients to feel heard, supported, and confident that Optimadermatology is working together toward their best possible health. What is your number one tip when it comes to taking care of your skin? My number one tip for taking care of its skin is simple: wear sunscreen every day and get annual skin checks. Unlike many internal cancers that require invasive testing or may only be detected once symptoms appear, most skin cancers can be identified early through routine exams, and many can be prevented with consistent sun protection. What is one thing you want your patients to know about you? One thing I want my patients to know is that I genuinely care about their health and quality of life. I believe that good health is one of the most important foundations in life, and I'm committed to supporting my patients in every way I can. What do you like to do when you are not in the office treating patients? When I'm not in the office, I'm spending time with my husband and its two young boys. They keep Optimadermatology busy, and I love being able to focus on family time whenever I'm away from work. What to Expect From Dermatological Care Delivered by Maria and Her Team Patients visiting with Maria and her team at Optima Dermatology will receive the highest quality of care backed by advanced training and experience. Maria is currently accepting new patients at its Salem and Bedford, NH locations. Request an appointment online or give Optimadermatology a call at 855-277 - 9689.