Claims Payables Specialist

🕒 4 days ago

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Logo of Vytalize Health

Vytalize Health

201 - 500 employees

🤝 B2B

☁️ SaaS

⚕️ Healthcare Insurance

💰 $100M Series C - Vytalize Health on 2023-02

B2B • SaaS • Healthcare Insurance

Vytalize Health is a healthcare technology and services company that helps primary care practices and Accountable Care Organizations (ACOs) transition to value-based care. It combines data-driven analytics, virtual and in-home clinical support, and care management services to improve patient outcomes, enable Medicare-approved remote services for chronic conditions, and help practices earn shared savings under value-based contracts. Vytalize partners with independent PCPs, group practices, community health centers and existing ACOs to deliver clinical enablement, practice-tailored workflows, and performance insights.

📋 Description

• Process and adjudicate value-based care claims in accordance with established policies, procedures, and regulatory requirements. • Review processed claims for accuracy, completeness, and compliance with contractual agreements and reimbursement guidelines. • Investigate and resolve discrepancies in claim information. • Ensure timely and accurate payment of value-based care claims. • Maintain thorough documentation of claims processing activities. • Collaborate with other departments to address claim-related inquiries. • Assist in the development and implementation of process improvements.

🎯 Requirements

• Bachelor's degree in Finance, Accounting, Healthcare Administration, or a related field • Minimum of 2 years of experience in claims processing, preferably in value-based care or healthcare reimbursement • Proficient in claims processing systems and EDI technology • Available to work full-time with occasional travel for training and provider engagement activities • Certification in healthcare billing or claims management (CPC, CPPS, or similar) is a plus • Must complete interviews and assessments independently without external assistance.

🏖️ Benefits

• Offers Bonus

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