Backend Claims Management Specialist

🕒 August 11

🇺🇸 United States – Remote

💵 $16 - $22 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔙 Backend Engineer

👻 Ghost score 1%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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EverCommerce

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

☁️ SaaS

🤝 B2B

📣 Marketing

💰 Private equity on 2019-08

SaaS • B2B • Marketing

EverCommerce is a provider of industry-tailored software that powers the service economy. It builds SaaS products to digitally transform daily operations for service professionals, including business management, electronic billing and mobile payments, omni-channel marketing, and customer engagement tools. EverCommerce focuses on verticalized solutions—not mass-market software—designed to modernize operations, marketing, and customer interactions for businesses that provide services.

📋 Description

• Investigate and resolve complex claims, denials, and reimbursement issues • Analyze denial trends and identify root causes to improve claim outcomes • Support reduction of aged accounts receivable and optimize reimbursement performance • Escalate complex payer or operational issues as needed • Develop expertise in payer policies, reimbursement methodologies, and client workflows • Identify payer trends, emerging risks, and process improvement opportunities • Partner with internal teams to implement solutions improving operational efficiency and financial performance • Partner with Service Managers to improve client health and revenue cycle performance • Present findings, recommendations, and performance trends to internal stakeholders • Support client retention through proactive issue resolution and operational improvements • Provide guidance and training to BPO teams on claims processing and denial prevention best practices • Develop and promote standardized processes improving quality and consistency • Collaborate with Revenue Cycle, Operations, and Client Services teams to drive continuous improvement • Improve revenue cycle performance through reduced denials and aged receivables, increased clean claim rates, stronger client health, and scalable operational improvements

🎯 Requirements

• Experience in Revenue Cycle Management (RCM), medical billing, or healthcare claims management • Strong knowledge of claims processing, denial management, and payer reimbursement methodologies • Analytical mindset with ability to identify trends, perform root cause analysis, and recommend solutions • Strong written and verbal communication skills with ability to influence cross-functional teams • Proficiency in data analysis and performance reporting • Preferred: experience in healthcare revenue cycle operations, denial prevention, appeals, or payer relations • Preferred: experience driving operational improvements and process optimization • Must be eligible to work without sponsorship in the United States

🏖️ Benefits

• Flexibility to work where/how you want within your country of employment – in-office, remote, or hybrid • Continued investment in your professional development • Day 1 access to a robust health and wellness benefits package, including an annual wellness stipend. • 401k with up to a 4% match and immediate vesting • Flexible and generous (FTO) time-off • Employee Stock Purchase Program