Backend Claims Management Specialist

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $16 - $22 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔙 Backend Engineer

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EverCommerce

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2016

🏥 Healthcare

💼 Consulting

📦 Logistics

💰 Private Equity Round on 2019-07

Healthcare • Consulting • Logistics

EverCommerce is the leading service commerce platform, providing vertically-tailored, integrated SaaS solutions to over 500,000 global service-based businesses. Established in 2016, EverCommerce offers software solutions that help businesses market their services, streamline day-to-day operations, and enhance customer engagement. The company specializes in powering the service economy with digital transformation across multiple industries, including Home & Field Services, Health Services, and Fitness & Wellness. EverCommerce's technology aims to accelerate growth, improve operations, and increase retention for small and medium-sized businesses, transforming the way they interact with customers through modern digital and mobile applications.

📋 Description

• Investigate and resolve complex claims, denials, and reimbursement issues • Analyze denial trends, identify root causes, and improve claim outcomes • Reduce aged accounts receivable and optimize reimbursement performance • Escalate complex payer or operational issues • Develop expertise in payer policies, reimbursement methodologies, and client workflows • Identify payer trends, emerging risks, and process improvement opportunities • Partner with internal teams to improve 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 • Guide and train BPO teams on claims processing and denial prevention best practices • Develop and promote standardized processes to improve quality and consistency • Collaborate with Revenue Cycle, Operations, and Client Services teams on continuous improvement

🎯 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 ability to identify trends, perform root cause analysis, and recommend solutions • Strong written and verbal communication skills 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 • May require occasional travel to the Corporate Headquarters in Denver, Colorado, or other US office locations

🏖️ 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