Backend Claims Management Specialist

📋 Description

• Investigate and resolve complex healthcare claims, denials, reimbursement issues, and other
• Analyze denial trends and perform root cause analysis to identify recurring issues and
• Support efforts to reduce aged accounts receivable and optimize reimbursement performance.
• Escalate complex payer, claims, or operational issues to the appropriate internal stakeholders when
• Develop and maintain strong knowledge of payer policies, reimbursement methodologies, claims
• Monitor payer trends and emerging risks to identify opportunities for process improvement and

🎯 Requirements

• Professional experience in Revenue Cycle Management (RCM), medical billing, healthcare claims
• Strong knowledge of healthcare claims processing, denial management, payer reimbursement
• Ability to investigate complex claims issues, identify root causes, recognize trends, and develop
• Strong analytical skills and demonstrated proficiency in data analysis and performance reporting.
• Excellent written and verbal communication skills, with the ability to present findings and
• Ability to collaborate effectively with operational teams, service leaders, BPO partners, and other

🎁 Benefits

• Target base compensation of $16–$22 USD per hour in most U.S. locations, with final compensation
• Flexible work arrangements, including fully remote, hybrid, or in-office options within the United
• Professional development and continued investment in employee growth.
• Comprehensive health and wellness benefits available from day one.
• Annual wellness stipend.
• 401(k) plan with up to a 4% company match and immediate vesting.