EverHealth - Backend Claims Management Specialist; Remote

## Ever Health - Backend Claims Management Specialist (Remote, US)
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Remote- UStime type:
Full time posted on:
Posted Todayjob requisition :
R-106420

At Ever Commerce [Nasdaq: EVCM], we are on a mission to digitally transform the service economy with tailored, end-to-end SaaS solutions that simplify and empower the lives of our 745,000+ customers. As a leading service commerce platform, our modern digital and mobile applications create predictable, informed, and convenient experiences between customers and their service professionals in the areas of Home & Field Services, Health Services, and Wellness industries.

We are building an extraordinary company and looking for talented, energetic, and motivated people to join our team. You can learn more about our Company, Culture and Values here:  Backend Claims Management Specialist enables timely claim resolution by providing operational expertise, strategic guidance, and educational support focused on backend revenue cycle performance. This role partners closely with Service Managers and BPO teams to identify barriers to payment, analyze denial trends, improve claim outcomes, and drive overall client health through data-driven recommendations.

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Key Responsibilities ### Revenue Cycle & Claims Management
* 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.### ### Payer & Operational Expertise
* Develop expertise in payer policies, reimbursement methodologies, and client workflows.
* Identify payer trends, emerging risks, and opportunities for process improvement.
* Partner with internal teams to implement solutions that improve operational efficiency and financial performance.### ### Customer Success & Performance Improvement
* Partner with Service Managers to improve overall 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.### ### Education & Collaboration
* Provide guidance and training to BPO teams on claims processing and denial prevention best practices.
* Develop and promote standardized processes that improve quality and consistency.
* Collaborate cross-functionally with Revenue Cycle, Operations, and Client Services teams to drive continuous improvement.## ## Qualifications### Required
* 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 the ability to identify trends, perform root cause analysis, and recommend solutions.
* Strong written and verbal communication skills with the 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.
* Experience driving operational improvements and process optimization.## ## Success in This Role Success in this role is measured by the ability to improve revenue cycle performance through reduced denials and aged receivables, increased clean claim rates, stronger client health, and the implementation of scalable operational improvements that enhance customer outcomes.
** Where:
** The Ever Commerce team is distributed globally, with teams across multiple regions. This role can be based anywhere in the United States – if you’re close to one of our offices, we can set you…