Backend Claims Management Specialist
New
J
JobgetherHealthcare Revenue Cycle
Based in the United StatesFull-Time
Salary$16–$22 USD per hour
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Job Details
- Required Skills
- Data Analysis
Requirements
- Professional experience in Revenue Cycle Management (RCM), medical billing, healthcare claims management, or a closely related field.
- Strong knowledge of healthcare claims processing, denial management, payer reimbursement methodologies, and revenue cycle operations.
- Ability to investigate complex claims issues, identify root causes, and develop practical recommendations.
- Strong analytical skills and demonstrated proficiency in data analysis and performance reporting.
- Excellent written and verbal communication skills with the ability to influence cross-functional stakeholders.
- Ability to collaborate effectively with operational teams, service leaders, and BPO partners.
- Strong organizational skills and attention to detail.
- Proactive, solution-oriented approach with a focus on measurable improvements.
- Ability to work independently in a fully remote environment.
Responsibilities
- Investigate and resolve complex healthcare claims, denials, reimbursement issues, and barriers to timely payment.
- Analyze denial trends and perform root cause analysis to identify recurring issues.
- Support efforts to reduce aged accounts receivable and optimize reimbursement performance.
- Partner with internal teams to implement operational solutions that improve claims efficiency and quality.
- Provide guidance, education, and training to BPO teams on claims processing and denial management.
- Develop and promote standardized processes to improve quality, consistency, and scalability.
- Present claims findings, performance trends, and recommendations to internal stakeholders.
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