Backend Claims Management Specialist

This is a remote opportunity focused on improving healthcare revenue cycle performance through expert claims management and data-driven operational insights.

• Investigate and resolve complex healthcare claims, denials, reimbursement issues, and other barriers to timely payment.
• Analyze denial trends and perform root cause analysis to identify recurring issues and opportunities to improve claim outcomes.
• Support efforts to reduce aged accounts receivable and optimize reimbursement performance.
• Escalate complex payer, claims, or operational issues to the appropriate internal stakeholders when necessary.
• Develop and maintain strong knowledge of payer policies, reimbursement methodologies, claims processes, and client workflows.
• Monitor payer trends and emerging risks to identify opportunities for process improvement and stronger financial performance.
• Partner with internal teams to implement operational solutions that improve claims efficiency, quality, and reimbursement outcomes.
• Collaborate with Service Managers to assess client health and identify opportunities to improve revenue cycle performance.
• Present claims findings, performance trends, root causes, and recommendations to relevant internal stakeholders.
• Support customer retention by proactively resolving operational issues and contributing to measurable improvements in client outcomes.
• Provide guidance, education, and training to BPO teams on claims processing, denial management, and prevention best practices.
• Develop and promote standardized processes that improve quality, consistency, and scalability.
• Collaborate across Revenue Cycle, Operations, and Client Services to drive continuous improvement initiatives.
• Track performance against key outcomes, including denial reduction, aged receivables, clean claim rates, and overall revenue cycle health.

• 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, recognize trends, 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 present findings and influence cross-functional stakeholders.
• Ability to collaborate effectively with operational teams, service leaders, BPO partners, and other internal stakeholders.
• Experience with healthcare revenue cycle operations, denial prevention, appeals, or payer relations is preferred.
• Experience driving operational improvements, process optimization, or standardized workflow initiatives is a plus.
• Strong organizational skills and attention to detail when managing claims, performance data, and competing priorities.
• Proactive, solution-oriented approach with a focus on measurable improvements and customer outcomes.
• Ability to work independently in a fully remote environment while collaborating effectively across geographically distributed teams.
• Must be eligible to work in the United States without employer sponsorship.
• Willingness to travel occasionally to company headquarters in Denver, Colorado, or other U.S. locations as business needs require.

• Target base compensation of $16–$22 USD per hour in most U.S. locations, with final compensation based on location, market conditions, experience, and expertise.
• Flexible work arrangements, including fully remote, hybrid, or in-office options within the United States.
• 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.
• Flexible and generous flexible time off (FTO).
• Employee Stock Purchase Program.
• Opportunity to work with distributed teams across multiple regions.
• Exposure to healthcare revenue cycle operations, claims analytics, payer strategy, and process optimization.
• Opportunities to contribute directly to improvements in financial performance, operational efficiency, and customer outcomes.
• Occasional travel opportunities for team collaboration and business needs.