At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.
Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
1. Review, investigate, and analyze claim appeals, working closely with coders to coordinate review of documentation. Assist customer service, providers, and clients on resolution of issues or inquires.
2. Research and manage claim inventory for inpatient, outpatient, and provider billing using review guidance supplied by our clinical teams.
3. Request and process documentation associated with special projects and clinical review inquiries.
4. Access, research, and retrieve information and documentation from Claritev and one of various external client systems.
5. Data Entry and database maintenance including review, validation, and maintenance of provider data.
6. Perform system claim adjustments based on appeal outcomes or to process corrected claims.
7. Manage manual distribution of workflow when system is unable to assign.
8. Assist with special projects as assigned in conjunction with daily workload; prioritizing and shifting focus as needed
9. Collaborate, coordinate, and communicate across disciplines and departments.
10. Ensure compliance with HIPAA regulations and requirements.
11. Demonstrate Company's Core Competencies and values held within.
12. Please note: due to the exposure of PHI sensitive data, this role is considered to be a High Risk Role.
13. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
COMPENSATION:
The salary range for this position is $45k-$50k. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.
* Experience in health care and/or knowledge of commonly used medical coding preferred.
* Required licensures, professional certifications, and/or Board certifications as applicable
* Communication (written, verbal and listening), analytical, organizational, prioritization, technical, etiquette and interpersonal skills
* Ability to use software and hardware peripherals related to job responsibilities including MS Office Suites with preferred proficiency with Word, Excel, and other database software.
* Ability to be flexible in quickly shifting priorities and keeping up with changes across multiple tasks in a fast paced environment while maintaining a positive and cooperative demeanor.
* Ability to demonstrate strong technical skills.
* Ability to identify issues and escalate for course of action for resolution.
* Ability to elicit trust and credibility with all levels of the organization.
* Ability to adjust/alter schedule to meet deadlines.
* Ability to work independently and handle confidential information.
* Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
BENEFITS
We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include:
- Medical, dental and vision coverage (low copay & deductible
- Life insurance
- Short and long-term disability
- 401(k) + match
- Generous Paid Time Off
- Paid company holidays
- Tuition reimbursement
- Flexible Spending Account
- Employee Assistance Program
- Summer Hours
BENEFITS
We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include:
- Medical, dental and vision coverage with low deductible & copay
- Life insurance
- Short and long-term disability
- Paid Parental Leave
- 401(k) + match
- Employee Stock Purchase Plan
- Generous Paid Time Off – accrued based on years of service
- WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
- 10 paid company holidays
- Tuition reimbursement
- Flexible Spending Account
- Employee Assistance Program
- Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits.
EEO STATEMENT
Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here.
APPLICATION DEADLINE
We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.
#LI-AN1
Skills Required
- High school diploma or GED plus two years of operations/service experience (claims processing, customer service, medical records, collections, data entry, or database management) OR Associate's degree in lieu of experience
- Experience in health care and/or knowledge of commonly used medical coding
- Required licensures, professional certifications, and/or Board certifications as applicable
- Strong written, verbal, and listening communication skills
- Analytical, organizational, prioritization, and interpersonal skills
- Proficiency with MS Office suite, specifically Microsoft Word and Excel, and other database software
- Ability to use software and hardware peripherals related to job responsibilities (keyboard, copier, telephone)
- Ability to be flexible, shift priorities quickly, and manage multiple tasks in a fast-paced environment
- Ability to work independently, handle confidential PHI, identify issues, and escalate for resolution
- Ability to sit and view monitors for extended periods and operate standard office equipment
Claritev Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Claritev and has not been reviewed or approved by Claritev.
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Leave & Time Off Breadth — Paid time off, paid holidays, and paid parental leave are part of the offering. Flexible schedules expand practical time‑off and scheduling options.
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Healthcare Strength — Medical (PPO and HDHP), dental, vision, and HSA/FSA options are available alongside an EAP and a Noom weight‑management program. These elements indicate broad healthcare coverage with added wellness support.
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Flexible Benefits — Work‑from‑home opportunities and flexible schedules are commonly advertised. Remote work and schedule flexibility are highlighted as positives that can offset cash‑pay concerns for some employees.
Claritev Insights
What We Do
Claritev is an independent and public healthcare technology, data and insights company making healthcare more transparent, fair and affordable for all. We work across the healthcare value chain to expose imbalanced and inefficient pricing practices. Led by deeply experienced analysts, negotiators and innovators, Claritev provides tech-enabled solutions and services fueled by proprietary data from over 40 years of experience. Today, along with machine learning and AI, we utilize a robust enterprise platform to deliver price transparency, improve payment accuracy, and drive more meaningful analytics and decision-making. Through Claritev, providers are able to make data-enabled decisions to optimize their service offerings, market position and ultimately deliver high-quality care. Payors and third-party administrators can deliver greater flexibility and value to plan sponsors. Employers can drive cost-efficient benefit design and patients can finally afford the care they need. By focusing on customized solutions that that improve transparency, affordability and quality for all key players, we’re igniting a more competitive marketplace — one that lowers overall costs while improving quality. Claritev brings the transparency our nation needs to see its way to a better healthcare system.
