Evry Health

Commercial Health Call Center Representative- REMOTE

Evry Health · Full Time · 5 days ago

Evry Health

🌎 United States ⭐ 2-5 yrs exp 💼 Support

Provide accurate information on commercial health plan benefits, eligibility, and claims via phone and email. Handle member inquiries, manage escalations, and document all interactions while maintaining quality standards.

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Bilingual (Spanish) Commercial Health Call Center Representative

Evry Health · Full Time · 7 days ago

Evry Health

🌎 United States ⭐ 2-5 yrs exp 💼 Support

Provide accurate information on commercial health plan benefits, eligibility, and claims via phone and email. Handle member inquiries, manage escalations, and collaborate with internal departments to resolve provider and member issues.

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Care Guide Advocate

Evry Health · Full Time · 13 days ago

Evry Health

🌎 United States ⭐ 2-5 yrs exp 💼 Others

The Care Guide Advocate supports RN Care Coordinators and Utilization Management RNs by assisting members and providers with navigation and administrative tasks. Key duties include managing prior authorizations, conducting provider searches, and ensuring a seamless patient experience.

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Network Relations Specialist

Evry Health · Full Time · 20 days ago

Evry Health

🌎 United States ⭐ 5-10 yrs exp 💼 Others

Lead the development and management of geographic medical networks by negotiating and amending contracts with healthcare providers. Monitor network adequacy and quality while maintaining relationships with contracted physicians and facilities.

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Commercial Health Actuary - Remote

Evry Health · Full Time · a month ago

Evry Health

🌎 United States ⭐ 5-10 yrs exp 💼 Finance

The role involves evaluating health insurance applications to set competitive premium rates and analyzing claims experience to inform underwriting decisions. The actuary will collaborate with sales teams to develop insurance products and ensure regulatory compliance.

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Enrollment Data Analyst

Evry Health · Full Time · a month ago

Evry Health

🌎 United States ⭐ 2-5 yrs exp 💼 Software Development

Manage the end-to-end lifecycle of member enrollment data, focusing on HIPAA 834 EDI file processing and system validation. Ensure data integrity across health plan systems through SQL queries, audits, and cross-functional collaboration with engineering and claims teams.

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Sr. Software Engineer (Node)

Evry Health · Full Time · a month ago

Evry Health

🌎 United States ⭐ 10+ yrs exp 💼 Software Development

Lead the design and implementation of scalable backend systems and RESTful APIs using Node.js and Next.js. Provide technical leadership through mentorship, code reviews, and performance optimization of SQL databases.

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Provider Dispute & Adjustment Specialist

Evry Health · Full Time · a month ago

Evry Health

🌎 United States 💵 $65000 - $70000 per year ⭐ 2-5 yrs exp 💼 Others

Manage the end-to-end provider dispute resolution process and process claim adjustments within a commercial health plan environment. Conduct in-depth research into claim histories and contracts to ensure accurate, compliant, and fair payment outcomes.

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Senior Software Engineer (.NET)

Evry Health · Full Time · a month ago

Evry Health

🌎 United States ⭐ 10+ yrs exp 💼 Software Development

Lead the design and implementation of scalable back-end systems using .NET technologies and Azure cloud infrastructure. Provide technical leadership through mentorship, code reviews, and performance optimization to ensure high availability.

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Healthcare Claims Specialist - Remote

Evry Health · Full Time · 2 months ago

Evry Health

🌎 United States 💵 $55000 - $60000 per year ⭐ 2-5 yrs exp 💼 Finance

Responsible for the end-to-end claims adjudication process, including verification of eligibility and coordination of benefits. The role involves auditing auto-adjudicated claims and maintaining desktop procedures to ensure regulatory compliance.

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AI Solutions Engineer

Evry Health · Full Time · 2 months ago

Evry Health

🌎 United States 💵 $115K - $140K per year ⭐ 2-5 yrs exp 💼 Software Development

Lead end-to-end technical implementations and custom integrations of AI tools for enterprise customers. Provide pre-sales technical support and collaborate with product teams to refine the AI roadmap based on customer feedback.

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Medical Director for Health Plan (Full-time or Part-time)

Evry Health · Full Time · 3 months ago

Evry Health

🌎 United States ⭐ 10+ yrs exp 💼 Healthcare

The Medical Director will lead utilization management strategy and medical policy development to ensure the delivery of cost-effective, high-quality healthcare services. They will also collaborate with cross-functional teams to identify care trends, improve clinical quality, and evaluate new patient engagement technologies.

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Healthcare Claims Specialist - REMOTE

Evry Health · Full Time · 4 months ago

Evry Health

🌎 United States 💵 $55000 - $60000 per year ⭐ 2-5 yrs exp 💼 Finance

Claims Specialists manage the end-to-end claims adjudication process, including testing configuration, verifying eligibility and coordination of benefits, and finalizing claim determinations based on the health benefits plan. They are also responsible for auditing auto-adjudicated claims for accuracy and ensuring compliance with regulations while developing and maintaining desktop procedures.

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