About Evolve
Evolve is a specialized delegated benefit manager headquartered in Salt Lake City, Utah, focused on home modifications for Medicaid and Medicare Advantage plans. Founded in 2014, we have grown into a trusted partner dedicated to optimizing home environments for improved clinical outcomes. We operate as an Organized Health Care Delivery System (OHCDS), managing a robust network of qualified vendors to provide environmental accessibility adaptations and asthma remediation nationwide. Our mission is to combine healthcare-forward mindsets with operational efficiency to enhance member experience and safety.
Job Summary
We are seeking a detail-oriented and experienced Medical Claims Biller to join our growing team. This role is critical to ensuring the financial health of our organization by managing the full claims lifecycle. You will work closely with Evolve’s Controller to manage submissions, reconciliations, and complex reconsiderations.
The ideal candidate possesses a strong background in healthcare billing portals and accounting software, ensuring that all financial transactions are recorded accurately and timely.
Role Details
Item
Details
Compensation
Starting at $45,000 annually (Dependent on Experience). Medical Insurance. Vision Insurance.
Location
Murray, UT (In-office for first 90 days; Hybrid may be an option thereafter)
Reports To
Controller
Employment Type
Full-Time
Key Responsibilities
- Execute end-to-end claims submission processes for Medicaid and Medicare Advantage plans.
- Monitor and process claims remittances, ensuring accurate posting to financial records.
- Manage claims reconsiderations and appeals, identifying and resolving denials or discrepancies.
- Perform regular claims reconciliations to ensure internal data matches clearinghouse and health plan records.
- Collaborate with the Controller to maintain accurate financial reporting.
- Utilize Availity and Payer Proprietary clearinghouse portal for all submission and tracking activities.
- Manage billing-related data entry and reconciliation within QuickBooks Online.
Qualifications & Requirements
- Experience: 2–3 years of professional experience in medical claims billing.
- Medical Biller Credentials is a plus! (CPB, CMRS, etc)
- Technical Proficiency: Preferred experience using Availity and Payer’s clearinghouse portal.
- Accounting Software: Proficiency in accounting software is required, with a strong preference for QuickBooks Online.
- Expertise: Demonstrated knowledge of claims submission, remittances, reconsiderations, and reconciliations.
- Attention to Detail: Exceptional accuracy in data entry and financial record-keeping.
- Compliance: Must be willing to pass a comprehensive background check prior to the start of employment.
Evolve is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Pay: $45,000.00 per year
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Parental leave
- Vision insurance
Work Location: In person
