Claims Representative - EviCore

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Claims Representative – EviCore based in the United States.

As a Claims Representative, you will play an essential role in ensuring the accurate and timely processing of post-service medical claims. You will review medical records, authorization documentation, and benefit information to support medical necessity reviews and ensure claims are handled in accordance with established policies and regulatory requirements. Working closely with clinical teams and operational stakeholders, you will help maintain efficient claims workflows and resolve discrepancies. Your responsibilities will span several medical specialties, including radiology, pain management, laboratory services, and gastroenterology. This position offers the opportunity to contribute to healthcare service quality in a collaborative, technology-driven, and fully remote environment. You will be part of a team focused on accuracy, compliance, productivity, and positive service outcomes.