Revenue Specialist, Denials (Healthcare)

Location: Remote within the United States; based in Franklin, Tennessee.

Company

hirify.global provides specialty revenue cycle management solutions for healthcare organizations through its E360 RCM intelligent automation platform and claims expertise.

What you will do

• Review and evaluate denied and assigned healthcare claims using proprietary software, payer documentation, and provider contract information.
• Research and obtain medical records and supporting documentation for hospital claims and submit them to the appropriate payer.
• Conduct timely telephone follow-up with payers to confirm receipt of documentation and facilitate reimbursement.
• Audit initial denials and resolve outstanding claims through the denials appeal process.
• Handle protected health information and maintain strict privacy and security of confidential data.

Requirements

• High school diploma or GED required; an associate or bachelor’s degree is preferred.
• 5+ years of experience in healthcare billing or collections and at least 1 year of client-facing or customer service experience.
• Intermediate understanding of insurance payer and provider claims processing, revenue cycle management, hospital reimbursement, and managed care contracts.
• Knowledge of ICD, HCPCS/CPT coding, medical terminology, EOBs, UB-04, and HCFA 1500 forms.
• Strong computer proficiency, including Microsoft Word, Excel, and Outlook.
• Strong analytical, problem-solving, written and verbal communication, prioritization, and customer service skills; ability to work independently and meet productivity targets.

Culture & Benefits

• Professional growth and development supported through tools, resources, and ongoing employee investment.
• Core values centered on cooperation, shared goals, employee empowerment, and client service.
• Flexible, family-oriented work environment with attention to work-life balance.
• Equal opportunity workplace committed to a discrimination- and harassment-free environment.

Hiring process

• Artificial intelligence tools may assist with application, resume, and response review.
• Final hiring decisions are made by humans.