Operations Configuration and Integration Analyst (Healthcare)

Location: Remote-NY; must be authorized to work in the United States without current or future employment-based visa sponsorship.

Salary: $27.02–$48.55 per hour

Company

hirify.global provides healthcare services focused on connecting people with the care they need and improving access to effective care.

What you will do

• Create, update, load, test, and maintain configuration tables, files, and software supporting claims adjudication.
• Support claim adjudication rules, benefit plans, provider reimbursement rules, and new benefit or contract designs.
• Develop and execute testing scenarios, test conditions, unit tests, and end-user tests.
• Research and resolve configuration-related claims issues using system queries and root-cause analysis.
• Identify automation opportunities, recommend system solutions, and improve claims processing.
• Coordinate system programming changes and schedules with business analysts and programmers.

Requirements

• Bachelor’s degree or an equivalent combination of education and experience in a managed care environment.
• Two to three years of experience in an automated medical claims and managed care or multi-product environment is desired.
• One to two years of experience with systems logic and testing is desired.
• Knowledge of claims adjudication rules, MC400 editing, claim processing programs, Macess imaging, and related claims software.
• U.S. work authorization is required; employment-based visa sponsorship is not available now or in the future.

Culture & Benefits

• Health insurance and comprehensive employee benefits.
• 401(k) and stock purchase plans.
• Tuition reimbursement, paid time off, and holidays.
• Flexible work approaches, including remote, hybrid, field, or office schedules.
• Equal opportunity workplace committed to diversity and accessibility.