Appeals Specialist (Healthcare)

Location: Fully remote; ability to support EST hours required

Salary: $31.25–$33.65 USD per hour

Company

hirify.global provides genomic testing, clinical data, and precision medicine services to support diagnosis, treatment decisions, and drug discovery.

What you will do

• Review denied claims, identify denial causes, and assess appeal potential.
• Gather documentation from healthcare providers and insurance representatives.
• Prepare, submit, track, and follow up on appeals according to payor requirements.
• Apply healthcare regulations, payor policies, and coding guidelines to maintain compliance.
• Analyze denial trends and recommend process improvements to reduce future denials.
• Collaborate with clinical teams, market access, and insurance representatives to resolve appeal issues.

Requirements

• 3–5 years of experience in laboratory billing appeals.
• Strong understanding of insurance policies, healthcare regulations, medical terminology, and coding.
• Experience handling appeals for major insurance plans, Medicaid, and Managed Medicaid.
• Knowledge of industry regulations, including HIPAA.
• Strong organizational skills, attention to detail, and ability to manage multiple priorities.
• Proficiency with Microsoft Office Suite, including Excel, Word, Outlook, and Teams.

Nice to have

• Experience with Xifin.

Culture & Benefits

• Fully remote work from a home office or other suitable location.
• Work with standard computer, phone, and video conferencing equipment.
• Schedule and working hours are established with the leader and may change with business needs.
• Culture emphasizes ownership, teamwork, continuous improvement, and meaningful patient impact.
• Compensation and benefits reflect local market practices and legal requirements.