Senior Analyst, Payment Integrity (Healthcare)

Location: Fully remote, open only to candidates residing in Atlanta, Chicago, Dallas, Louisville, Minneapolis, Philadelphia, or Salt Lake City, United States. Future work models may include hybrid presence at the associated hub office.

Salary: $64,832–$85,092 per year, plus benefits and annual performance bonuses.

Company

hirify.global is a health insurance company built around a full-stack technology platform and a focus on member experience.

What you will do

• Provide subject-matter expertise on reimbursement policies, internal claims-processing edits, and external vendor edits.
• Investigate policy and payment-integrity inquiries, disputes, adverse claim outcomes, and escalated operational issues.
• Research industry coding rules and contribute to reimbursement policy language, scope, and implementation.
• Identify payment-integrity opportunities through claims review, data mining, process monitoring, and partner submissions.
• Translate improvement opportunities into business requirements and collaborate with internal partners to deliver solutions.
• Perform root-cause analysis, training, status communication, and stakeholder coordination.

Requirements

• Bachelor’s degree or 4+ years of equivalent experience.
• 4+ years of experience in claims processing, coding, auditing, or healthcare operations.
• 3+ years of medical coding experience within payment integrity.
• Medical coding certification through AAPC or AHIMA, such as CPC, COC, CCS, RHIT, or RHIA.
• Experience with reimbursement methodologies, provider contract concepts, claims processing, business insights from datasets, and workflow improvement.
• Experience collaborating with internal or external stakeholders.

Nice to have

• Technical, process improvement, Six Sigma, or Lean Six Sigma experience.
• Experience using SQL.

Culture & Benefits

• Fully remote work within the specified U.S. locations.
• Medical, dental, and vision benefits.
• Unlimited vacation program, paid holidays, paid sick time, paid parental leave, and paid wellness time.
• 401(k) participation, life and disability insurance, and annual performance bonuses.
• Equal-opportunity environment focused on belonging, support, transparency, and collaboration.