Care Navigator (US Health Insurance)

Location: Fully remote; work from anywhere globally

Company

hirify.global builds software-based health, insurance, and retirement products as a global social safety net for remote workers.

What you will do

• Support members with confusing medical bills, denied claims, coverage questions, and complex cases.
• Guide members through appeals and review explanations of benefits to identify errors.
• Coordinate with members, healthcare providers, payers, and internal teams to resolve billing and coverage issues.
• Help members and providers manage prior authorization requirements, including specialty and pharmacy pre-authorization.
• Explain plan design and benefits in clear language and direct members to high-value, in-network care.
• Identify patterns in claims and cost data to support improvements to the health insurance plan.

Requirements

• Several years of experience in a medical-administrative or patient-facing coordination role.
• Hands-on experience with claims, medical billing, pre-authorizations, and reviewing EOBs.
• Working familiarity with CPT and ICD coding and how charges are built and submitted.
• Ability to coordinate persistently across members, providers, and payers through resolution.
• Warm, clear communication with members.

Nice to have

• Experience on the payer or claims-administration side of health insurance.
• BCPA certification.
• Clinical-adjacent experience.

Culture & Benefits

• Fully remote work with a globally distributed team.
• Worldwide health, income, and travel coverage through hirify.global's products.
• At least four weeks of vacation per year.
• Laptop replacement when needed.
• Potential equity compensation and a yearly home office allowance.