Claims Benefit Configuration Senior Associate (Healthcare)

Location: Remote USA

Salary: $58,000–$96,000 annually

Company

hirify.global is a healthcare company building an integrated care platform that combines data, AI, clinical services, and member support to improve the health and well-being of older Americans.

What you will do

• Interpret, analyze, implement, and audit claims configuration for benefits, authorizations, denial libraries, billing guidelines, and payment policies.
• Manage the claims benefit configuration inbox and provide accurate, timely responses to stakeholders.
• Develop and enforce quality-control procedures, conducting routine reviews to improve configuration accuracy and performance.
• Lead annual benefit-configuration readiness and BID application management, including timelines, documentation, and cross-functional alignment.
• Oversee the Devoted Denial Reasons library and maintain accurate mappings for internal denial codes.
• Design and implement process improvements, including AI and automation, to reduce errors and manual operational work.

Requirements

• Experience analyzing data sets, generating insights, and turning findings into operational action.
• Strong analytical, problem-solving, organizational, communication, and collaboration skills.
• Fluency in Google Sheets or Excel and the ability to learn new tools and work with data analytics teams.
• Experience managing high-impact workflows with compressed timelines in a fast-paced, metrics-driven environment.
• Ability to prioritize effectively and work comfortably with ambiguity.
• Must be based in the USA for this remote role.

Nice to have

• Bachelor’s degree, or equivalent relevant professional experience.
• Knowledge of health insurance claims processing, regulations, and compliance requirements.
• Certified Professional Coder (CPC) certification.
• Experience collaborating with offshore or distributed teams without direct managerial authority.
• Experience applying AI and automation to operational processes.

Culture & Benefits

• Employer-sponsored health, dental, and vision plans with low or no premium.
• Generous paid time off and parental leave.
• $100 monthly mobile or internet stipend.
• Stock options for all employees and bonus eligibility for most roles.
• 401(k) program and a collaborative, supportive work environment.