AR Recovery/Healthcare Denials Specialist III (Healthcare Revenue Cycle)

Location: Virtual — United States

Company

hirify.global develops healthcare revenue management software and solutions that help hospitals improve reimbursement and collections.

What you will do

• Learn and use the Rubixis AR Follow Up platform and related resources.
• Manage assigned healthcare accounts from initial review through resolution.
• Contact insurance companies, affiliates, and providers to resolve contract and payment issues.
• Analyze billing, pricing, cash costing, collections, and reimbursement variances in accordance with applicable policies and regulations.
• Investigate denied, rejected, underpaid, and otherwise unexpected insurance payments.
• Collaborate with leadership and colleagues on trends, challenges, and solutions while mentoring junior representatives.

Requirements

• 5+ years of hospital billing and follow-up experience with advanced knowledge of payer types.
• Knowledge of Medicare payer rules, denial reasons, appeals, portals, and Medicare Direct Data Entry.
• Experience resolving unpaid, denied, underpaid, and rejected claims for healthcare providers.
• Experience with UB-04 facility pricing, reimbursement variance, contract analysis, and revenue cycle operations.
• Basic familiarity with healthcare information technology systems such as EPIC, Paragon, or Zirmed.
• Strong analytical, problem-solving, organizational, and detail-oriented skills; an associate or bachelor's degree is preferred.

Nice to have

• 2+ years of UB-04 follow-up or contract and reimbursement analysis experience.
• 2+ years of experience with Medicare processes and systems.
• Detailed knowledge of facility reimbursement contracts, fee schedules, and reimbursement procedures.
• Advanced Microsoft Excel skills.

Culture & Benefits

• Remote work in the United States.
• Customer-centric, agile, reliable, and engaged working culture.
• Commitment to integrity, continuous learning, feedback, and self-development.
• Compliance with HIPAA, FCRA, GLBA, confidentiality, and other applicable requirements.
• Equal opportunity employment and reasonable accommodation for qualified applicants.