Associate Director, Billing Strategy - Denials & Appeals (Healthcare RCM)

Location: Remote within the United States

Salary: $132,100–$165,100 USD annually

Company

hirify.global develops cell-free DNA testing and personalized genetic diagnostics for oncology, women’s health, and organ health.

What you will do

• Lead denial management and appeals strategy across commercial, Medicare, Medicaid, and managed care payers.
• Monitor overturn rates, appeal timelines, recovery performance, and payer behavior patterns.
• Oversee outsourced RCM and BPO/vendor performance, identifying workflow gaps and driving accountability.
• Partner with eligibility, prior authorization, coding, billing, engineering, and vendors to prevent denials and improve reimbursement.
• Translate denial and appeals workflows into system logic, routing rules, appeal triggers, and automation requirements.
• Lead UAT and QA for billing system changes and analyze denial drivers using Power BI, SQL, Excel, or Snowflake.

Requirements

• 8–12+ years of healthcare Revenue Cycle Management experience with a deep focus on denials and appeals.
• Expertise in laboratory billing, CPT coding, reimbursement methodologies, and medical necessity criteria.
• Strong knowledge of commercial, Medicare, Medicaid, and managed care payer policies.
• Demonstrated success improving appeal overturn rates and resolving medical necessity denials.
• Experience working with BPO or offshore RCM vendors and leading cross-functional initiatives without direct authority.
• Strong analytical skills with Power BI, Excel, SQL, or Snowflake.

Nice to have

• Experience with revenue cycle automation, rules engines, RPA, or workflow automation tools.
• Experience partnering with engineering teams or vendors on billing system enhancements.
• Familiarity with AI-driven workflow concepts, AMD or similar billing platforms, and Jira.

Culture & Benefits

• Remote work within the United States.
• Medical, dental, vision, life, and disability insurance for eligible employees and dependents.
• Free testing for employees and immediate family members, plus fertility care benefits.
• Pregnancy and baby bonding leave, 401(k) benefits, commuter benefits, and an employee referral program.
• Work alongside statisticians, geneticists, physicians, laboratory scientists, software engineers, and business professionals.