Systems Analyst (Healthcare Payment Integrity)

Location: Remote within the continental United States, excluding California, New York, Alaska, and Hawaii; Chicago, Illinois is listed as the role location.

Base pay: $69,800–$125,900 annually, with eligibility for an annual incentive bonus.

Company

hirify.global is a healthcare organization focused on improving claims accuracy, payment integrity, affordability, and member experience.

What you will do

• Design, enhance, and support technology solutions for payment integrity initiatives and claims adjudication accuracy.
• Translate business and operational requirements into technical specifications, system designs, and solution documentation.
• Collaborate with Product Owners, Business Analysts, Architects, Developers, and Operations teams throughout the software development lifecycle.
• Analyze large healthcare datasets to identify trends, measure savings, and support payment accuracy initiatives.
• Manage production support, troubleshoot application issues, and resolve incidents affecting claims processing.

Requirements

• Bachelor’s degree in Computer Science, Information Technology, Healthcare Informatics, or a related field.
• Experience with payment integrity, claims processing, claims adjudication, and healthcare payer operations.
• Knowledge of healthcare claims platforms, provider reimbursement methodologies, ICD, CPT, HCPCS, and payment policy implementation.
• Experience translating business needs into technical specifications and system designs.
• Knowledge of cloud technologies, SaaS platforms, APIs, REST services, system integration patterns, Agile delivery, and SDLC collaboration.
• Strong analytical, problem-solving, communication, and stakeholder management skills.

Nice to have

• Experience with SQL, data analysis, reporting, and healthcare data warehouses.
• Knowledge of Blue Cross Blue Shield business processes.
• Experience with pre-pay and post-pay edits, clinical editing, fraud, waste and abuse detection, and reimbursement accuracy initiatives.

Culture & Benefits

• Work-from-home position within the permitted U.S. locations.
• Collaborative product organization focused on innovation and continuous improvement.
• Health and wellness benefits, 401(k) savings plan, pension plan, paid time off, and paid parental leave.
• Disability insurance, supplemental life insurance, employee assistance, paid holidays, tuition reimbursement, and other incentives.
• Visa sponsorship is not available, including for candidates currently on OPT.