Jurisdictional Analyst (Healthcare)

Location: Fully remote, Remote-MD, Maryland, United States

Salary: $30–$40/hour

Company

hirify.global develops data-centric healthcare solutions combining technology, clinical expertise, and quality data to improve care efficiency and health outcomes.

What you will do

• Determine whether corporate conflicts of interest prevent dispute review.
• Screen cases covered by prior decisions during the 90-day cooling-off period and verify other regulatory timeframes required for jurisdiction.
• Determine whether cases fall under state or federal jurisdiction and write appropriate jurisdictional determinations.
• Include relevant information for medical coders, nurses, and legal arbitrators when federal jurisdiction applies.
• Review medical records to support final IDR determinations and escalate issues, concerns, or discrepancies appropriately.
• Protect patient confidentiality through HIPAA and HITECH compliance.

Requirements

• Associate degree in paralegal studies, or bachelor’s degree in legal services or business administration with a paralegal studies major and/or paralegal certification; relevant experience may substitute for formal training.
• Knowledge of state and federal medical and jurisdictional laws applicable to the IDR process.
• General understanding of how healthcare insurance functions.
• Excellent attention to detail, proofreading, organization, oral and written communication, and clear, concise, logical writing.
• Ability to manage multiple projects, task functions, complex contractual requirements, competing demands, and differing deadlines.
• Proficiency in Microsoft Office, including Word and Excel.
• Ability to work effectively with attorneys, professionals, and other staff.

Nice to have

• Knowledge of insurance claim processing, medical coding, and claim rejections relevant to IDR cases.
• Medical coding certification.

Culture & Benefits

• Full-time, fully remote position.
• Purpose-driven culture focused on straightforward communication, clinical expertise, and improving healthcare outcomes.
• Equal employment opportunity employer.
• Reasonable accommodations are available during the application process.

Hiring process

• Unless requesting an accommodation, submit applications through the online application system.