Revenue Specialist (Healthcare)

TL;DR

Revenue Specialist (Healthcare): Managing the submission and adjudication of Medicaid claims to ensure accurate reimbursement for healthcare providers with an accent on Medicaid protocols, billing accuracy, and HIPAA compliance. Focus on analyzing claim payments, coordinating medical documentation, and appealing denials to optimize revenue recovery.

Location: Remote (Must be based in the United States)

Company

hirify.global provides Specialty Revenue Cycle Management solutions for healthcare organizations leveraging an intelligent automation platform to improve financial sustainability for hospitals and health systems.

What you will do

• Verify patient eligibility and analyze Medicaid claim payments using internal systems.
• Research and acquire necessary medical records and supporting documentation for hospital claims.
• Review UB-04 billing components for accuracy in accordance with billing laws.
• Conduct telephone follow-ups with payers to facilitate prompt reimbursement.
• Prepare and submit initial Medicaid bill packets with all required documentation.
• Appeal claim denials and underpayments to ensure correct reimbursement.

Requirements

• High School Diploma or GED required; Associates or Bachelor’s Degree preferred.
• 1-2+ years of experience in healthcare billing or collections.
• 1+ years of experience specifically with UB-04 billing and collections.
• 1+ years of client-facing or customer service experience.
• Proficiency in MS Office (Word, Excel, and Outlook).
• Must be based in the United States.

Culture & Benefits

• Recognized as a Top Workplaces award recipient and Inc. 5000 fastest-growing private company.
• Culture focused on fostering professional growth and development.
• Family-oriented and flexible work environment.
• Emphasis on work-life balance and cooperation among team members.