Claims Operations Manager (Fintech)

TL;DR

Claims Operations Manager (Fintech): Leading the modernization of the provider refund ecosystem, focusing on recovering, reconciling, and managing provider overpayments with an accent on accuracy and regulatory compliance. Focus on transforming manual workflows into automated, high-performing, and audit-ready engines.

Location: Remote (USA)

Salary: $73,000-$125,000 / year

Company

hirify.global is on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family.

What you will do

• Lead the end-to-end modernization of the provider refund ecosystem.
• Act as a hands-on operator by deploying internal toolkit to hit specific recovery outcomes and performance targets.
• Define and own the "Source of Truth" for program health, ensuring recoupment targets are met and leakage is eliminated.
• Build and manage BI dashboards to track recovery trends and take corrective action.
• Ensure 100% compliance with CMS regulatory timelines and internal standards.
• Act as the primary liaison between Payment Integrity, Finance, and Product to close feedback loops on overpayment root causes.

Requirements

• Must be based in the USA
• Proven ability to use complex data sets to drive performance and influence organizational outcomes.
• Proficiency with BI platforms (e.g., Snowflake, Looker, Tableau) and a track record of using LLMs or automation to solve business problems.
• Ability to translate complex technical or financial concepts into actionable plans for any audience.
• An elite eye for detail with the ability to pivot between tactical tasks and high-level goal alignment.
• Bachelor’s degree required, or equivalent experience in a high-growth or regulated environment.

Nice to have

• Background in healthcare technology, management consulting, or tech-ops.
• Success in becoming an SME in complex tools or regulatory frameworks to drive better business outcomes.
• Experience building collaborative, performance-driven relationships with cross-functional partners and offshore teams.

Culture & Benefits

• Employer sponsored health, dental and vision plan with low or no premium.
• Generous paid time off.
• $100 monthly mobile or internet stipend.
• Stock options for all employees.
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles.
• Parental leave program and 401K program.