Administrative Analyst (Healthcare)

TL;DR

Administrative Analyst (Healthcare): Generating and tracking member service denial notifications in compliance with URAC, NCQA, CMS, and DMHC standards with an accent on regulatory compliance and administrative accuracy. Focus on coordinating workflows with MNA/CQE teams, maintaining denial matrices, and ensuring strict turnaround time standards.

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

Salary: $16.36 - $17.00 per hour

Company

hirify.global Incorporated provides medical necessity and benefits administration services.

What you will do

• Generate and mail member service denial notifications to members, health plans, and practitioners.
• Develop and maintain procedures and matrices for service denial processes based on regulatory mandates (URAC, NCQA, CMS, DMHC).
• Coordinate workflows with MNA and CQE teams to ensure appropriate notification delivery.
• Track service denial turnaround times and submit daily/monthly logs to contracted health plans.
• Perform system queries, generate reports, and provide general administrative support to management.
• Ensure strict confidentiality of member, provider, and proprietary information.

Requirements

• High School Diploma or GED certificate.
• 2 years of progressive administrative experience.
• Internal experience at ASH is required.
• Proficiency in MS Word, Excel, and Access.
• Knowledge of CMS and DMHC regulations.
• Strong analytical and written communication skills.

Culture & Benefits

• Remote work environment with company-provided technology equipment.
• Equal Opportunity/Affirmative Action Employer.
• Supportive environment focusing on positive, respectful, and cooperative working relationships.
• Strict adherence to confidentiality and professionalism standards.