Resolution Analyst, Denials (Healthcare)

TL;DR

Resolution Analyst, Denials (Healthcare): Facilitating payment review and recovery efforts for denied and underpaid healthcare accounts with an accent on claim evaluation and payer contract analysis. Focus on resolving complex underpayment appeals, researching pertinent medical records, and ensuring accurate reimbursement from insurance providers.

Location: Remote (United States)

Company

hirify.global provides Specialty Revenue Cycle Management solutions for healthcare organizations using its intelligent automation platform E360 RCM.

What you will do

• Review, evaluate, and appeal outstanding, denied, and underpaid claims using proprietary software and tools.
• Analyze medical provider contracts to determine correct reimbursement and identify cash payments from insurance companies.
• Research and acquire pertinent medical records to create and submit complex underpayment appeals.
• Conduct telephone follow-ups with payers to ensure documentation receipt and facilitate resolution of receivables.
• Act as a primary liaison between key client contacts and the denials/underpayment appeal process.

Requirements

• Must be based in the United States
• 5+ years of experience in the healthcare field focusing on billing or collections.
• 1+ years of experience in client-facing or customer service roles.
• Intermediate understanding of ICD, HCPCS/CPT coding, and medical terminology.
• Strong understanding of the revenue cycle process, hospital reimbursement, and Managed Care contracts.
• Proficiency in MS Office (Word, Excel, and Outlook).

Culture & Benefits

• Recognized as a Top Workplace and a member of the Inc. 5000 fastest-growing private companies.
• Strong organizational commitment to professional growth and employee development.
• Family-oriented and flexible corporate culture that values work-life balance.
• Collaborative environment centered around shared goals and cooperation.