Claims Specialist (Healthcare)

TL;DR

Claims Specialist (Healthcare): Managing the end-to-end claims process for diagnostic laboratory services with an accent on accurate submission, denial management, and payer follow-up. Focus on maximizing reimbursement, reducing denials, and ensuring compliance with complex medical coding guidelines.

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

Salary: $34–$37 per hour

Company

hirify.global is a leader in genomics and rare disease diagnostics, dedicated to enhancing patient care through cutting-edge science and accurate genetic testing.

What you will do

• Prepare, review, and submit claims for diagnostic lab services to commercial and government payers.
• Analyze denied claims to identify root causes and initiate corrective actions, including appeals.
• Proactively follow up on outstanding claims and monitor aging reports to expedite payment.
• Maintain accurate documentation of claim status and payer correspondence in the billing system.
• Collaborate with billing and reimbursement teams to resolve complex claims and support RCM initiatives.
• Stay current with regulatory changes, coding updates, and payer requirements.

Requirements

• Must be based in the United States.
• 2+ years of experience in medical claims processing, preferably in a diagnostic laboratory or healthcare setting.
• Strong knowledge of insurance billing, payer requirements, and denial management.
• Familiarity with laboratory coding (CPT, ICD-10), EOBs, and remittance advice.
• Proficiency with billing software and Microsoft Office Suite.
• Excellent attention to detail and organizational skills.

Culture & Benefits

• Comprehensive health, dental, vision, and life insurance.
• 401k retirement savings plan with company contributions.
• Up to 22 weeks of fully paid parental leave.
• Generous support for family planning, fertility, adoption, and surrogacy.
• Employee stock purchase plan and various voluntary benefits.
• Collaborative, fast-paced environment focused on patient outcomes.