Reimbursement Specialist (Healthcare)

TL;DR

Reimbursement Specialist (Healthcare): Maximizing insurance reimbursement by collecting outstanding balances and managing unresolved claims with an accent on appeals and payer dispute resolution. Focus on identifying non-payment trends and collaborating with Revenue Cycle leadership to optimize collections and prevent denials.

Location: Must be based in the US (Remote) or within commuting distance of Brisbane, CA (Hybrid)

Salary: $26 - $33 per hour

Company

hirify.global is a leading precision medicine solutions company providing genomics-based information and healthcare solutions for transplant patients and caregivers.

What you will do

• Resolve aged claims and appeals using payer portals and outbound phone calls.
• Identify and manage the escalation of claims through first, second, and third-level appeals.
• Prioritize work queues to ensure the most payable claims are processed timely.
• Investigate non-payment trends and propose solutions to the Denials Management Steering Committee.
• Collaborate with patients to assist in the appeal process.
• Partner with Payer Dispute Resolution and Market Access teams to ensure appropriate reimbursement.

Requirements

• High school diploma or equivalent (Bachelor's degree can substitute for experience).
• 3-5 years of experience in medical billing; preference for molecular laboratory billing experience.
• Must be based in the United States.
• Deep understanding of HIPAA and proper handling of protected health information (PHI).
• Working knowledge of health insurance terminology.
• Strong analytical and problem-solving abilities with meticulous attention to detail.

Culture & Benefits

• Competitive base salary and incentive compensation.
• Comprehensive health and welfare benefits, including a gym reimbursement program.
• 401(k) savings plan match and Employee Stock Purchase Plan.
• Pre-tax commuter benefits for office-based employees.
• Living Donor Employee Recovery Policy providing up to 30 days of paid leave annually for organ or bone marrow donors.