Operations Support Specialist I (Healthcare)

TL;DR

Operations Support Specialist I (Healthcare): Managing daily fee processing and appeals intake for a high-volume claims operation with an accent on invoice reconciliation, credit resolution, and system data accuracy. Focus on maintaining procedural compliance, processing vendor invoices, and ensuring seamless claims operations within a medical insurance environment.

Location: Tuzla, Bosnia and Herzegovina

Company

hirify.global provides a personalized health platform that integrates health plan administration, wellbeing solutions, and care navigation to improve health outcomes and reduce costs.

What you will do

• Monitor email and system mailboxes to review and log incoming appeals.
• Process vendor invoices end-to-end, including PBM vendors, and allocate fees via Excel.
• Research and resolve invoice credit entries while maintaining accurate credit data.
• Stay updated on procedural guidelines and group-specific instructions for claims processing.
• Provide operational backup for colleagues, including overpayment calls and document retrieval.

Requirements

• High school diploma or GED.
• Knowledge of medical terminology and coding standards including ICD-10, CPT, and HCPCS.
• Prior experience working within medical insurance companies.
• Proficiency in Microsoft Office suite, specifically Word, Excel, and Outlook.
• Working understanding of medical claims processing workflows.

Nice to have

• Experience with QicLink or Eldorado claims systems.

Culture & Benefits

• Commitment to diversity, equity, inclusion, and belonging.
• Supportive work environment focused on professional growth and health outcomes.
• Mission-driven team focused on empowering healthier lives.