RCM Insurance Claims Manager (Healthcare)

TL;DR

RCM Insurance Claims Manager (Healthcare): Overseeing the claims process for diagnostic laboratory services with an accent on claim submission, denial resolution, and accounts receivable management. Focus on optimizing claims performance, leading the claims team, and maximizing reimbursement outcomes.

Location: Remote (US)

Salary: $113,000 - $136,000 USD

Company

hirify.global is a genomics company dedicated to empowering patients to live their healthiest lives through earlier diagnosis.

What you will do

• Lead and manage the full claims process for diagnostic laboratory services to ensure timely reimbursement.
• Oversee the review and resolution of denied, pending, and aging claims.
• Partner with internal teams and external billing vendors to resolve complex claim issues.
• Monitor claims inventory, accounts receivable performance, and operational metrics.
• Coach and develop the Claims team, driving accountability for productivity and quality.
• Analyze denial trends and implement process improvements to reduce preventable denials.

Requirements

• Bachelor’s degree in healthcare administration, business, finance, or equivalent experience.
• 5–7 years of experience in laboratory billing, insurance claims, or revenue cycle management.
• Strong understanding of HIPAA and healthcare compliance requirements.
• Advanced knowledge of payer requirements, claim adjudication, and reimbursement methodologies.
• Proven leadership and communication skills for managing a team.
• Proficiency in Microsoft Office applications.

Nice to have

• Familiarity with AI tools and technologies to improve productivity and data analysis.

Culture & Benefits

• Culture centered on urgency, purpose, and high standards.
• Emphasis on ownership, agility, and continuous professional growth.
• Competitive compensation and benefits aligned with local market practices.
• Collaborative environment that values direct feedback and curiosity.