Insurance Reimbursement Specialist (Healthcare)

TL;DR

Insurance Reimbursement Specialist (Healthcare): Maximizing reimbursement for molecular diagnostics by resolving outstanding insurance claims, denials, and multi-level appeals with an accent on payer follow-up, revenue cycle analysis, and coverage optimization. Focus on investigating non-payment trends, escalating complex claims, and collaborating with Market Access, Payer Dispute Resolution, and Revenue Cycle teams.

Location: United States only. Candidates within commuting distance of Brisbane, California must work from the office regularly; remote candidates work and collaborate from home.

Salary: $28–$36 USD per hour for San Francisco Bay Area roles; $24–$30 USD per hour for remote US-only roles.

Company

hirify.global is a precision medicine diagnostics company developing molecular diagnostics, digital health solutions, AI-powered data and analytics, and patient support services for transplant, oncology, and cell therapy.

What you will do

• Resolve aged claims and appeals through payer portals and outbound calls.
• Identify claims requiring first-, second-, or third-level appeals and manage an assigned denial work queue.
• Investigate denial and non-payment trends and escalate claim groups to Payer Dispute Resolution or Market Access.
• Propose upstream improvements to prevent denials and improve reimbursement outcomes.
• Support patients during the appeal process and collaborate with Revenue Cycle teammates and cross-functional committees.

Requirements

• Must be based in the United States; Brisbane-area candidates must be within commuting distance and attend the office regularly.
• High school diploma or equivalent; a bachelor's degree may substitute for medical billing experience.
• 3–5 years of medical billing experience.
• Knowledge of health insurance terminology and patient protections under HIPAA, including proper handling of protected health information.
• Strong communication, analytical, problem-solving, organizational, and attention-to-detail skills.

Nice to have

• Experience with molecular laboratory billing.

Culture & Benefits

• Full-time Monday–Friday schedule with occasional overtime as needed.
• Regular office collaboration for eligible Brisbane-area employees, with remote work available for other US-based candidates.
• Health and welfare benefits, gym reimbursement, and a 401(k) savings plan match.
• Employee Stock Purchase Plan and pre-tax commuter benefits.
• Up to 30 days of paid annual leave under the Living Donor Employee Recovery Policy for eligible full-time employees.