Revenue Cycle & Claims Operations Manager (Healthcare)

Location: Remote

Salary: $115,000–$140,000/year + company equity

Company

hirify.global is a fast-growing healthcare services company that partners with health plans to deliver technology-enabled home modifications and environmental supports for older adults and high-needs populations.

What you will do

• Own end-to-end claims and revenue-cycle operations, including claim readiness, submission, rejections, denials, appeals, payer follow-up, payment posting, reconciliation, aging, and collections reporting.
• Manage billing operations across Medicaid managed-care, commercial, and other payer programs.
• Build and optimize payer- and program-specific workflows, including claim configuration, test claims, provider setup, coding and modifier requirements, credentialing, and payer linkage.
• Partner with Operations, Partner Success, Clinical, Product, Data, and Finance to resolve missing information and improve cross-functional handoffs.
• Build a scalable revenue-cycle function capable of supporting more than $1M in monthly claims.

Requirements

• 7+ years of experience in medical billing, claims operations, or revenue-cycle management.
• 3+ years owning or leading a substantial portion of a revenue-cycle function.
• Hands-on experience with claim submission, rejections, denials, appeals, payer follow-up, payment posting, and accounts receivable management.
• Experience with Medicaid managed-care plans and complex payer requirements.
• Experience configuring and launching new payer or program billing workflows.
• Knowledge of billing and rendering-provider structures, NPIs, modifiers, diagnosis and procedure codes, authorizations, and timely-filing requirements.
• Strong analytical, organizational, project-management, cross-functional, and stakeholder-accountability skills.

Nice to have

• Experience in occupational therapy, home health, behavioral health, HCBS, value-based care, or other nontraditional provider models.
• Provider credentialing, payer enrollment, CAQH, roster management, or provider-linkage experience.
• Experience bringing revenue-cycle operations in-house or transitioning between billing vendors.
• Experience with claims-management, practice-management, clearinghouse, or RCM technology.
• Familiarity with Salesforce, Waystar, Availity, PaySpan, CPC, CPB, or CRCR certification.

Culture & Benefits

• Remote-first team with a $1,000 work-from-home stipend.
• Health, vision, dental, HSA, FSA, disability, life, personal accident, and hospital insurance plans.
• 401(k) available immediately upon hire.
• Unlimited PTO and 10 paid holidays.
• Yearly wellness stipend, laptop, frequent team off-sites, monthly town halls, and a collaborative, high-trust environment.