Claims Processing Professional

Location: Miramar, FL; in-office position

Salary: $53,700–$72,600 per year

Company

hirify.global is a U.S. healthcare company providing insurance and healthcare services, with OneHome coordinating post-acute care for health plan members.

What you will do

• Review and process electronic and paper healthcare claims within established turnaround times.
• Verify member eligibility, provider information, authorizations, and contractual requirements.
• Determine whether claims should be approved, denied, adjusted, or returned for additional information.
• Investigate discrepancies by gathering and evaluating supporting documentation.
• Use multiple internal systems to review claims, document findings, and complete processing.
• Collaborate with internal departments to resolve claim issues and support claim adjudication.

Requirements

• At least 1 year of healthcare claims processing experience.
• Knowledge of healthcare claims processing practices and medical insurance terminology.
• Ability to work across multiple computer systems, prioritize tasks, and work independently.
• Commitment to HIPAA compliance and applicable policies and regulations.
• Ability to meet productivity, quality, and performance expectations.

Nice to have

• Experience processing medical, home health, or managed care claims.
• Knowledge of CPT, ICD-10, and HCPCS coding.
• Experience with provider contracts, authorizations, or eligibility verification.
• Bilingual English/Spanish communication skills.
• Associate's degree or higher in Business, Healthcare Administration, or a related field.

Culture & Benefits

• Full-time schedule of 40 hours per week.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, and wellness-focused benefits.