Sr Eligibility Specialist RCM

Location: Remote, United States

Company

hirify.global operates in the genetics and healthcare sector.

What you will do

• Oversee verification of patient eligibility and benefits across insurance payers.
• Identify and resolve eligibility discrepancies to prevent billing and reimbursement delays.
• Handle complex and escalated cases in collaboration with payers and internal departments.
• Mentor junior eligibility specialists and provide guidance on advanced issues and best practices.
• Coordinate with billing, coding, and payer relations teams to address verification issues.
• Maintain payer-system data and analyze eligibility reports, trends, and process improvement opportunities.

Requirements

• Experience managing insurance eligibility and benefits verification within revenue cycle management.
• Ability to resolve complex eligibility cases and work directly with payers.
• Knowledge of insurance policies, payer requirements, billing, and reimbursement processes.
• Ability to analyze eligibility performance reports and identify discrepancies and trends.
• Ability to guide junior team members and collaborate across billing, coding, and payer relations functions.

Culture & Benefits

• Full-time remote position based in the United States.
• Equal opportunity workplace committed to an inclusive and diverse workforce.