Clinical Revenue Operations Specialist

Claim Health; New York (NY); On-site; USD 85,000 - 110,000; Full time

Job summary

Claim Health is hiring a Clinical Operations Specialist to ensure the accuracy of platform decisions across the revenue cycle. You will own edge cases, verify automation outputs, and drive improvements through collaboration with product and engineering.

This role suits recent graduates with healthcare interest; you’ll work in a fast-paced environment handling intake, eligibility, authorization, and billing workflows to keep care timely and compliant.

Qualifications

• 0–2 years of experience; recent graduates encouraged to apply.
• Comfort making judgment calls on unfamiliar cases and documenting playbooks afterward.
• Exceptional attention to detail; revenue cycle work is unforgiving of small errors.
• Clear, concise written communication; daily escalation documentation.
• Fast at picking up new software and navigating payer portals.

Responsibilities

• Own the Exception Queue: resolve edge cases in intake, eligibility, authorization, notices, and claims when automation falls short.
• Audit Quality and Accuracy: verify automation outputs before submission to agencies or payers.
• Denials, Appeals, and Revenue Recovery: investigate denied/underpaid claims and drive resolution.
• Turn Edge Cases Into Automation: configure rules and document findings to guide engineering.
• Cross-Functional Execution: collaborate with product and engineering to improve workflows and payor knowledge.

Skills

Attention to detail

Healthcare domain knowledge

Adaptability

Written communication

Problem solving

Education

Healthcare-related degree (optional)

Tools

EMR systems familiarity

SQL

Excel/Google Sheets

Job description

Claim Health is hiring a Clinical Operations Specialist to ensure the accuracy of platform decisions across the revenue cycle. You will own edge cases, verify automation outputs, and drive improvements through collaboration with product and engineering.

This role suits recent graduates with healthcare interest; you’ll work in a fast-paced environment handling intake, eligibility, authorization, and billing workflows to keep care timely and compliant.