Revenue-Cycle Clinical Operations Specialist

Claim Health; New York (NY); On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Equity

Autonomy

Learning opportunities

Job summary

Claim Health is hiring a Clinical Operations Specialist to ensure the platform’s revenue cycle decisions are accurate across referrals, eligibility, prior authorizations, notices, denials, and billing.

You will work on edge cases, assess automation gaps, and collaborate with product and engineering to improve automation. Recent graduates are welcome, and healthcare experience is a plus but not required.

Qualifications

• 0–2 years of experience; recent graduates encouraged to apply
• Ability to judge unfamiliar cases and write the playbook afterward
• Exceptional attention to detail. Revenue cycle work is unforgiving of small errors
• Clear, concise written communication; you’ll document causes and write escalations daily
• Fast at picking up new software. You’ll learn several EMRs and payer portals
• Ability to thrive in fast-paced, ambiguous environments
• High ownership mentality and bias toward action

Responsibilities

• Own the Exception Queue: resolve edge cases against payer, state, and agency requirements
• Audit Quality and Accuracy: review automation outputs before they reach payer or agency
• Denials, Appeals, and Revenue Recovery: investigate denied/underpaid claims to resolution
• Turn Edge Cases Into Automation: configure rules and document findings for engineering
• Cross-Functional Execution: partner with product and engineering to refine intake, eligibility, and billing logic

Skills

Attention to detail

Decision making

Written communication

Fast learner

Ownership mindset

Education

Healthcare-related degree

Tools

SQL

Excel/Sheets

EMR systems

Job description

Claim Health is hiring a Clinical Operations Specialist to ensure the platform’s revenue cycle decisions are accurate across referrals, eligibility, prior authorizations, notices, denials, and billing.

You will work on edge cases, assess automation gaps, and collaborate with product and engineering to improve automation. Recent graduates are welcome, and healthcare experience is a plus but not required.