Revenue-Cycle Ops Specialist: Automation & Edge-Case QA

Health Data Innovations, Inc.; New York (NY); On-site; USD 60,000 - 85,000; Full time

Job summary

Claim Health is hiring an Operations Specialist to ensure the accuracy of platform decisions across the revenue cycle. You will handle edge cases in intake, eligibility, and denials, working closely with the automation team to improve precision.

This role suits recent graduates and candidates with a healthcare affinity seeking a fast-paced environment. You will review outputs for accuracy, catch upstream errors, and document root causes to help shape future automation.

Qualifications

• 0–2 years of experience; recent graduates encouraged to apply.
• Attention to detail is essential in revenue cycle work.
• Excellent written and verbal communication required.
• Willingness to learn multiple EMRs and payer portals.
• Ability to work independently in a fast-moving environment.
• Strong ownership mindset and problem-solving skills.

Responsibilities

• Work a live queue of edge cases for intake, eligibility, authorization, and denials; resolve where automation lacks.
• Meet tight turnaround times for time-sensitive tasks to avoid delayed care or filing windows.
• Review automation outputs for accuracy and compliance before submission.
• Document causes of exceptions to help surface recurring issues for engineering.
• Investigate denied/underpaid claims and drive root-cause analysis to resolution.
• Collaborate with product and engineering to improve automation rules and workflows.

Skills

0-2 years experience

Attention to detail

Communication skills

Ownership

Fast learner

Healthcare knowledge

Education

Healthcare related degree (optional)

Tools

SQL

Excel

Job description

Claim Health is hiring an Operations Specialist to ensure the accuracy of platform decisions across the revenue cycle. You will handle edge cases in intake, eligibility, and denials, working closely with the automation team to improve precision.

This role suits recent graduates and candidates with a healthcare affinity seeking a fast-paced environment. You will review outputs for accuracy, catch upstream errors, and document root causes to help shape future automation.