We're hiring a Clinical Operations Specialist to own the accuracy of what our platform decides. Our automation runs the revenue cycle end to end for the majority of cases — referral intake, eligibility and benefits verification, prior authorization, notices of election, denials and appeals, and billing. You own the cases it can't, and you make sure the cases it can are right.

This is a high-autonomy role spanning the full revenue cycle, not a single workflow. Thousands of referrals, authorizations, eligibility checks, and claims move through the platform every week, and a missed detail means a delayed start of care or unpaid work. You'll sit directly alongside the team building the automation — the edge cases you catch and the patterns you surface become the next version of the product.

This role is open to recent graduates. Healthcare experience is a plus, not a requirement.

Own the Exception Queue

Work a live queue containing edge cases for intake, eligibility, authorization, notices, and claims — resolving each case against payer, state, and agency requirements when no automation covers them

Meet turnaround expectations on time-sensitive work where a few minutes delay means delayed care or a missed filing window

Audit Quality and Accuracy

Review automation outputs for accuracy, consistency, and compliance before they reach the agency or the payer

Catch errors upstream — a wrong payer, a missing face-to-face, a misread document, a coverage gap — rather than discovering them as denials

Tag every exception with a clear cause so recurring failures become visible instead of absorbed

Denials, Appeals, and Revenue Recovery

Investigate denied and underpaid claims, determine root cause, and work the appeal through to resolution

Clinical Operations Specialist

Responsibilities

Qualification

Required

Preferred

Benefits

Company

Claim Health

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