Operations Specialist

About Claim Health

Claim Health is the AI Revenue Platform for Post-Acute Care.

With the US population aging and preference for care moving to the home, post-acute care (home health, skilled nursing, home care, hospice) is one of the fastest growing verticals within healthcare. Post-acute providers operate across fragmented systems, manual workflows, and reactive processes that create operational drag and financial uncertainty. Claim Health replaces this fragmentation with an intelligent, software-driven platform that unifies data, automates execution, and enables real-time decision-making across revenue-critical operations.

We're building an adaptive platform that brings clarity, predictability, and scale to environments where reliability matters.

About the Role

We're hiring an 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.

What You'll Do

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