Hiring: Senior Claims Specialist Company: Personify Health Location: Tempe, AZ Job Posted Time: 2026-09-16 11:22:51 Target Skills & Keywords : CPT, Microsoft Office, REST About the job Experience: •4+ years of experience in claims processing, adjudication, or related healthcare/insurance operations •4+ years of experience working across multiple claims processing systems •Healthcare industry background strongly preferred, including experience in health insurance, medical office, billing, admissions, or clinical front-desk settings Required Skills: •Ready to bring precision and expertise to the claims that matter most? •This role is located in Tempe AZ- all candidates must be able to commute into this location weekly. •Adjudicate high-dollar and specialty claims: Review, analyze, and process complex healthcare, dialysis, and stop loss claims with a level of scrutiny that catches errors before they become liabilities. •Enforce quality and procedural standards: Conduct thorough claim reviews and examinations to confirm every claim is handled in full accordance with company policy and procedure. •Stay current on regulatory and industry standards: Track evolving claims processing guidelines and regulatory requirements so every decision holds up to compliance scrutiny. •Hit production and timeliness targets: Complete claims work within required timeframes while maintaining the production standards the team depends on. •Resolve escalations for the claims team: Serve as a go-to resource for questions and complex claim issues that need a deeper level of expertise. •Validate plan setup and documentation: Review plans, documents, and vendor information to confirm proper system setup, and flag any errors or issues in plan documents, processing, or configuration to management before they escalate. Qualifications: •Degree in Business, Healthcare Administration, or a related field preferred; equivalent experience considered Compensation: •Comprehensive medical and dental through our own health solutions (yes, we use what we build) Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!