• Structure and improve revenue, performance, and forecast dashboards, ensuring reliability and clarity for different audiences (teams and leadership). • Support the development and refinement of revenue forecasting models (pipeline, conversions, cycle, mix, renewals/expansion when applicable). • Conduct performance and operational efficiency analyses (e.g., funnel bottlenecks, throughput, productivity, SLAs, aging, conversion by stage). • Ensure data integrity and quality between CRM and other sources by performing hygiene routines and acting as data steward; enforce standardization and governance. • Map operational bottlenecks and propose data-driven improvements (processes, cadences, rules, fields, automations). • Produce recurring executive reports with insights and actionable recommendations. • Support the governance and standardization of metrics (definitions, data dictionary, formulas, and criteria).

About the Role We’re looking for a Senior Reimbursement Analyst to join our laboratory revenue cycle team, focused entirely on pre-claim accuracy and reimbursement readiness. In this role, you’ll act as the final quality gate before claims are submitted — ensuring patient data, eligibility, coding, and medical necessity are correct so claims move cleanly through TELCOR, clearinghouses, and payer systems. This is a hands-on, problem-solving role ideal for someone who enjoys digging into data, identifying root causes, and improving front-end workflows to prevent downstream denials. What You’ll Be Responsible For Pre-Claim Review & Accuracy - Review lab orders and patient records to identify missing or conflicting demographic, insurance, or clinical data - Validate CPT and diagnosis alignment to meet payer medical necessity requirements - Ensure ordering provider information (NPI, credentials, facility details) is complete and accurate - Proactively resolve coverage and data issues before claims are generated Eligibility & Coverage Analysis - Verify insurance eligibility using 270/271 transactions, payer portals, and integrated tools - Interpret benefits, exclusions, and coordination of benefits that impact reimbursement - Identify and resolve inactive coverage, invalid policy numbers, and payer mismatches - Recommend front-end process improvements to reduce eligibility-related errors Clearinghouse & Pre-Adjudication Support - Review claim acknowledgments, clearinghouse reports, and payer responses - Analyze and resolve pre-submission rejections related to formatting, coding, or payer edits - Work with clearinghouse partners to troubleshoot recurring rejection patterns - Partner with operations teams to ensure accurate claim creation and routing TELCOR System Support - Use TELCOR to review claims, data feeds, file processing issues, and mapping errors - Troubleshoot order imports, payer mapping, demographic ingestion, and coverage files - Identify systemic TELCOR issues that cause recurring pre-claim errors - Collaborate with IT, billing, and analytics teams to resolve interface or data-pipeline issues Data Analysis & Reporting - Use SQL to investigate missing data, eligibility mismatches, and payer configuration issues - Identify trends in pre-claim errors to support process improvements - Contribute to reporting, dashboards, or automated audits that improve claim quality What We’re Looking For Required - Experience in laboratory billing, reimbursement, or pre-claim operations - Hands-on experience working with TELCOR (RCS or QML) - Strong understanding of eligibility, benefits, and payer requirements - Ability to analyze pre-claim issues and identify root causes - Comfort working with data and systems to validate claim accuracy Preferred (Not Required) - SQL experience for data validation or reporting - Familiarity with EDI / HL7 workflows (270/271, 837, 835) - Experience in molecular, toxicology, or high-volume lab environments - Experience building audits or automated checks We encourage candidates who meet most — but not all — qualifications to apply. Why Join Us - Fully remote role with a specialized, high-impact focus - Opportunity to influence front-end revenue quality, not just fix denials - Collaborative environment with IT, billing, and analytics teams - Work that directly improves reimbursement outcomes and operational efficiency

About The Company: Tricura Insurance Group is a next-generation, tech-enabled insurance and risk-management company transforming how healthcare organizations protect, manage, and grow their operations. We’re a global remote-first team working to reshape the future of healthcare insurance. We combine deep industry expertise with cutting-edge technology to deliver smarter, faster, and more transparent insurance solutions across the continuum of care! If you're passionate about creating impactful solutions that empower those who care for others, we’d love to meet you. Role Overview: We're looking for a hands-on RevOps Specialist to own the outbound operations infrastructure for our production underwriting team. This is not a strategy role. You'll be the person who actually builds, fixes, and improves the systems that power our broker outreach — working side by side with our Director of RevOps in a two-person team. Right now our outbound motion is largely founder-led and manual. Your job is to change that: structure the process, build the tooling, automate what can be automated, and make the sales team faster and more effective every week. You'll work directly with the Director of RevOps, the CEO, and production underwriting leadership from day one. What the day-to-day actually looks like We want to be transparent: this is a fast-moving, interrupt-driven environment. You won't have long uninterrupted focus blocks every day. A typical day might look like: - A sales rep messages saying calls aren't logging in HubSpot — you investigate and fix it - Leadership needs a dashboard updated before an afternoon meeting - You're mid-way through building a prospect list when an automation breaks - Aleph asks you to troubleshoot a workflow while you're already on three other things If that sounds exhausting, this role probably isn't the right fit. If it sounds like a normal Tuesday, keep reading. Key Responsibilities: 1. Tooling & Systems Management - Own AirCall configuration, troubleshooting, and HubSpot integration - Manage outbound tools (SMS platforms, LinkedIn Sales Navigator, etc.) - Ensure all calls, meetings, and outreach activities are correctly tracked in HubSpot - Evaluate and maintain the outbound technology stack 2. Reporting & Analytics - Build and maintain dashboards tracking outbound activity (calls, emails, LinkedIn touches) - Monitor conversion rates by list, rep, geography, and outreach type - Identify underperforming lists, campaigns, and sequences - Track outbound KPIs such as: - connect rate - conversation rate - meeting set rate 3. List Management & Research - Research and identify qualified broker prospects using tools like LinkedIn and data providers - Build and maintain segmented prospect lists in HubSpot - Ensure strong data hygiene and consistent categorization - Work with leadership to define and refine broker ICP criteria 4. Process Optimization - Shadow production underwriting and leadership to understand real-world workflows - Identify operational bottlenecks and friction points - Translate observed best practices into scalable processes - Optimize outbound sequences (call/email/LinkedIn cadences) - QA outbound execution for quality, consistency, and tracking accuracy - Implement automations of workflows Must-Have Requirements: Must have - Hands-on HubSpot experience — workflows, automations, list management, integrations, reporting. Not just dashboards. You need to have built things. - Experience in outbound operations — Sales Ops, SDR Ops, RevOps, or similar. You understand how outbound sales teams work and what they need from ops. - Experience with calling tools — Aircall or similar, including HubSpot integration - Comfortable with data work — spreadsheets, list uploads, data cleanup, segmentation - Fluent English — written and spoken, including technical conversations - Startup experience — ideally you've been the only ops person, or close to it, and built things without a playbook - Full-time availability — 9am–6pm EST. This role requires being present and responsive during business hours. Nice-to-Have: - Experience with ZoomInfo, Apollo, or similar prospecting tools - Automation tools beyond HubSpot: Zapier, Make, n8n - Curiosity about AI tools — even personal experimentation counts - Experience in insurance, B2B SaaS, or healthcare - SQL or advanced spreadsheet skills What we're not looking for - Someone whose RevOps experience was mostly in large companies with dedicated engineering or data teams handling the technical parts - Someone who prefers structured, project-based work with clear swim lanes - Someone who needs a quiet environment to do deep focus work all day - Pure data analysts or BI specialists — this role is operational, not analytical Why Join Us: - Fully remote team across North & South American countries - High-growth environment with direct exposure to leadership - Mission-driven company transforming healthcare with cutting-edge technology - Opportunity to build and scale operational systems from the ground up in a fast-growing startup environment - Competitive compensation, paid in USD - Unlimited PTO Please note that the later you apply - the more intensive your selection process will be, for example, you will have fewer interview time slots to choose from, etc. Selection Process: - Submit the application form with your CV - Zoom screening interview with a Hire5 recruiter - Technical Zoom meeting with Director of RevOps - Final interview with the CEO - Offer! 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• Architect and optimize the technology, systems, and processes that power our internal lifecycle—from lead generation to financial offboarding. • Serve as a strategic engine for the organization, identifying and eliminating friction points that hinder scale. • Diagnose technological solutions to complex commercial challenges. • Own the integrity of our cross-departmental data. • Lead high-impact projects that directly influence the company’s profitability and operational agility. • Partner with leadership to develop CRM and Tech Stack enhancements. • Build and maintain sophisticated, recurring dashboards that provide a "single source of truth" for KPIs including Revenue At Risk, Net Retention, and growth trends. • Act as the primary operational bridge between Business Development, Finance, Client Delivery and Marketing. • Create and drive the adoption of Standard Operating Procedures (SOPs). • Proactively identify and pursue system enhancements across Salesforce, Gong, and related platforms. • Collaborate with department heads to develop programs, playbooks, and feedback loops.