Remote Healthcare Reimbursement Specialist – Nationwide Opportunity – Unlock Your Career Growth

Join a fast‑growing, fully remote healthcare organization where your expertise in claims processing and payer compliance directly impacts patient access and revenue integrity. We offer a collaborative virtual environment, competitive compensation, and a clear path for professional advancement.

About the Role

As a Healthcare Reimbursement Specialist, you will be the linchpin between clinical operations and insurance payers. Your day‑to‑day focus includes verifying eligibility, submitting clean claims, managing denials, and ensuring timely reimbursement across Medicare, Medicaid, and commercial plans. You’ll work closely with coding teams, providers, and finance leaders to optimize the revenue cycle while maintaining strict regulatory compliance.

Key Responsibilities

• Review and validate patient insurance information for accuracy before claim submission.
• Prepare, edit, and transmit electronic claims (837P/837I) using industry‑standard clearinghouses.
• Monitor claim status, identify denial trends, and execute appeals with supporting documentation.
• Collaborate with clinical staff to resolve coding discrepancies and improve first‑pass claim rates.
• Maintain up‑to‑date knowledge of CMS guidelines, payer policies, and state‑specific reimbursement rules.
• Generate weekly and monthly reimbursement reports for leadership review.

Qualifications & Requirements

• Associate’s degree or higher in Health Information Management, Business Administration, or related field.
• Minimum 3 years of hands‑on experience in medical billing, claims adjudication, or reimbursement analysis.
• Proficiency with major practice management systems (e.g., Epic, Cerner, Athenahealth) and clearinghouse portals.
• Strong command of CPT, HCPCS, ICD‑10‑CM/PCS coding structures and modifier usage.
• Certified Professional Biller (CPB) or Certified Revenue Cycle Representative (CRCR) preferred.
• Excellent analytical skills, attention to detail, and the ability to thrive in a fully remote, asynchronous team.

Salary Range

Estimated annual compensation: $48,000 – $68,000 USD/year, commensurate with experience, certifications, and geographic cost‑of‑living adjustments. Performance‑based bonuses and annual salary reviews are part of the total rewards package.

Benefits & Perks

• 100 % remote work with flexible scheduling – choose the hours that fit your life.
• Comprehensive health, dental, and vision insurance effective day 1.
• 401(k) with company match up to 4 %.
• Generous paid time off, including wellness days and a paid volunteer day.
• Annual professional development stipend ($1,500) for certifications, conferences, or courses.
• Home office setup allowance ($500) and monthly internet reimbursement.

Company Culture

Our culture is built on transparency, continuous learning, and patient‑first thinking. Weekly virtual huddles keep the team aligned, while quarterly “Innovation Sprints” encourage cross‑functional problem solving. We celebrate diverse perspectives and invest heavily in mentorship programs that pair seasoned reimbursement experts with newer team members.

How to Succeed in This Role

Master Payer Nuances

Deeply understand each payer’s unique editing rules, timely filing limits, and appeal processes. Create quick‑reference cheat sheets that you can share with the team to reduce repeat denials.

Leverage Data Analytics

Use built‑in reporting tools or export data to Excel/Power BI to spot trends—such as rising denial codes or shifting reimbursement rates—before they become revenue leaks.

Communicate Proactively

When a claim requires additional documentation, reach out to the clinical team within 24 hours. Clear, concise communication shortens the revenue cycle and builds trust across departments.

Stay Certified & Current

Allocate time each quarter to review CMS updates, attend webinars, and pursue advanced credentials (e.g., Certified Revenue Cycle Executive). Your growth fuels the organization’s competitive edge.