Healthcare Reimbursement Specialist – Remote Job for residents of United States – Unlock Your Career in Healthcare Finance

Join a leading healthcare organization as a Healthcare Reimbursement Specialist and master the art of claim processing, payer negotiations, and revenue cycle optimization. Work entirely from home, enjoy flexible hours, and drive financial success for patients and providers alike.

About the Role

We are seeking a detail‑oriented Healthcare Reimbursement Specialist to join our fully remote team of 120 professionals dedicated to optimizing revenue cycles for leading medical institutions across the United States. In this role you will analyze patient billing records, coordinate with insurance carriers, and ensure accurate claim submissions that maximize revenue for our healthcare partners. Your expertise will directly impact the financial health of medical practices, reduce claim denials, and enhance patient satisfaction through transparent billing communications. Working from home, you will leverage cutting‑edge analytics tools and collaborate virtually with coders, clinicians, and finance leaders to drive continuous improvement.

Key Responsibilities

• Review and reconcile Explanation of Benefits (EOBs) to confirm claim accuracy and identify discrepancies.
• Prepare and submit Medicare, Medicaid, and private payer claims with proper coding, ensuring compliance with the latest CMS guidelines.
• Resolve denied claims by communicating with payers and providers, negotiating adjustments, and resubmitting corrected documentation promptly.
• Monitor reimbursement trends, identify opportunities for process improvement, and generate performance reports for senior management.
• Maintain compliance with HIPAA, Medicare regulations, and internal policies while protecting patient confidentiality.
• Utilize claim denial analytics software to pinpoint root causes and develop corrective action plans.
• Coordinate with clinical staff to verify documentation completeness before claim submission.
• Provide training and support to junior billing team members on best practices and software functionality.

Requirements

Qualifications

• Associate’s or bachelor’s degree in Health Information Management, Medical Billing, or related field.
• Minimum 3 years of experience in medical reimbursement, preferably within a hospital or large medical practice.
• Proficiency with electronic health record (EHR) systems, claim adjudication software, and Microsoft Office Suite.
• Strong analytical skills, attention to detail, and ability to interpret complex payer contracts and fee schedules.
• Excellent written and verbal communication for liaison with insurers, providers, and internal stakeholders.
• Experience using claim denial analytics tools to reduce rejection rates and improve cash flow.
• Familiarity with HIPAA compliance, Medicare/Medicaid regulations, and state‑specific billing requirements.
• Preferred certifications: CPC, CCS‑P, or Certified Revenue Cycle Professional (CRCP).

Benefits

What We Offer

• Competitive salary ranging from $48,000 to $68,000 USD per year, paid bi‑weekly, with annual performance bonuses up to 10% of base salary.
• Comprehensive health, dental, and vision insurance with low employee premiums and a health savings account (HSA) option.
• 401(k) plan with employer matching up to 4% and immediate vesting.
• Generous paid time off, holidays, and flexible work schedule that supports work‑life balance.
• Continuing education stipend and full coverage for industry certifications such as CPC, CCS‑P, and CRCP.
• Home office setup allowance of $1,000 and high‑speed internet reimbursement.
• Employee assistance program, wellness initiatives, and mental health resources.
• Monthly virtual team building events and professional networking opportunities.

Salary Range

Compensation

Our salary range for this remote position is $48,000 – $68,000 USD/year, commensurate with experience, qualifications, and performance. In addition to base pay, employees may receive quarterly performance bonuses, profit‑sharing incentives, and a sign‑on bonus of up to $2,000 for qualified candidates. All compensation details are clearly outlined in the offer letter.