Healthcare Reimbursement Specialist in Austin, TX: Ensure Every Dollar is Rightfully Earned

Become the financial cornerstone of our healthcare operations as a Healthcare Reimbursement Specialist. In this pivotal role, you will expertly navigate the complex landscape of insurance claims, denial management, and revenue cycle optimization, directly impacting our organizational financial health and patient care quality. If you are a detail-oriented analyst with a passion for the intricate dance of healthcare finance, we offer a challenging and deeply rewarding career path.

About the Role

Our healthcare network is seeking a meticulous Healthcare Reimbursement Specialist to safeguard and enhance our revenue integrity. You will serve as a key liaison between clinical teams, insurance payers, and patients, ensuring that every service rendered is accurately coded, billed, and reimbursed. This role is central to our mission of providing exceptional care without financial friction, requiring a sharp eye for detail, a firm grasp of ever-changing regulations, and a commitment to precision. You will operate within a collaborative finance department, leveraging advanced billing software and data analysis tools to turn complex claims into clear, compliant revenue.

Key Responsibilities

Claims Processing & Denial Resolution

You will meticulously review, verify, and submit medical claims to a variety of commercial and government payers. A core part of your mission will be investigating and appealing denied or underpaid claims, using your analytical skills to identify root causes—from coding errors to authorization gaps—and implement corrective actions to recover maximum revenue.

Revenue Cycle Optimization

By analyzing day-to-day operations and key performance indicators (KPIs) like Days in A/R and Clean Claim Rate, you will identify bottlenecks and propose process improvements. You will work to streamline workflows from patient registration through final payment, ensuring a smooth, efficient cycle that minimizes delays and maximizes cash flow.

Compliance & Regulatory Adherence

You will ensure all billing activities strictly comply with federal and state regulations, including HIPAA, CMS guidelines, and payer-specific policies. This involves staying ahead of industry updates, conducting internal audits, and preparing documentation for external reviews, thereby protecting the organization from financial risk and penalties.

What You Bring (Requirements)

Essential Qualifications

• Associate’s degree in Health Information Management, Medical Billing and Coding, Finance, or a related field. Bachelor’s degree is a plus.
• 3+ years of hands-on experience in healthcare reimbursement, medical billing, or revenue cycle management within a hospital, clinic, or large physician practice setting.
• Proficient mastery of ICD-10-CM, CPT, and HCPCS coding guidelines, with a strong understanding of payer policies and medical necessity criteria.
• Demonstrated experience with major EHR/EMR systems (e.g., Epic, Cerner, Allscripts) and dedicated billing software (e.g., eClinicalWorks, Athenahealth).
• Exceptional analytical skills with high proficiency in Excel (pivot tables, VLOOKUPs) for data analysis and reporting.

Preferred Skills & Attributes

• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification.
• Direct experience with Medicaid/Medicare claims and complex medical specialties (e.g., oncology, cardiology).
• Familiarity with healthcare analytics platforms and business intelligence tools.
• Excellent communication skills to articulate complex billing issues to clinical staff and negotiate with payer representatives.
• A proactive, solutions-oriented mindset with the ability to thrive in a fast-paced, deadline-driven environment.

Compensation & Benefits

Salary Range

We offer a competitive salary range of $55,000 – $75,000 USD/year, commensurate with your experience, certifications, and proven track record in revenue recovery. This role is eligible for an annual performance-based bonus tied to departmental financial goals.

Comprehensive Benefits Package

• Health & Wellness: Premium medical, dental, and vision plans with generous employer contributions.
• Financial Security: 401(k) plan with company match, life insurance, and short/long-term disability.
• Work-Life Balance: Generous Paid Time Off (PTO), flexible scheduling options, and 11 company-paid holidays.
• Growth & Development: Annual stipend for continuing education, certification maintenance, and conference attendance.
• Modern Workplace: Hybrid work model (3 days in-office/2 days remote) in our downtown Austin office with updated ergonomic equipment.

Why Join Our Team?

You will become part of a mission-driven organization that values integrity, collaboration, and innovation in patient care. Here, your expertise in reimbursement directly translates to financial stability that allows us to invest in cutting-edge technology and community health programs. We foster a culture of continuous learning and recognize that our revenue cycle specialists are vital strategic partners—not just processors. If you are ready to elevate your career in a supportive, impactful environment where your analytical work truly makes a difference, we encourage you to explore this opportunity.