Healthcare Reimbursement Specialist Remote Job for residents of United States – Transform Your Career with Competitive Pay

Join a leading healthcare organization seeking a detail‑driven Healthcare Reimbursement Specialist to manage claim submissions, ensure accurate coding, and optimize revenue cycles—all from the comfort of your home. This fully remote position offers the flexibility to work from anywhere while making a tangible impact on patient financial outcomes.

About the Role

We are a fully remote‑first healthcare services firm dedicated to delivering high‑quality patient care while maximizing financial efficiency. As a Healthcare Reimbursement Specialist, you will be the linchpin that connects clinical services with the billing ecosystem, ensuring that every claim is processed accurately, timely, and in full compliance with federal and state regulations. Your expertise will directly impact our bottom line and patient satisfaction, making this role both strategic and rewarding. You will collaborate with cross‑functional teams, including physicians, coders, and finance leaders, to streamline workflows and implement best practices that reduce claim rejections by up to 20%. Our technology stack includes AI‑enhanced claim scrubbing tools and real‑time analytics dashboards, giving you the data you need to drive continuous improvement.

Key Responsibilities

• Review and analyze Explanation of Benefits (EOBs) to verify accuracy of submitted claims, ensuring alignment with provider documentation and payer contracts.
• Perform claim adjudication, including coding verification, modifier application, and denial resolution, while leveraging automated claim scrubbing tools to minimize errors.
• Liaise with providers, payers, and internal teams to correct errors and resubmit claims promptly, documenting all communications for audit trails.
• Maintain up‑to‑date knowledge of reimbursement policies, payer contracts, and regulatory changes, attending monthly webinars and completing continuing education credits.
• Generate detailed reports on claim turnaround times, denial rates, and revenue performance for management review, presenting insights that inform strategic decisions.

Requirements

Qualifications

• Minimum 3 years of experience in medical billing, coding, or reimbursement within a healthcare setting.
• Proven expertise with CPT, ICD‑10, and HCPCS codes and strong understanding of payer policies.
• Proficiency in electronic health record (EHR) systems such as Epic, Cerner, or Athenahealth, and claim management software.
• Excellent analytical skills with the ability to interpret complex billing data and identify root causes of denials.
• Strong written and verbal communication for effective collaboration with providers and insurers.
In addition, candidates should have a track record of improving collection rates, demonstrated through measurable KPI improvements such as reduced days in accounts receivable or increased claim acceptance ratios. Familiarity with revenue cycle management software, such as Availity or Change Healthcare, and experience conducting root‑cause analyses of denial trends are highly valued. Strong organizational skills and the ability to manage multiple priorities in a fast‑paced remote environment are essential.

Benefits

What We Offer

• Competitive salary ranging from $45,000 to $65,000 USD per year, commensurate with experience.
• Fully remote work environment with flexible scheduling and no commute.
• Comprehensive health, dental, and vision insurance plans.
• 401(k) with employer match and generous PTO accrual.
• Ongoing professional development, including certification reimbursements for CPC, CCS‑P, or similar credentials.
• Monthly team‑building webinars and access to a supportive remote community.
• Home‑office stipend, high‑speed internet allowance, and a wellness program that includes monthly virtual fitness classes and mental‑health resources.
• Employees receive a dedicated career mentor, access to an internal knowledge base, and quarterly innovation challenges with monetary prizes.

Why Join Us

Impact and Innovation

Our organization prides itself on fostering a culture of innovation where every team member contributes to improving healthcare financial outcomes. As a Healthcare Reimbursement Specialist, you will have the opportunity to pilot new reimbursement models, experiment with predictive analytics, and influence policy changes that shape the future of healthcare financing. Join us and be part of a mission‑driven team that values transparency, continuous learning, and work‑life balance.