Remote Healthcare Reimbursement Specialist – Nationwide Opportunity – Maximize Revenue Integrity from Anywhere

Join a forward‑thinking healthcare organization that values precision, compliance, and remote flexibility. As a Healthcare Reimbursement Specialist, you’ll drive accurate claim processing, optimize reimbursement rates, and ensure regulatory adherence—all from the comfort of your home office.

About the Role

We are seeking a detail‑oriented Healthcare Reimbursement Specialist to manage the end‑to‑end reimbursement lifecycle for a diverse portfolio of providers. In this fully remote position, you will analyze claim data, resolve denials, collaborate with coding teams, and implement process improvements that boost revenue capture. Your expertise will directly impact the financial health of our clients and the quality of patient care.

Key Responsibilities

• Review and validate inpatient, outpatient, and professional claims for accuracy and compliance.
• Identify and appeal denied or underpaid claims, documenting root causes and corrective actions.
• Maintain up‑to‑date knowledge of Medicare, Medicaid, and commercial payer policies.
• Collaborate with clinical documentation improvement (CDI) and coding staff to ensure optimal DRG/APC assignment.
• Generate and present reimbursement analytics, trend reports, and KPI dashboards to leadership.
• Participate in internal audits and external payer audits, providing supporting documentation.
• Recommend and help implement workflow automation tools to increase efficiency.

Qualifications

Required

• Bachelor’s degree in Health Information Management, Finance, Business Administration, or related field.
• Minimum 3 years of experience in healthcare reimbursement, claims analysis, or revenue cycle operations.
• Proficiency with major EHR/RCM platforms (e.g., Epic, Cerner, Meditech, Change Healthcare).
• Strong command of ICD‑10‑CM/PCS, CPT/HCPCS coding systems and DRG/APC grouping logic.
• Excellent analytical skills with advanced Excel (pivot tables, VLOOKUP, Power Query) and familiarity with SQL or Tableau a plus.
• Proven ability to work independently, manage multiple priorities, and meet tight deadlines in a remote environment.

Preferred

• Certified Revenue Cycle Representative (CRCR) or Certified Professional Coder (CPC).
• Experience with value‑based reimbursement models (bundled payments, ACOs, MACRA/MIPS).
• Background in denial management software (e.g., Experian Health, Waystar).

Salary Range

$55,000 – $78,000 USD per year, commensurate with experience, certifications, and geographic cost‑of‑living adjustments. This range reflects current market data for fully remote reimbursement specialists across the United States.

Benefits & Perks

• 100% remote work with a flexible schedule—core hours 10 am–3 pm ET.
• Comprehensive health, dental, and vision insurance (employer‑paid premiums for employee).
• 401(k) with 4% company match, immediate vesting.
• Annual professional development stipend ($2,000) for certifications, conferences, or courses.
• Generous paid time off: 15 days PTO, 10 paid holidays, and 2 volunteer days.
• Home office setup allowance ($1,500 one‑time) and monthly internet reimbursement.
• Wellness program including mental‑health resources, fitness reimbursement, and virtual community events.

Company Culture

Our team thrives on transparency, continuous learning, and a shared commitment to improving healthcare finance. We celebrate diverse perspectives, encourage open dialogue, and invest heavily in employee growth. Regular virtual town halls, peer‑recognition programs, and cross‑functional project squads keep everyone connected and engaged, no matter where they log in from.

How to Succeed in This Role

Success hinges on a blend of technical expertise and proactive communication. The ideal candidate anticipates payer policy shifts, leverages data analytics to uncover revenue leakage, and builds strong relationships with clinical and coding partners. By consistently delivering clean claims and actionable insights, you’ll become a trusted advisor who drives measurable financial improvement for our clients.