Remote Healthcare ReimbursementSpecialist for Residents of Florida

Join our dynamic healthcare technology team as a Remote Healthcare Reimbursement Specialist, playing a pivotal role in optimizing financial outcomes for healthcare providers through expert claim processing and reimbursement analysis. This fully remote position offers the flexibility to work from anywhere in Florida while contributing directly to the efficiency and profitability of healthcare delivery.

About the Role

As a Healthcare Reimbursement Specialist, you will be the critical link between healthcare providers, payers, and patients, ensuring accurate and timely reimbursement for services rendered. Your primary focus will involve meticulously reviewing complex medical claims, identifying and resolving billing discrepancies, and implementing strategies to maximize revenue capture and compliance. This role demands exceptional attention to detail, strong analytical skills, and a deep understanding of healthcare reimbursement policies, insurance regulations (including Medicare, Medicaid, and private payers), and coding systems. You will collaborate closely with clinical and administrative teams to streamline processes and support the financial health of our client organizations.

Key Responsibilities

• Thoroughly review, verify, and process medical claims for accuracy and compliance with payer policies and regulations.
• Investigate and resolve claim denials, rejections, and underpayments through meticulous research and communication with payers.
• Analyze reimbursement trends and identify opportunities to improve revenue cycle efficiency and cash flow.
• Maintain comprehensive knowledge of current healthcare reimbursement methodologies, coding updates (CPT, ICD-10), and regulatory changes.
• Collaborate with clinical documentation specialists, physicians, and billing staff to ensure accurate coding and billing practices.
• Prepare and submit appeals for denied claims and manage the appeals process effectively.
• Utilize specialized billing and reimbursement software platforms proficiently.

Requirements

Successful candidates will possess:

• Proven experience (minimum 2 years) as a Healthcare Reimbursement Specialist, Billing Specialist, or similar role within a healthcare setting.
• Comprehensive understanding of healthcare reimbursement principles, insurance claim processing, and denial management.
• Advanced proficiency in medical coding (CPT, ICD-10) and familiarity with common payer systems (e.g., EPIC, Meditech, billing software).
• Strong analytical skills with the ability to interpret complex data and identify root causes of financial discrepancies.
• Excellent written and verbal communication skills for effective collaboration and clear explanation of complex billing issues.
• Ability to thrive in a fast-paced, remote environment with minimal supervision.
• High school diploma or equivalent; Associate’s degree in Healthcare Administration, Business, or related field preferred.

Benefits

We offer a competitive compensation package and a supportive remote work environment, including:

• Competitive Salary: $60,000 – $85,000 USD/year based on experience and qualifications.
• Comprehensive Health, Dental, and Vision Insurance.
• Retirement Savings Plan with company match.
• Generous Paid Time Off (PTO) policy.
• Flexible Work Schedule (core hours required).
• Professional Development Opportunities.
• Remote Work Equipment Stipend.

This is an exciting opportunity to make a significant impact on healthcare financial operations from the comfort of your Florida home. If you are a detail-oriented, analytical thinker with a passion for healthcare finance and a commitment to excellence, we want to hear from you.