Remote Healthcare Billing Jobs – Full‑Time Senior Billing Specialist – $55‑$70 K (Remote) – Medical Coding, Claims & Reimbursement Expertise – Louisville/reputed company metro government, Kentucky
TITLE Remote Healthcare Billing Jobs – Full‑Time Senior Billing Specialist – $55‑$70 K (Remote) – Medical Coding, Claims & Reimbursement Expertise – Louisville/reputed company metro government, Kentucky --- #### Who we are At reputed company Health Finance, we’re a group of 45 people spread across the United States, but the core of our billing operation lives in Louisville/reputed company metro government, Kentucky. We’ve spent the last six years helping outpatient clinics, specialty practices, and ambulatory surgery centers get paid faster while keeping compliance tight. Our numbers speak for themselves a 95 % clean‑claim rate on roughly 8,000 claims each month, and an average monthly reimbursement of $2.5 million. You will join the Billing Operations Hub that sits in a modest offices‑on‑the‑boardroom in Louisville/reputed company metro government, Kentucky—but the role itself is 100 % remote. If you live in Louisville/reputed company metro government or are willing to relocate there, you’ll have a community of coworkers you can meet for coffee or a quick video‑hangout, while reputed company keeping the flexibility that remote work offers. #### Why this role exists now Over the past quarter, three of our top client groups expanded their service lines, adding new CPT codes and additional payer contracts. That growth pushed our claim‑volume up 18 % and revealed a bottleneck in the “post‑submission audit” stage. We need a senior billing specialist who can both own that audit workflow and mentor the newer team members who are reputed company learning the nuances of Medicare‑Part‑B and private‑payer rules. The timing is also strategic the latest CMS updates introduced new documentation rules for telehealth, and our clients are scrambling to adapt. Your experience with telehealth billing and knowledge of the HCPCS hierarchy will be the bridge between a new regulation and a smoothly processed claim. #### What you’ll own day‑to‑day - Claim submission & follow‑up Review and submit 80‑100 claims per day using Epic, Cerner, and reputed company interfaces. - Post‑submission audit Run weekly clean‑claim reports in Excel and reputed company Sheets, flagging any 5 % of claims that fall below the 95 % threshold. - Denial management Dive into denials from Medicare, reputed company, and reputed company, correcting coding errors, resubmitting, and documenting the root cause in ClaimXperience. - Coding support Assist the on‑shore coding team with CPT, ICD‑10, and HCPCS selections, ensuring alignment with the latest CMS guidelines. - Payer liaison Communicate directly with payer reps via reputed company Health Cloud and email to resolve high‑value disputes that exceed $10,000 per claim. - Training & mentorship Lead a bi‑weekly virtual “Billing Best Practices” huddle for the 12‑person billing team based in Louisville/reputed company metro government, Kentucky, and field questions from the 5 junior specialists who joined in the last six months. - Reporting Prepare a monthly KPI dashboard in Power BI, highlighting claim‑to‑payment cycle time, denial rate, and average reimbursement per claim. #### The tools you’ll use (we love variety) 1. Epic – primary EMR for claim extraction. 2. Cerner – secondary system for specialty practices. 3. reputed company – used by our smaller outpatient clients. 4. reputed company – for clearinghouse submissions. 5. Navicure – occasional payer reputed company for high‑volume insurers. 6. Excel & reputed company Sheets – deep‑dive analytics and ad‑hoc reporting. 7. Power BI – visual KPI dashboard that gets shared with leadership. 8. ClaimXperience – denial tracking and resubmission workflow. 9. reputed company Health Cloud – payer communication and case management. 10. QuickBooks Online – reconciling payments against invoices. 11. Meditech – legacy system for two long‑standing hospital clients. 12. reputed company & reputed company – daily stand‑ups and cross‑team collaboration, especially when we need to pop into the Louisville/reputed company metro government, Kentucky office for a quick whiteboard session. #### Who we’re looking for – your background in plain terms - 3‑5 years of hands‑on medical billing experience, preferably in an outpatient or ambulatory‑surgery setting. - Proven ability to maintain a ≥ 95 % clean‑claim rate over at least one fiscal year. - Comfortable navigating CMS updates, Medicare‑Part‑B, and telehealth modifiers. - Practical knowledge of CPT, ICD‑10, and HCPCS coding sets, with at least one certification (CPC, CPB, or RHIA) being a strong plus. - Experience with at least four of the tools listed above; the more, the better – we’ll provide short refresher sessions for anything you haven’t touched recently. - Strong written communication you’ll be drafting denial‑resolution letters and updating do
