Reimbursement Specialist – Healthcare

About the role

Join a fast‑paced revenue‑cycle team where you’ll lead the resolution of complex insurance claims, drive timely reimbursements, and directly influence financial performance and operational success.

Key responsibilities

• Manage denied and rejected insurance claims by researching root causes, correcting issues, and following up with payers to secure reimbursement.
• Review Explanation of Benefits (EOBs), payment variances, aging reports, and negative balances to ensure accurate claim processing.
• Work directly with insurance payers to resolve denials, authorization issues, filing errors, and reimbursement discrepancies.
• Escalate recurring payer trends and recommend process improvements to leadership.
• Verify patient eligibility, qualifying diagnoses, prior testing, and authorization requirements.
• Utilize Excel, dashboards, and worklists to track claim activity, monitor productivity, and identify reimbursement trends.
• Maintain compliance with internal processes, reimbursement standards, and quality expectations.
• Support team collaboration by assisting with payer resolution efforts across accounts and ensuring timely follow‑up on outstanding claims.

Required profile

• 2+ years of experience in accounts receivable, reimbursement, collections, or denial management, with hands‑on experience resolving denied insurance claims.
• Bachelor’s degree, high school diploma, GED, or vocational training in finance, accounting, business administration, economics, or a related field.
• Strong analytical, problem‑solving, and communication skills, with the ability to work independently in a fast‑paced environment.

Required skills

• Excel
• Dashboards
• Claim processing systems

What we offer

• Competitive hourly pay ranging from $26 to $41.
• Comprehensive benefits including generous PTO, 401(k) match up to 7%, HSA contributions, stock purchase plan, and education reimbursement.