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 reputed company 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 reputed company or a quick video‑hangout, while reputed company keeping the flexibility that reputed company 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 reputed company‑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‑resolu