Remote opportunity at
PRO-spectusReimbursement Specialist - Healthcare Appeals, A/R & Payor Collections
PRO-spectus is hiring a remote Reimbursement Specialist II on a full-time basis to ensure that medical organizations receive proper compensation for their services. This position involves…
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About This Role
PRO-spectus is hiring a remote Reimbursement Specialist II on a full-time basis to ensure that medical organizations receive proper compensation for their services. This position involves managing accounts receivable, resolving billing issues, reviewing claims against contracted rates, and navigating complex insurance guidelines across commercial, Medicare, Medicaid, and Workers' Compensation payors. The professional in this role will handle appeals, communicate with stakeholders including insurers, patients, and clinical staff, and perform light…
Job Description
PRO-spectus is hiring a remote Reimbursement Specialist II on a full-time basis to ensure that medical organizations receive proper compensation for their services. This position involves managing accounts receivable, resolving billing issues, reviewing claims against contracted rates, and navigating complex insurance guidelines across commercial, Medicare, Medicaid, and Workers' Compensation payors. The professional in this role will handle appeals, communicate with stakeholders including insurers, patients, and clinical staff, and perform light clerical and accounting tasks.
The ideal candidate is comfortable operating remotely from home, possesses strong computer and database management skills, and maintains attention to detail under stressful circumstances. PRO-spectus offers a supportive and teamwork-driven culture centered on improving patient lives, along with comprehensive benefits and pay transparency. The hourly compensation ranges from $32.00 to $35.00, determined by individual experience and qualifications.
Responsibilities
- Ensure timely collection of outstanding accounts receivable and resolve billing or claims disputes
- Research, evaluate, and interpret complex data regarding appeals and payor billing policies
- Monitor assigned accounts to maintain positive cash flow and take appropriate actions
- Stay informed on insurance regulations and policy changes across commercial, Medicare, Medicaid, and Workers Compensation payors
- Identify payments that deviate from contracted rates and fee schedules to escalate them correctly
- Provide cross-training department coverage and handle various clerical, data entry, and record-keeping duties
Requirements
- Extensive background in insurance collections, appeals, and specific payor billing policies
- Comprehensive grasp of healthcare coding and billing workflows
- Proficiency in navigating intricate insurance regulations
- Strong verbal and written communication abilities for interacting with patients, insurers, and providers
- High attention to detail, organizational aptitude, and the ability to adapt to shifting priorities
- Capability to maintain composure during stressful circumstances and manage proprietary electronic software
Qualifications
- Prior exposure to clinical guidelines, medical policy, and third-party payors
- Familiarity with billing and medical terminology
- High school diploma paired with over five years of healthcare sector experience
- Associate degree in a health-related discipline combined with more than three years of professional experience
Core Skills
Benefits
- Comprehensive and generous benefits package designed to support well-being and work-life balance
Frequently Asked Questions
Answers are based only on the employer’s listing; where it doesn’t say, neither do we.
Is this position remote?
Yes, this is a remote-forward role where employees telework from their home address listed in their employment file.
What is the salary for this role?
The compensation ranges from $32.00 to $35.00 per hour, based on qualifications and experience.
What education and experience are required?
Candidates need either a high school diploma with at least five years of healthcare experience or an associate's degree in a healthcare-related field with over three years of experience.
Sample Interview Questions
AI-generated questions tailored to this specific role — a preview of the full practice set.