Remote Medical Reimbursement Specialist – Claims Processing & Revenue Cycle Excellence at brighthush

Introduction

At brighthush, we believe that every patient deserves the highest quality of care, and that starts with a seamless, transparent, and efficient revenue cycle. As a leading force in the healthcare industry, brighthush is committed to delivering innovative solutions that empower clinicians, support patients, and drive financial sustainability across our extensive network of hospitals, urgent care centers, imaging facilities, and specialty clinics.

We are currently seeking a dedicated Remote Medical Reimbursement Specialist to join our dynamic shared services team. In this role, you will be the guardian of accuracy and compliance in our claims processing workflow, ensuring that every reimbursement is handled with precision, speed, and integrity. If you thrive in a fast-paced, data-driven environment and are passionate about making a tangible impact on patient care and organizational success, we invite you to explore this exciting opportunity.

Key Responsibilities

• Process, review, and verify medical reimbursement claims, guaranteeing adherence to payer guidelines and regulatory requirements.
• Analyze account balances, identify discrepancies, and apply appropriate transaction codes to facilitate accurate claim adjudication.
• Resolve claim discrepancies, including incorrect payments, denials, or underpayments, and take corrective action to secure timely reimbursement.
• Monitor outstanding claims, follow up with payers, and ensure prompt resolution and payment collection.
• Collaborate with revenue cycle teams and external payers to investigate denials, prepare appeals, and negotiate favorable outcomes.
• Research and interpret payer policies, staying current on changes to reimbursement requirements and claim submission rules.
• Document all account actions accurately and thoroughly in the designated systems, maintaining compliance with department protocols.
• Identify process improvement opportunities, contributing to increased efficiency and streamlined reimbursement workflows.
• Maintain strict confidentiality of patient and financial information, ensuring compliance with HIPAA and corporate policies.
• Perform additional duties as assigned, supporting the overall success of the revenue cycle team.

Essential Qualifications

• High school diploma or GED required.
• Associate degree or coursework in Accounting, Finance, Healthcare Administration, or a related field preferred.
• 0–1 year of experience in medical billing, reimbursement, claims processing, or accounts receivable.
• Strong foundational knowledge of medical billing, reimbursement procedures, and payer guidelines.
• Proficiency with electronic health records (EHR), billing software, and reimbursement systems.
• Excellent analytical skills, with the ability to scrutinize account balances and identify discrepancies.
• Effective communication and collaboration skills, enabling productive interactions with payers, revenue cycle teams, and internal departments.
• Knowledge of HIPAA, compliance regulations, and healthcare reimbursement standards.

Preferred Qualifications

• Experience with payer reimbursement policies, claim adjudication, and healthcare revenue cycle operations.
• Familiarity with claim submission, denial management, and appeals processes.
• Demonstrated ability to work independently in a remote setting while maintaining high productivity and accuracy.
• Proficiency in data analysis tools (e.g., Excel, Power BI) to generate insights and support process improvements.
• Previous exposure to a large, multi-site healthcare organization with a complex revenue cycle.

Skills & Competencies

• Attention to Detail: Meticulous in reviewing claims and ensuring compliance with all guidelines.
• Problem-Solving: Ability to diagnose issues quickly and implement effective solutions.
• Critical Thinking: Evaluate complex scenarios and make informed decisions.
• Time Management: Prioritize tasks to meet deadlines in a fast-paced environment.
• Communication: Clear, concise, and professional in written and verbal interactions.
• Team Collaboration: Work seamlessly with cross-functional teams to achieve shared goals.
• Adaptability: Thrive in a changing regulatory landscape and evolving technology platforms.

Career Growth & Learning Opportunities

At brighthush, your professional development is a top priority. As a Remote Medical Reimbursement Specialist, you will have access to:

• Structured onboarding and mentorship programs to accelerate your learning curve.
• Regular training sessions on the latest payer policies, compliance updates, and revenue cycle best practices.
• Opportunities to cross-train in related areas such as coding, denial management, and financial analytics.
• Clear career pathways to roles such as Senior Reimbursement Analyst, Revenue Cycle Manager, or Director of Billing Operations.
• Support for continuing education, including tuition reimbursement for relevant certifications (e.g., Certified Professional Biller).

Work Environment & Culture

Although this is a fully remote position, you will be part of a vibrant, collaborative team that values innovation, integrity, and patient-centered care. Our culture is built on:

• Open communication channels, including weekly virtual huddles and real-time chat platforms.
• A commitment to diversity, equity, and inclusion, ensuring every voice is heard and respected.
• Flexibility to balance professional responsibilities with personal life, supported by a robust remote work infrastructure.
• A focus on continuous improvement, encouraging team members to propose ideas that enhance efficiency and quality.

Compensation & Benefits

While specific salary ranges are not disclosed in this posting, brighthush offers a competitive compensation package that reflects your experience, expertise, and the critical nature of your role. In addition to base pay, you can expect:

• Paid Time Off (PTO) and holiday schedule.
• Comprehensive health benefits, including medical, dental, and vision coverage.
• 401(k) retirement plan with company match.
• Tuition reimbursement for approved educational pursuits.
• Health and wellness programs, such as virtual fitness classes and mental health resources.
• Employee assistance programs and flexible spending accounts.

Why Join brighthush?

At brighthush, you will not only advance your career but also contribute to a mission that matters: delivering high-quality, accessible healthcare to communities across the nation. By joining our team, you will:

• Play a pivotal role in ensuring patients receive the care they need, while safeguarding the financial health of our organization.
• Work with cutting-edge technology and data analytics tools that streamline revenue cycle operations.
• Collaborate with passionate professionals who are dedicated to innovation and excellence.
• Benefit from a supportive, inclusive culture that values your growth and well-being.

How to Apply

If you are ready to bring your expertise to a forward-thinking organization and make a real difference in patient care, we encourage you to apply today. Please submit your resume and a brief cover letter outlining your relevant experience and why you are excited about this role.

Note: This position is not eligible for immigration sponsorship now or in the future. Applicants must be authorized to work in the U.S. for any employer.