Remote Healthcare Billing Jobs – Full‑Time Senior Billing Specialist – $55‑$70 K (Remote) – Medical Coding, Claims & Reimbursement Expertise – Louisville/Jefferson County metro government, Kentucky

TITLE: Remote Healthcare Billing Jobs – Full‑Time Senior Billing Specialist – $55‑$70 K (Remote) – Medical Coding, Claims & Reimbursement Expertise – Louisville/Jefferson County metro government, Kentucky --- #### Who we are At **ClearPath Health Finance**, we’re a group of 45 people spread across the United States, but the core of our billing operation lives in Louisville/Jefferson County 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/Jefferson County metro government, Kentucky—but the role itself is 100 % remote. If you live in Louisville/Jefferson County 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 still 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 still 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 **AdvancedMD** interfaces. - **Post‑submission audit:** Run weekly clean‑claim reports in **Excel** and **Google Sheets**, flagging any 5 % of claims that fall below the 95 % threshold. - **Denial management:** Dive into denials from **Medicare**, **UnitedHealthcare**, and **Aetna**, 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 **Salesforce 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/Jefferson County 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. **AdvancedMD** – used by our smaller outpatient clients. 4. **Office Ally** – for clearinghouse submissions. 5. **Navicure** – occasional payer portal for high‑volume insurers. 6. **Excel** & **Google 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. **Salesforce 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. **Slack** & **Zoom** – daily stand‑ups and cross‑team collaboration, especially when we need to pop into the Louisville/Jefferson County 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 documentation in **Salesforce Health Cloud** for auditors. - A collaborative mindset: you’ll be mentoring junior staff, so patience and the ability to explain “why” behind each step matter as much as getting the claim processed. - Residency (or willingness to relocate) in **Louisville/Jefferson County metro government, Kentucky** – we need you to attend the quarterly in‑person “Billing Jam” at our local hub, which is why we specifically call out Louisville/Jefferson County metro government in the title. #### How we measure success – metrics that matter - **Clean‑claim rate** stays at or above 95 % each month. - **Average claim‑to‑payment cycle** drops from 48 hours to 36 hours within the first 90 days. - **Denial reversal** rate improves by at least 12 % quarter‑over‑quarter. - **Mentorship impact:** junior specialists achieve a 5 % increase in claim accuracy after six months of your coaching. We’ll review these numbers during our quarterly “Billing Health Check” and tie performance bonuses to them, but we also keep a pulse on how you feel about the workload and your own professional growth. #### What you’ll get from us – not just the paycheck - **Salary**: $55,000 – $70,000 base, commensurate with experience, plus a performance‑based bonus up to 8 % of annual earnings. - **Benefits**: Medical, dental, vision, 401(k) match, and a **$1,000 annual education stipend** for coding or billing certifications. - **Flexibility**: Fully remote, but we cover a **$150/month** co‑working space stipend for those who prefer an office vibe in Louisville/Jefferson County metro government. - **Community**: Quarterly in‑person meet‑ups at our Louisville/Jefferson County metro government hub, a yearly “Billing Retreat” in a nearby ski town, and a Slack channel for quick memes and support. - **Career path**: Clear ladder from Billing Specialist → Senior Billing Specialist → Billing Team Lead → Billing Operations Manager, with transparent expectations at each step. #### A human moment (because numbers aren’t everything) > “I still remember the first time I saw a claim go from denied to approved after we corrected a single line of code. The relief on the provider’s face, the quick “thank you” email, and the knowledge that we’d helped a patient get the care they needed—that’s why I love this work,” shares Maya Patel, Senior Billing Lead, who has been with ClearPath for four years and now lives just a few blocks from the Louisville/Jefferson County metro government office. #### The hiring process – what to expect 1. **Resume & cover letter** – send us a short note about why billing matters to you and a copy of your most recent clean‑claim report (if you can share it). 2. **Phone screen (15 min)** – quick chat with our Talent Branding Lead to confirm logistics, remote‑work setup, and your availability for the quarterly Louisville/Jefferson County metro government meet‑ups. 3. **Technical interview (45 min)** – a live walk‑through of a sample claim in **Epic**, including denial analysis and coding decisions. 4. **Team interview (30 min)** – meet the Billing Operations Hub in Louisville/Jefferson County metro government, Kentucky via Zoom; you’ll hear about their day‑to‑day challenges and get a chance to ask real‑world questions. 5. **Offer** – we’ll send a detailed package outlining salary, benefits, and our remote‑work policy. If you’re reading this from a coffee shop in Louisville/Jefferson County metro government or a home office in Kentucky, and you think you can keep our clean‑claim rate high while guiding junior teammates, we’d love to hear from you. --- *ClearPath Health Finance is an equal‑opportunity employer. We celebrate the diverse perspectives that make our billing team stronger, and we welcome applicants of all backgrounds.* Apply tot his job Apply To this Job