Medical billing and credentialing specialist (Athena Proficiency)
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AI Summary
Manage the full medical billing and Revenue Cycle Management process, including monitoring aging accounts receivable and resolving claim denials. Handle provider credentialing and recredentialing processes while maintaining accurate records within the Athena system.
Our client, a growing healthcare practice, is seeking an experienced Medical Billing & Credentialing Specialist to support its financial and administrative operations. This role is ideal for a detail-oriented healthcare professional with strong experience in medical billing, Revenue Cycle Management (RCM), Accounts Receivable (AR), and provider credentialing.
The ideal candidate is self-motivated, organized, and able to work independently while managing billing processes, resolving claim issues, and maintaining provider credentialing within Athena.
Key Responsibilities
- Manage the full medical billing and Revenue Cycle Management (RCM) process.
- Monitor and follow up on aging Accounts Receivable (AR) and outstanding claims.
- Investigate and resolve claim denials, payment discrepancies, and reimbursement issues.
- Verify patient insurance eligibility and benefits.
- Complete provider credentialing and recredentialing processes.
- Maintain accurate billing, credentialing, and provider records within Athena.
- Communicate with insurance companies regarding claims, credentialing, enrollments, and payment issues.
- Maintain accurate documentation within the practice management system.
- Support additional healthcare administrative tasks as needed.
- Ensure compliance with HIPAA regulations and medical billing best practices.
Required Qualifications
- Minimum 3 years of experience in medical billing, Accounts Receivable (AR), and provider credentialing.
- Strong understanding of the complete Revenue Cycle Management (RCM) process.
- Hands-on experience using Athena.
- Proven experience resolving denied claims and managing aging AR.
- Excellent verbal and written English communication skills.
- Ability to work independently with minimal supervision.
- Strong organizational, analytical, and time-management skills.
- High level of accuracy and attention to detail.
Preferred Qualifications
- Experience supporting multiple medical specialties.
- Knowledge of Medicare, Medicaid, and commercial insurance plans.
- Experience with provider enrollment and payer credentialing.
- Comfortable working remotely in a fast-paced healthcare environment.
We're Looking For Someone Who Is
- Self-driven, proactive, and highly accountable.
- Organized with excellent problem-solving skills.
- Detail-oriented and committed to accuracy.
- Able to prioritize competing tasks effectively.
- Results-oriented with a strong sense of ownership.
- Comfortable working independently while consistently meeting deadlines.
Work Schedule
- Part-Time initially, with the opportunity to transition into a Full-Time role based on business needs.
- Schedule aligned with the U.S. Eastern Time (ET) zone.
Technical Requirements
- Reliable computer or laptop capable of supporting healthcare software.
- Stable high-speed internet connection.
- Professional headset with microphone.
- Quiet, distraction-free home office.
- Fully remote position.
- Opportunity to grow into a full-time role with a growing healthcare practice.
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