Medical Billing Specialist - athenahealth
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AI Summary
The specialist will manage the full revenue cycle in athenahealth, focusing on resolving claim holds, rejections, and appealing denials. They will also handle patient billing inquiries, set up payment plans, and report A/R performance to leadership.
This is a remote position.
Job Summary
RCM Staff BPO is hiring a full-time Medical Biller and Denial Management Specialist to support a telehealth practice in Colorado.
You will own the full revenue cycle in athenahealth, working claim holds and rejections, appealing denials through resolution, following up on payer and patient A/R, posting payments, and serving as a friendly point of contact for patient billing calls. This role requires hands-on denial management experience, excellent spoken English, and strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans.
Key Responsibilities
- Work payer A/R in athenahealth: resolve claim holds and rejections, follow up on unpaid claims, and appeal denials through resolution
- Manage prior authorizations, including DME requests
- Answer inbound patient billing calls; explain EOBs and patient responsibility clearly and with empathy
- Set up payment plans and conduct outreach on outstanding patient balances
- Post and reconcile payments; prepare accounts for collections or write-off per practice policy
- Track denial trends and report A/R performance to practice leadership
- Maintain punctual, on-camera presence in the practice's virtual office during scheduled hours
- Protect patient information and follow HIPAA requirements
Requirements
Qualifications
- Excellent spoken English and a warm, professional phone presence (this role speaks with patients daily)
- At least 3 years of medical billing experience with hands-on denial management and appeals
- At least 3 years working commercial, Medicare, and Medicare Advantage claims; comfortable in payer portals
- At least 3 years managing patient A/R and medical collections
- At least 1 year of hands-on athenahealth experience
- Excellent attention to detail and follow-up skills
- Ability to work independently and manage multiple patient accounts
- Reliable high-speed internet connection and a private, quiet, HIPAA-compliant remote workspace
Preferred Qualifications
- CPB, CPC, or any industry certification
- Experience supporting sleep medicine, DME, or telehealth practices
- Familiarity with Colorado payers and Medicare Advantage plans
Schedule
- Full-time position
- Must be available 8:00 AM to 5:00 PM Mountain Time
- Final schedule will be determined based on practice needs
Work Arrangement
- Remote, Philippines-based applicants preferred
Hiring Process
- Practical skills assessment
- Video interviews with the hiring team and the client
- Background check prior to onboarding (required for HIPAA compliance)
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