Accounts Receivable (A/R) and Denial Management Specialist (athenahealth)

This is a remote position.

Key Responsibilities

• Work a daily worklist in athenaOne, starting with new denials and payer correspondence, then open A/R prioritized by filing deadline, age and balance
  
• Follow up with payers on unpaid and underpaid claims through payer portals and phone calls
  
• Document claim status, call reference numbers and next steps on every account worked
  
• Review denials, identify the root cause, and correct and resubmit claims
  
• Prepare and submit reconsiderations and appeals, and track them through to a decision
  
• Monitor timely filing and appeal deadlines so claims do not age out
  
• Route coding, authorization and provider enrollment issues to the right team for resolution
  
• Join scheduled meetings with the client team and send a daily end-of-shift summary of completed work and open items
  
• Protect patient information and follow HIPAA requirements
  

Qualifications

• At least 3 years of U.S. medical billing experience, focused on A/R follow-up and denial management
  
• Hands-on experience working claims and denials in athenahealth (athenaOne)
  
• Experience preparing and submitting appeals and reconsiderations
  
• Familiarity with commercial insurance and government health plans, such as Medicare and Medicaid
  
• Comfortable calling insurance companies and using payer portals for claim follow-up
  
• Strong written and spoken English
  
• Excellent attention to detail and follow-up skills
  
• Ability to work independently and manage a high volume of accounts
  
• Reliable internet connection and a suitable remote workspace
  

Preferred Qualifications

• Experience working for a U.S. medical billing company that supports multiple client practices
  
• Multi-specialty billing experience, especially cardiology, orthopedics, podiatry, ophthalmology/retina, OB/GYN or behavioral health
  
• Familiarity with Ohio payers, including Ohio Medicaid managed care plans
  
• Experience with Medicare Advantage plans and aged A/R cleanup projects
  

Schedule

• Full-time position
  
• Must be available for hours that overlap U.S. Eastern Time business hours (night shift, Philippine time) for meetings, real-time communication and payer calls
  
• Final schedule will be determined based on client needs
  

Work Arrangement

• Remote
  
• Philippines-based applicants preferred