Medical Billing & Revenue Cycle Specialist

The U.S.-based healthcare services organization is seeking an experienced Medical Billing & Revenue Cycle Specialist to manage the full revenue cycle, including claims submission, payment posting, denial management, appeals, and patient billing support.

The ideal candidate has strong U.S. medical billing experience, direct experience with athenahealth (Athena), and the communication skills to professionally assist U.S. patients and practice teams. This is a full-time, fully remote position with two weeks of initial training.

Duties / Tasks to Perform

• Review and submit claims in Athena, ensuring accuracy and completeness before submission.
• Verify coding, modifiers, and payer requirements before claims are submitted.
• Monitor clearinghouse rejections and promptly resolve and resubmit affected claims.
• Track claim status throughout the full billing cycle.
• Post insurance and patient payments from ERA/EOB documentation accurately and on time.
• Reconcile payments against expected reimbursement and identify discrepancies.
• Apply adjustments, write-offs, and contractual allowances according to established practice and payer guidelines.
• Identify, categorize, and work denied or underpaid claims.
• Research denial root causes, including coding, eligibility, authorization, and timely filing issues, and take corrective action.
• Prepare and submit appeals with the appropriate supporting documentation.
• Track denial trends and escalate recurring issues for upstream resolution.
• Respond to patient billing questions regarding statements, payment plans, insurance, balances, and related concerns through phone, email, and portal communications.
• Explain EOBs, balances, and billing policies clearly and professionally to patients.
• Coordinate with practice and front-office teams to resolve patient account issues.
• Escalate complex account or clinical-adjacent matters appropriately.
• Maintain daily tracking of key billing outputs, including claim submissions and patient statements.

Requirements

• 3+ years of hands-on U.S. medical billing and Revenue Cycle Management (RCM) experience, including claims, payment posting, and denials.
• Direct working experience with athenahealth (Athena) EHR/PM.
• Strong understanding of the complete revenue cycle: charge entry → claims → ERA/EOB posting → denials → appeals.
• Understanding of EDI transactions, including 837 claims, 835 remittances, and 270/271 eligibility transactions.
• Familiarity with CPT, ICD-10, HCPCS, and payer-specific billing requirements for Medicare, Medicaid, and commercial payers.
• Strong spoken and written English, with the ability to communicate directly and professionally with U.S. patients.
• Excellent organization, attention to detail, follow-up, communication, and customer empathy.
• Reliable internet connection and a quiet remote workspace.
• Full-time availability, with the ability to treat this as a primary and dedicated role.
• Primary care billing experience is strongly preferred.
• Experience supporting multiple practices or accounts simultaneously is strongly preferred.
• Previous BPO/offshore RCM experience supporting U.S. healthcare organizations is preferred.
• CPB, CPC, or a similar billing/coding credential is a plus but not required.