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

This is a remote position. Job Summary RCM Staff BPO is hiring 2 full-time A/R and Denial Management Specialists to support a U.S. medical billing company that serves multi-specialty physician practices nationwide, with a large provider base in Ohio. The specialist will work claims and denials daily inathenaOneacross specialties such as cardiology, orthopedics, podiatry, retina, family medicine, OB/GYN and behavioral health. This role requires solid A/R and denial experience, such as strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans. 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 Originally posted on Himalayas