Medical Biller
Job Overview
About the Role
We are seeking an experienced and detail-oriented Medical Billing Specialist to join our Revenue Cycle Management (RCM) team. The ideal candidate will have a strong background in medical billing, claims review, and payment reconciliation within a clinical or DME setting. This role requires accuracy, attention to detail, and a proactive approach to maintaining clean claims, resolving denials, and ensuring timely reimbursement.
Key Responsibilities
Claims & Payment Management
- Review and resolve eligibility issues daily to ensure claims are submitted with correct insurance details.
- Maintain accuracy of insurance IDs and uploads in Phreesia, verifying legibility and data integrity.
- Monitor and clear all HOLD and MGRHOLD claims on a daily basis.
- Review and resolve 90+ day old claims, prioritizing aged receivables.
- Work on unpostables and manage the correspondence dashboard to ensure timely posting and reconciliation.
- Support pre-collections in Phreesia as needed, particularly during clinic surges or staff absences.
Payment Reconciliation
- Review and reconcile Optum Pay and ECHO payments from the past 13 months through the current month.
- Conduct Zero Pay Report analysis, validating adjustments made in Athena from the prior month.
- Assist with DME and Square Payments reconciliation as part of the monthly reporting cycle.
Remote Therapeutic Monitoring (RTM) Billing
- Manage RTM billing at the start of each month in coordination with the billing lead.
- Bill for prior month’s setup, download, and counseling for CPAP and INSPIRE patients.
- Maintain an active RTM patient log and ensure accuracy in billing data.
Reporting & Analysis
- Prepare and submit monthly financial reports, including charges and payments posted in Athena.
- Track and report on:
- Nurse Practitioner productivity and volume
- Clean claim rate and denial rate
- RTM payments
- Zero Pay reports
- DME and Square payments
Qualifications
- 2+ years of experience in medical billing or revenue cycle management (RCM).
- Strong understanding of claims processing, eligibility verification, and denial management.
- Experience with AthenaHealth, Phreesia, or similar EHR/PM systems.
- Proficient in interpreting EOBs, payment reports, and denial codes.
- Excellent attention to detail and ability to work independently.
- Strong Excel and data entry skills; able to track and reconcile reports efficiently.
- Team-oriented with strong communication and analytical skills.
This is a full time role
Up to $8/hr
100% Remote job