RC
Accounts Receivable (A/R) and Denial Management Specialist (athenahealth)
- Hiring from
- Philippines
- Work type
- Remote
- Posted
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Job Description
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 in athenaOne across 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
