Medical Biller/Revenue Cycle Specialist

Meet productivity and performance expectations related to claims worked, worklist aging, denial turnaround, clean claim rates, and unresolved claims. Experience working with Athena claims, holds, manager holds, edits, worklists, remittances, payment issues, and claim status.

Client Overview:
Our client is a healthcare organization providing comprehensive medical and dental services to the local community. The organization is committed to providing quality patient care while maintaining efficient, accurate, and compliant revenue cycle operations. They are currently expanding and looking to bring on a Medical Biller/Revenue Cycle Specialist to join their team.

Salary/Hourly Rate:
$21/hr - $23/hr

Position Overview:
Our client is seeking a temporary Medical Biller/Revenue Cycle Specialist for a temporary assignment with potential for permanent placement. This position will support the full revenue cycle process, from patient registration and eligibility through claim submission, denial resolution, payment posting, reconciliation, and AR follow-up. The ideal candidate will have strong end-to-end medical billing and revenue cycle experience, particularly with Medicaid and Managed Medicaid. Candidates should be analytical, detail-oriented, accountable, and comfortable investigating the root causes of billing issues rather than simply rebilling claims. This is a 35-hour work week with hours of either 8:00 AM to 4:00 PM or 9:00 AM to 5:00 PM, depending on the team member being shadowed.

Responsibilities of the Medical Biller/Revenue Cycle Specialist:

• Manage the full medical billing and revenue cycle process from registration and eligibility through payment and reconciliation.
• Review and process claims for accuracy and timely submission.
• Work with Medicaid, Managed Medicaid, and other insurance payers.
• Resolve claim denials and rejections by identifying root causes and correcting issues.
• Perform AR follow-up and manage aging accounts, including 30/60/90+ day AR.
• Research payer delays, underpayments, no-response claims, and other reimbursement issues.
• Identify recurring denial trends and communicate potential workflow or system issues.
• Review coding-related information and understand how CPT, HCPCS, ICD-10, modifiers, medical necessity, and basic bundling concepts impact clean claims.
• Monitor claims, worklists, edits, holds, remittances, and payment issues.
• Reconcile payments and billing information as needed.
• Maintain accurate documentation and follow-up notes.
• Meet productivity and performance expectations related to claims worked, worklist aging, denial turnaround, clean claim rates, and unresolved claims.
• Collaborate with Patient Access, providers, credentialing, payers, and internal leadership to resolve revenue cycle issues.
• Assist with identifying and resolving systemic billing and workflow issues.
• Maintain confidentiality and compliance with applicable healthcare regulations.
• Perform other duties as assigned.

Required Experience/Skills for the Medical Biller/Revenue Cycle Specialist:

• Strong end-to-end medical billing and revenue cycle experience.
• Experience with Medicaid and Managed Medicaid.
• Experience resolving claim denials and rejections.
• Strong AR follow-up and aging management experience.
• Understanding of medical billing and coding terminology.
• Knowledge of CPT, HCPCS, ICD-10, modifiers, and medical necessity.
• Strong analytical and problem-solving skills.
• Ability to investigate billing issues and identify root causes.
• Strong attention to detail and accuracy.
• Ability to manage a high-volume workload and meet productivity expectations.
• Strong communication and follow-through skills.
• Ability to take ownership of issues from identification through resolution.

Preferred Experience/Skills for the Medical Biller/Revenue Cycle Specialist:

• Hands-on AthenaOne experience.
• Experience working with Athena claims, holds, manager holds, edits, worklists, remittances, payment issues, and claim status.
• Dentrix experience.
• Dental billing experience.
• Previous FQHC (Federally Qualified Health Center) experience.
• Knowledge of FQHC billing, including PPS encounters, WRAP/LOA concepts, qualifying vs. non-qualifying encounters, same-day encounters, and carve-outs.
• Experience working with both medical and dental billing systems.
• Strong Excel skills.

Education Requirements:

• Bachelor's degree is preferred but not required.

Benefits:

• Atrium Care Package available, upon eligibility (including healthcare plans, discount programs, and paid time off).

Job Wrapping ID: #LI-AJ3

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EOE/M/F/D/V/SO

Position ID: 406510