Medical Billing & Revenue Cycle Specialist
Core
Manage the full revenue cycle for U.S. primary care practices, including claims submission, payment posting, denial management, and patient billing support.
Role type
Senior Medical Billing & Revenue Cycle Specialist
Builds
Cleaned claims, posted payments, and resolved denials for primary care practices
Domain
U.S. Healthcare / Revenue Cycle Management
Required skills
U.S. medical billing, Revenue Cycle Management (RCM), athenahealth (Athena) EHR/PM, EDI transactions (837, 835, 270/271), CPT/ICD-10/HCPCS coding, Medicare/Medicaid/commercial payer guidelines, ERA/EOB processing, denial appeals, patient communication
Preferred skills
Primary care billing, multi-account management, BPO/offshore RCM experience, CPB/CPC credential
Technologies
athenahealth, clearinghouses, ERA/EOB systems
Responsibilities
Review and submit accurate claims in Athena; verify coding and modifiers; monitor and resolve clearinghouse rejections; post insurance and patient payments from ERA/EOB; reconcile payments and identify discrepancies; apply adjustments and write-offs; research denial root causes and submit appeals; respond to patient billing inquiries via phone/email/portal; coordinate with practice teams on account issues; track billing outputs and denial trends.
Seniority
Senior, hands-on IC