Medical Biller

3 days ago

Philippines Remote Raven Full time $64,000 per year

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

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