Job Description
Overview: Demonstrate competency as a claims resolution specialist for a large-scale multi-specialty/multi-site healthcare organizations in the U.S.
• Perform claims resolution or medical billing and appeals or claims denials in Athena within the last two years.
• Conduct AR Follow-up both on front end scrubs and back end denials through best practices. Scrub charges for submission and launch appeals via the Athena billing platform.
• Review and clear claim edits in the system. Types of edits to be worked include registration, insurance, charge, and related issues for high volume practices.
• Demonstrate a detailed understanding of how to read and interpret EOB's and denials from all insurance carriers (including the financial components such as co-pays, deductibles, and co-insurance).
• Possess a thorough knowledge of appeals processing from end to end across all payer categories based on insurance denials.
• Differentiate between best practices of appeal, coding review, credentialing review and/or adjustment.
• Contact insurance companies and utilize web portal and websites for appeal, eligibility, remittance, and payment information.
• Candidate must be able to report and communicate issues and trends.
• Meet or exceed daily productivity benchmarks.
Knowledge, Skill, and Experience Requirements:
• 3+ years of experience in claims resolution or medical billing.
• A minimum of 1 year of recent Athena Health billing platform is required.
• Working knowledge of CPT, ICD-10, and medical terminology.
• Complete understanding of follow-up processes.
• Solid background in AR and overall Revenue Cycle policies and procedures.
• Experience working in a physician billing environment.
• Excellent communication skills.
• Proficiency in Microsoft Office Suite, including Word and Excel.
About CaduceusHealth:
CaduceusHealth has partnered with athenahealth, offering fully outsourced clinical and revenue cycle solutions to large healthcare networks. Jersey City, New Jersey-based CaduceusHealth, has over 200 employees in 38 states, supporting over 4,500 providers in 400 medical practices on the athenahealth platform. “We bring clarity and efficiency to healthcare business operations to heighten the value of the provider and patient healthcare experiences,” said James Bonomo, CEO of CaduceusHealth.
CaduceusHealth offers a competitive compensation and benefits package, including health and dental, vision, 401K plan, generous PTO, and business casual dress.
At CaduceusHealth, we are committed to equal employment opportunity. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religion, age, sex, ****** orientation, transgender, national origin, disability, genetic information, veteran, or marital status, or any other characteristic protected by law.
• Perform claims resolution or medical billing and appeals or claims denials in Athena within the last two years.
• Conduct AR Follow-up both on front end scrubs and back end denials through best practices. Scrub charges for submission and launch appeals via the Athena billing platform.
• Review and clear claim edits in the system. Types of edits to be worked include registration, insurance, charge, and related issues for high volume practices.
• Demonstrate a detailed understanding of how to read and interpret EOB's and denials from all insurance carriers (including the financial components such as co-pays, deductibles, and co-insurance).
• Possess a thorough knowledge of appeals processing from end to end across all payer categories based on insurance denials.
• Differentiate between best practices of appeal, coding review, credentialing review and/or adjustment.
• Contact insurance companies and utilize web portal and websites for appeal, eligibility, remittance, and payment information.
• Candidate must be able to report and communicate issues and trends.
• Meet or exceed daily productivity benchmarks.
Knowledge, Skill, and Experience Requirements:
• 3+ years of experience in claims resolution or medical billing.
• A minimum of 1 year of recent Athena Health billing platform is required.
• Working knowledge of CPT, ICD-10, and medical terminology.
• Complete understanding of follow-up processes.
• Solid background in AR and overall Revenue Cycle policies and procedures.
• Experience working in a physician billing environment.
• Excellent communication skills.
• Proficiency in Microsoft Office Suite, including Word and Excel.
About CaduceusHealth:
CaduceusHealth has partnered with athenahealth, offering fully outsourced clinical and revenue cycle solutions to large healthcare networks. Jersey City, New Jersey-based CaduceusHealth, has over 200 employees in 38 states, supporting over 4,500 providers in 400 medical practices on the athenahealth platform. “We bring clarity and efficiency to healthcare business operations to heighten the value of the provider and patient healthcare experiences,” said James Bonomo, CEO of CaduceusHealth.
CaduceusHealth offers a competitive compensation and benefits package, including health and dental, vision, 401K plan, generous PTO, and business casual dress.
At CaduceusHealth, we are committed to equal employment opportunity. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religion, age, sex, ****** orientation, transgender, national origin, disability, genetic information, veteran, or marital status, or any other characteristic protected by law.
💡 Quick Summary
Seeking a career-building opportunity? The Medical Billing Specialist with Athena Experience position is now open for candidates interested in the Work from home Jobs sector. This role in Albert City offers a professional environment and growth potential.
Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in Work from home Jobs is a plus.