Medical Biller

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