About the Role
We are seeking an experienced Medical Billing & Patient Accounts Specialist – Bilingual (Filipino / Spanish) with specialized, hands-on expertise in athenaOne (AthenaHealth) billing and revenue cycle workflows.
In this position, you will be responsible for managing end-to-end claim follow-ups, resolving claim holds, tracking unpaid or denied claims, and serving as the primary point of contact for patients calling with billing, statement, or balance inquiries. Because AthenaHealth integrates billing directly into its EHR platform, candidate fluency with Athena's Collector module, claim status rules, and hold queues is strictly required on day one.
Requirements
Key Responsibilities
1. Claim Follow-Up & Denial Resolution (Athena Collector)
- Monitor and manage daily athenaOne billing worklists, claim hold queues, and claim status dashboards.
- Research, correct, and resubmit unpaid, rejected, or denied claims with commercial insurance payers, Medicare, and Medicaid.
- Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) directly within Athena to resolve claim discrepancies and process appeals.
2. Patient Billing & Inbound Phone Support
- Answer inbound patient phone calls regarding billing statements, account balances, co-pays, deductibles, and co-insurance.
- Clearly and empathetically explain medical bills, charge breakdowns, and insurance coverage decisions to patients over the phone.
- Set up approved patient payment plans, process phone payments, and resolve patient billing disputes directly within Athena.
3. Account Reconciliation & Charge Auditing
- Review patient account ledgers in Athena to verify proper insurance payment posting and patient balance adjustments.
- Identify recurring billing errors or payer rules to help streamline practice revenue cycle management.
- Maintain clear, thorough documentation of all insurance follow-up attempts and patient call interactions in the patient chart.
Qualifications & Requirements
- AthenaHealth Mastery (Non-Negotiable): Direct, recent hands-on experience using athenaOne / AthenaHealth billing modules (Athena Collector, Claim Worklists, Hold Queues, Patient Statements).
- Medical Billing Experience: Minimum 2+ years of U.S. medical billing, accounts receivable (A/R) follow-up, and insurance denial management experience.
- Patient Accounts & Phone Skills: Proven background handling inbound patient billing calls with exceptional telephone etiquette, conflict resolution skills, and spoken English clarity.
- Revenue Cycle Literacy: Strong knowledge of CPT/ICD-10 coding rules, modifiers, EOB/ERA interpretation, and payer-specific authorization guidelines.
- Technical Setup: Dedicated, quiet home office, noise-canceling headset, high-speed internet, and familiarity with web-based VOIP phone systems.