Medical Billing & Revenue Cycle Specialist

We are seeking an experienced Medical Billing & Revenue Cycle Specialist to support a U.S.-based healthcare services organization working with primary care practices. This hands-on role manages the full revenue cycle, including claims submission, payment posting, denial management, appeals, and patient billing support.

The ideal candidate has strong U.S. medical billing experience, direct experience with athenahealth (Athena), and the communication skills to professionally assist U.S. patients and practice teams. This is a full-time, fully remote position with two weeks of initial training.

Duties / Task to perform

• Review and submit claims in Athena, ensuring accuracy and completeness before submission.

• Verify coding, modifiers, and payer requirements before claims are submitted.

• Monitor clearinghouse rejections and promptly resolve and resubmit affected claims.

• Track claim status throughout the full billing cycle.

• Post insurance and patient payments from ERA/EOB documentation accurately and on time.

• Reconcile payments against expected reimbursement and identify discrepancies.

• Apply adjustments, write-offs, and contractual allowances according to established practice and payer guidelines.

• Identify, categorize, and work denied or underpaid claims.

• Research denial root causes, including coding, eligibility, authorization, and timely filing issues, and take corrective action.

• Prepare and submit appeals with the appropriate supporting documentation.

• Track denial trends and escalate recurring issues for upstream resolution.

• Respond to patient billing questions regarding statements, payment plans, insurance, balances, and related concerns through phone, email, and portal communications.

• Explain EOBs, balances, and billing policies clearly and professionally to patients.

• Coordinate with practice and front-office teams to resolve patient account issues.

• Escalate complex account or clinical-adjacent matters appropriately.

• Maintain daily tracking of key billing outputs, including claim submissions and patient statements.

Requirements

• 5+ years of hands-on U.S. medical billing and Revenue Cycle Management (RCM) experience, including claims, payment posting, and denials.

• Direct working experience with athenahealth (Athena) EHR/PM.

• Strong understanding of the complete revenue cycle: charge entry → claims → ERA/EOB posting → denials → appeals.

• Understanding of EDI transactions, including 837 claims, 835 remittances, and 270/271 eligibility transactions.

• Familiarity with CPT, ICD-10, HCPCS, and payer-specific billing requirements for Medicare, Medicaid, and commercial payers.

• Strong spoken and written English, with the ability to communicate directly and professionally with U.S. patients.

• Excellent organization, attention to detail, follow-up, communication, and customer empathy.

• Reliable internet connection and a quiet remote workspace.

• Full-time availability, with the ability to treat this as a primary and dedicated role.

• Primary care billing experience is strongly preferred.

• Experience supporting multiple practices or accounts simultaneously is strongly preferred.

• Previous BPO/offshore RCM experience supporting U.S. healthcare organizations is preferred.

• CPB, CPC, or a similar billing/coding credential is a plus but not required.

Schedule & availability: Monday through Friday, 9:00 AM–5:00 PM Eastern Time | Full-time | Fully remote.

Benefits

• Fully remote work environment

• Stable, long-term collaboration

• Clear scope of responsibilities and structured workflows

• Training and onboarding support

• Opportunity to work with international teams

• Exposure to modern tools and professional processes

• Supportive and collaborative work culture

• Opportunity for skill development and career growth

📌 Before You Apply, Please Read:

At Freelance Latin America, we’re excited to connect you with meaningful remote opportunities. However, we want to be clear:

⏰ These are professional roles with set schedules defined by the client.

Consistent availability is expected. You will have a set work schedule determined by the client, and you are expected to be present during those hours.

🤝 You will be part of the client’s team.

You’ll follow their company guidelines, communication practices, and workflows, ensuring seamless collaboration.

📈 KPIs and goals matter.

Your performance will be measured to ensure alignment with client expectations and project objectives.

🧑‍🏫 Training may be required.

You might need to complete training to fully understand your role, tools, and client processes.

🎯 Commitment and responsibility are essential.

We work with clients who rely on your dedication to deliver consistent, high-quality results. This is key to building trust and long-term partnerships.

🚀 Ready to grow your career with us?

Apply only if you are ready to commit, learn, and take ownership of your role.

Originally posted on Himalayas