医疗计费与收入周期专员
Medical Billing & Revenue Cycle Specialist
我们正在寻找一位经验丰富的医疗账单与收入周期专员，为一家美国本土的医疗服务平台工作，该平台与初级护理机构合作。这个实操性岗位负责整个收入周期，包括索赔提交、付款记录、拒付管理、申诉以及患者账单支持。
理想的候选人具备扎实的美国医疗账单经验，有直接使用athenahealth（Athena）的经验，并具备良好的沟通能力，能够专业地协助美国患者和诊所团队。这是一份全职、完全远程的工作，包含两周的初始培训。
职责 / 工作任务
- 在Athena中审核并提交索赔，确保提交前准确完整。
- 在索赔提交前验证编码、附加码和保险公司要求。
- 监控清算中心的拒绝情况，并及时解决并重新提交受影响的索赔。
- 跟踪整个账单周期中的索赔状态。
- 准确且及时地从ERA/EOB文档中记录保险和患者付款。
- 核对付款与预期报销金额，识别差异。
- 根据既定的诊所规定和保险公司指南应用调整、核销和合同允许。
- 识别、分类并处理被拒或支付不足的索赔。
- 研究拒付的根本原因，包括编码、资格、授权和及时提交问题，并采取纠正措施。
- 准备并提交带有适当支持文件的申诉。
- 跟踪拒付趋势，并将重复出现的问题上报以解决。
- 通过电话、电子邮件和门户通讯回应患者关于账单明细、付款计划、保险、余额及相关问题的咨询。
- 向患者清晰且专业地解释EOB、余额和账单政策。
- 与诊所和前台团队协作解决患者账户问题。
- 适当上报复杂账户或临床相关事项。
- 每日跟踪关键账单输出，包括索赔提交和患者账单。
要求
- 5年以上美国医疗账单和收入周期管理（RCM）的实际经验，包括索赔、付款记录和拒付处理。
- 有直接使用athenahealth（Athena）EHR/PM的经验。
- 对完整的收入周期有深入了解：费用录入 → 索赔 → ERA/EOB记录 → 拒付 → 申诉。
- 了解EDI交易，包括837 c
查看英文原文
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