Accounts Receivable (A/R) and Denial Management Specialist (athenahealth)

This is a remote position. Job Summary RCM Staff BPO is hiring 2 full-time A/R and Denial Management Specialists to support a U.S. medical billing company that serves multi-specialty physician practices nationwide, with a large provider base in Ohio. The specialist will work claims and denials daily in athenaOne across specialties such as cardiology, orthopedics, podiatry, retina, family medicine, OB/GYN and behavioral health. This role requires solid A/R and denial experience, such as strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans. Key Responsibilities Work a daily worklist in athenaOne, starting with new denials and payer correspondence, then open A/R prioritized by filing deadline, age and balance Follow up with payers on unpaid and underpaid claims through payer portals and phone calls Document claim status, call reference numbers and next steps on every account worked Review denials, identify the root cause, and correct and resubmit claims Prepare and submit reconsiderations and appeals, and track them through to a decision Monitor timely filing and appeal deadlines so claims do not age out Route coding, authorization and provider enrollment issues to the right team for resolution Join scheduled meetings with the client team and send a daily end-of-shift summary of completed work and open items Protect patient information and follow HIPAA requirements Qualifications At least 3 years of U.S. medical billing experience, focused on A/R follow-up and denial management Hands-on experience working claims and denials in athenahealth ( athenaOne ) Experience preparing and submitting appeals and reconsiderations Familiarity with commercial insurance and government health plans, such as Medicare and Medicaid Comfortable calling insurance companies and using payer portals for claim follow-up Strong written and spoken English Excellent attention to detail and follow-up skills Ability to work independently and manage a high volume of accounts Reliable internet connection and a suitable remote workspace Preferred Qualifications Experience working for a U.S. medical billing company that supports multiple client practices Multi-specialty billing experience, especially cardiology, orthopedics, podiatry, ophthalmology/retina, OB/GYN or behavioral health Familiarity with Ohio payers, including Ohio Medicaid managed care plans Experience with Medicare Advantage plans and aged A/R cleanup projects Schedule Full-time position Must be available for hours that overlap U.S. Eastern Time business hours (night shift, Philippine time) for meetings, real-time communication and payer calls Final schedule will be determined based on client needs Work Arrangement Remote Philippines-based applicants preferred Originally posted on Himalayas