Billing Specialist, Provider Services (eCW)

Pavago; México; A distancia; MXN 1.684.000 - 2.433.000; Jornada completa

Descripción de la vacante

Pavago is seeking an experienced Billing Manager to lead a Provider Services billing team of 5–6 billers, owning day-to-day performance, collections, denial resolution, and accounts receivable.

The ideal candidate will be an expert in eClinicalWorks (eCW), drive process improvements, and reduce aged AR while ensuring accurate billing across CMS 1500/837P claims. This hands-on leadership role requires strong problem-solving, coaching skills, and the ability to deliver measurable results.

Formación

• 5+ years of professional claims billing experience for physician practices, CMS-1500/837P.
• At least 2 years leading or managing a billing team.
• Expert, hands-on eCW billing experience including claim screens, work queues, payment posting and reports.
• Experience with hub-and-spoke billing environments preferred.
• Strong knowledge of Medicare Part B, Medicare Advantage, Medicaid, and commercial payer billing.
• Proven experience reducing aged AR backlogs, supported by measurable results.
• Ability to read and interpret ERAs and CARC/RARC codes.
• Strong Excel skills and clear written and spoken English.

Responsabilidades

• Lead Billing Manager responsible for day-to-day billing performance, collections, denial resolution and AR.
• Oversee claim workflows, and ensure timely, accurate submission and posting.
• Drive improvements in denial management, front-end fixes, and eCW rule development.
• Oversee AR aging, with focus on 90+ day backlogs and timely filing requirements.
• Coordinate with eCW vendor and leadership on reporting and performance trends.

Conocimientos

eCW billing expert

Team leadership

CMS 1500/837P claims

Medicare/Medicaid knowledge

Payer filing & appeals

Excel skills

Process improvement

Herramientas

Waystar clearinghouse

eCW reporting tools

Descripción del empleo

Position Type: Full-Time | Remote
Working Hours: Must overlap with U.S. Mountain Time business hours for at least 4 hours per day

About the Role

We are looking for an experienced Billing Manager to lead a Provider Services billing team of 5–6 billers and take ownership of day-to-day billing performance, collections, denial resolution, and accounts receivable.

Reporting to the Director of Provider Services, you will manage team productivity, oversee claim workflows, and ensure billing issues are resolved efficiently. This is a hands‑on leadership role requiring expert eClinicalWorks (eCW) knowledge, strong problem‑solving skills, and the ability to reduce aged accounts receivable while improving billing processes.

The ideal candidate can quickly identify claim issues, implement process improvements, assign accountability, and keep the team focused on measurable results.

Key Responsibilities

Team Leadership & Performance Management

• Assign every billing work queue and practice to a designated biller.
• Review individual productivity daily and follow up on performance gaps the same day.
• Lead weekly team billing meetings and one‑on‑one check‑ins.
• Train, coach, and support billers while maintaining accountability for individual and team performance.

Accounts Receivable & Claims Management

• Manage accounts receivable across two priorities: current claims and the backlog of claims over 90 days old.
• Prioritize aged AR based on timely filing requirements and appeal deadlines.
• Monitor claim progress and ensure outstanding balances are collected or properly closed.
• Drive improvements in clean claim submission and overall billing performance.

Denial Management & Process Improvement

• Oversee daily denial management and maintain a denial trend log.
• Identify recurring denial patterns and turn them into eCW rules, workflow improvements, and front‑end fixes.
• Resolve complex billing issues and prevent repeat errors.
• Oversee corrected claims, reopenings, redeterminations, and appeals.

Payment Posting & Financial Oversight

• Oversee payment posting, including $0 remits, zero‑payment ERAs, payer recoupments, and takebacks.
• Review and prepare write‑off requests with documented collection efforts for approval by U.S. leadership.
• Drive month‑end close cutoffs and ensure billing activities are completed accurately.

eCW Systems & Reporting

• Serve as the primary eCW billing expert for the team and leadership.
• Troubleshoot billing issues and coordinate with the eCW vendor team when needed.
• Pull and review daily and weekly eCW reports, explaining performance trends and outstanding issues.
• Lead agency billing review calls and communicate progress, challenges, and results.

Required Experience & Skills

• 5+ years of professional claims billing experience for physician practices, including CMS‑1500 and 837P claims.
• At least 2 years of experience leading or managing a billing team.
• Expert, hands‑on eCW billing experience, including claim screens, work queues, payment posting, and billing reports.
• Experience with hub‑and‑spoke billing environments preferred.
• Strong knowledge of Medicare Part B, Medicare Advantage, Medicaid, and commercial payer billing.
• Understanding of payer timely filing requirements, reopenings, redeterminations, and appeal processes.
• Proven experience reducing aged AR backlogs, supported by measurable results.
• Ability to read and interpret ERAs and CARC/RARC codes.
• Strong Excel skills and clear written and spoken English.
• Strong leadership, organization, problem‑solving, and performance management skills.

Preferred Experience & Qualifications

• Experience with wound care billing, including debridement and skin substitutes.
• Familiarity with chronic care management, palliative care, and telehealth billing.
• Experience with Noridian (Medicare Jurisdiction F) and Waystar clearinghouse.
• Experience designing eCW work queue rules and using eBO reporting.
• AAPC CPB/CPC or HFMA CRCR certification.

Work Arrangement & Compliance Requirements

• Full‑time remote position.
• Must have at least 4 hours of daily overlap with U.S. Mountain Time business hours.
• eCW access and training will be provided through secure remote access only.
• Must complete HIPAA training and sign a business associate agreement with Pavago.
• Must pass a background check.
• Patient data must not be stored on personal devices.

Interview Process

1. AI Screening
2. Client Interview
3. Offer Stage

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