Job Title: Healthcare Medical Biller & AR Denial Specialist
Location: Knoxville, TN (On-site)
Pay Rate: $20.00 – $23.00/hour
Schedule: Full-Time, Monday – Friday | 8:00 AM – 4:30 PM (Fixed Schedule)
Position Overview
We are seeking an experienced Medical Billing & Accounts Receivable Specialist to join a premier, fast-paced Centralized Business Office (CBO) in Knoxville. This role focuses on resolving complex commercial and government claim denials, performing root-cause analysis, and delivering top-tier patient customer service.
If you thrive in a self-directed environment, have hands-on experience navigating payor portals, and enjoy bringing order to high-volume workflows, this is an excellent opportunity to expand your expertise in specialized specialty billing.
Key Responsibilities
- Denial Resolution & Appeals: Perform manual review, root-cause analysis, and resubmissions/appeals for complex commercial and government claim denials (BlueCross ~30%, Medicare/Medicare Advantage ~30%, Humana, etc.).
- Practice Management System Navigation: Utilize enterprise billing software (Athena IDX) to review clinical notes, correct ICD-10/CPT codes, apply appropriate modifiers, and drive clean claim resolution.
- Payor Communication: Work directly through payor portals and phone lines to investigate and resolve unpaid or rejected claims.
- Patient Services: Answer incoming patient phone calls regarding billing inquiries, statement balances, and payment arrangements during standard office hours.
- Production Standards: Maintain a consistent target production goal of working roughly 50 tasks or accounts per day.
Required Qualifications
- Experience: Minimum 2+ years of hands-on healthcare AR collections and claim denial management experience.
- Financial Knowledge: Proven ability to read and interpret Remittance Advice (RA) and Explanation of Benefits (EOB), as well as write formal appeals.
- Coding & Compliance: Working knowledge of ICD-10, CPT codes, modifiers, and medical necessity rules.
- Customer Service: Comfortable taking inbound patient phone calls regarding account balances with a compassionate, resolution-focused mindset.
- Core Competencies: High accountability, self-starter mentality, and strong verbal communication skills.
Preferred Qualifications
- Direct hands-on experience operating within Athena IDX (Candidates with Athena experience will be prioritized).
- Prior experience with specialty medical billing, particularly Oncology, Hematology, or Infusion.
- Background working in a Centralized Business Office (CBO) or physician practice group environment.
Why Join Us?
- Growth Potential: Clear contract-to-hire pathway into a leading regional healthcare practice.
- Specialty Experience: Gain high-value experience in complex oncology billing and enterprise software systems.
- Culture: Collaborative, supportive management team committed to team success and professional development.
- Equipment Provided: Full hardware provided on-site.