Athena-Savvy Billing & Claims Analyst — Data-Driven RCM

Porter Cares, Inc.; Annapolis (MD); On-site; USD 58,000 - 75,000; Full time

Benefits offered by this job

Full Equipment provided.

Opportunities for professional growth

Continuing education

A supportive, collaborative work环境

Job summary

Porter Cares, Inc. is seeking a Billing & Claims Analyst to join our team in Annapolis, MD. You will track submissions, holds, payments, and invoicing across penny-claim and encounter-based workflows in Athena, ensuring accuracy and flagging patterns for fixes.

You will work with Revenue Cycle & Claims Operations Lead to resolve issues, document recurring causes, and support testing of new rules. A detail-oriented professional will thrive in this data-driven role.

Qualifications

• 1-3+ years of experience in medical billing, claims processing, or revenue cycle operations.
• Working proficiency in Athena (or comparable EMR/RCM system) - running reports, navigating claim status and hold queues, and pulling claim-level detail.
• Strong Excel skills (pivot tables, VLOOKUP/XLOOKUP, basic reconciliation building)
• High attention to detail and comfort with repetitive reconciliation work - this role lives in the data, not just the summary.
• Clear written communication for documenting issues and escalations.

Responsibilities

• Build and maintain recurring reports in Athena covering claim submission status, hold/edit queues, and payment status.
• Reconcile claims sent to payers against invoices sent separately for encounter/penny-claim arrangements, confirming amounts match and nothing has fallen through the cracks.
• Track partial payments and underpayments, flagging cases where Athena has applied a standard allowable amount or co-insurance deduction that conflicts with the actual contracted rate.
• Maintain claim-aging reports so nothing sits in a hold queue unnoticed.
• Monitor daily/weekly claim submission activity to confirm claims are actually reaching payers, not just leaving Athena.
• Review current holds in Athena, distinguish routine/expected holds from ones tied to our known penny-claim or allowable-amount issues, and route the latter for escalation.
• Perform basic first-line correction on claims where the fix is known and documented, escalating anything new or ambiguous.
• Document recurring issues with enough detail for the Operations Lead to elevate to Athena or the payer.
• Support testing and validation whenever a new custom rule or workflow change is implemented in Athena, confirming it behaves as expected across a sample of claims.
• Contribute claim-level detail to the 90-day Athena assessment and any future EMR evaluation.

Skills

Excel

Clear written communication

Attention to detail

Reconciliation

Tools

Athena

SQL

Job description

Porter Cares, Inc. is seeking a Billing & Claims Analyst to join our team in Annapolis, MD. You will track submissions, holds, payments, and invoicing across penny-claim and encounter-based workflows in Athena, ensuring accuracy and flagging patterns for fixes.

You will work with Revenue Cycle & Claims Operations Lead to resolve issues, document recurring causes, and support testing of new rules. A detail-oriented professional will thrive in this data-driven role.