Medical Biller

MEDREV Consultants LLC; Phoenix (AZ); On-site; USD 52,000 - 72,000; Full time

Job summary

MEDREV Consultants LLC seeks an experienced Medical Billing Specialist to manage claims accuracy, postings, and denials across athenaOne and eCW. You will analyze 835s, appeal denials, and work aging AR to optimize recoveries, while ensuring patient data privacy and policy adherence.

The role requires 3+ years in medical billing, posting experience, and knowledge of CPT/HCPCS/ ICD-10. Prior MSO or billing company exposure is a plus. This on-site position participates in revenue cycle functions.

Qualifications

• Minimum 3 years of professional medical billing experience.
• Minimum 2 years of professional payment posting experience.
• Hands-on experience in athenaOne and eClinicalWorks (eCW) for billing and posting.
• Ability to read and interpret an 835 remittance file and determine claim-level disposition.
• Working knowledge of CPT, HCPCS, ICD-10, and modifier application.
• Experience with commercial, Medicare, and Medicaid payers.
• High school diploma or equivalent.

Responsibilities

• Review charges for accuracy and completeness prior to claim submission.
• Resolve claim edits, scrubber holds, and rejections daily in athenaOne and eCW.
• Research, document, and appeal denied claims with supporting documentation.
• Work aged accounts receivable by payer, aging bucket, and value.
• Contact payers by phone and portal to obtain claim status and resolve errors.
• Perform root-cause analysis on recurring denials to prevent recurrence.
• Post 835 files and reconcile with bank deposits.
• Post patient payments, refunds, and adjustments per policy.

Skills

athenaOne

eClinicalWorks (eCW)

CPT/HCPCS/ICD-10

CARC/RARC denial codes

PHI privacy

Payer billing knowledge

Payment posting

Education

High school diploma or equivalent

Tools

athenaOne

eCW

Job description

1. Review charges for accuracy and completeness prior to claim submission, identifying coding, modifier, and demographic errors that would result in rejection or denial.

2. Resolve claim edits, scrubber holds, and clearinghouse rejections on a daily basis in both athenaOne and eCW.

3. Research, document, and appeal denied claims, including preparation of appeal correspondence and assembly of supporting documentation.

4. Work aged accounts receivable by payer, aging bucket, and dollar value, prioritizing by recovery likelihood and timely filing exposure.

5. Contact payers by telephone and portal to obtain claim status, resolve processing errors, and pursue reprocessing.

6. Perform root-cause analysis on recurring denials and communicate the coding, configuration, or front-end workflow corrections required to prevent recurrence.

Payment posting and reconciliation

7. Post electronic remittance advice (835) files and manual EOBs across assigned client practices and payers in both systems.

8. Reconcile each posting batch to the corresponding bank deposit and resolve variances prior to batch closure.

9. Work the unpostables queue, identifying the cause of unapplied cash and routing transactions correctly.

10. Post takebacks, offsets, and recoupments accurately, ensuring affected accounts reflect true balances.

11. Apply contractual adjustments in accordance with the loaded fee schedule and identify allowed amounts inconsistent with contracted rates.

12. Post patient payments, refunds, and credit balances in accordance with practice policy.

13. Verify that secondary claims and crossovers generate appropriately following primary payment posting.

Cross-functional

14. Identify and escalat underpayments, reimbursement variances, and payment patterns suggesting incorrect fee schedule configuration or payer processing error.

15. Maintain accurate, contemporaneous account and batch documentation sufficient for another team member to assume the work without loss of continuity.

16. Meet or exceed established productivity, accuracy, and turnaround standards.

17. Maintain the confidentiality and security of protected health information at all times.

18. Perform other duties as assigned in support of revenue cycle operations.

Required qualifications

• Minimum 3 years of professional medical billing experience in a practice, billing company, or MSO setting.
• Minimum 2 years of professional payment posting experience, which may run concurrent with billing experience.
• Demonstrated hands‑on production experience in athenaOne , covering both billing and posting functions.
• Demonstrated hands‑on production experience in eClinicalWorks (eCW) , covering both billing and posting functions.
• Ability to read and interpret an 835 remittance file and determine claim-level disposition.
• Working knowledge of CPT, HCPCS, ICD-10, and modifier application sufficient to identify charge-level errors.
• Working knowledge of CARC and RARC denial codes, contractual adjustment versus write-off, and patient responsibility allocation.
• Experience with commercial, Medicare, and Medicaid payers.
• High school diploma or equivalent required.

Preferred qualifications

• Multi‑specialty or multi‑practice experience, particularly across multiple tax identification numbers.
• Arizona AHCCCS and Medicare Part B experience.
• Prior experience in an MSO, billing company, or consulting environment.
• Exposure to fee schedule loading, maintenance, or contract rate validation.
• Experience documenting billing workflows or standard operating procedures.