Medical Billing Account Manager

Pavago; United States; Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Fully remote

Job summary

Pavago is seeking a Medical Billing Account Manager to support Revenue Cycle Management operations in a fully remote role. You will manage claim submissions, denials, follow-up, and client communication to ensure timely reimbursement.

Ideal candidates have hands-on medical billing experience, strong accuracy, and the ability to own claims from submission through payment, while adhering to payer requirements and compliance standards.

Qualifications

• Prior professional experience in Revenue Cycle Management (RCM) is required.
• Hands-on medical billing experience in a production environment.
• Strong knowledge of claim submission, denial management, claims follow-up, and collections.
• Ability to read and interpret EOBs and ERAs; experience with diagnosis/procedure code relationships; familiarity with modifiers and scrubbing.

Responsibilities

• Review EOBs and ERAs to identify payment discrepancies, denials, rejections, underpayments, and non-payments.
• Analyze and resolve claim denials and rejections; manage denial follow-up and resolution.
• Maintain accurate billing records, claim notes, and client communication; follow up on unpaid or underpaid claims.
• Submit initial, corrected, and secondary claims following payer requirements and workflows.

Skills

RCM expertise

Medical billing

Claim submission

Denial management

EOB/ERA review

Accounts follow-up

Client communication

Tools

EHR systems

Practice management

Payer portals

Job description

Medical Billing Account Manager – Revenue Cycle Management (RCM) | Remote

Position Type: Full-Time, Remote
Working Hours: Standard U.S. Business Hours

About the Role

At Pavago, one of our clients is hiring an experienced Medical Billing Account Manager to support day-to-day Revenue Cycle Management (RCM) operations and ensure accurate, timely reimbursement across assigned client accounts.

This is an execution-focused role for a highly organized medical billing professional who can independently manage claim submissions, denial resolution, insurance follow-ups, collections, EOB/ERA review, and account management.

You’ll work within established billing workflows, manage high volumes of claims, communicate with insurance carriers and clients, and help ensure outstanding balances are resolved efficiently.

If you have hands-on medical billing and RCM experience and can independently take ownership of claims from submission through payment, this role is a strong fit.

What You’ll Own

Medical Billing & Revenue Cycle Management

• Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to identify:
  • Payment discrepancies
  • Claim denials
  • Rejections
  • Underpayments
  • Non-payment reasons
• Analyze, investigate, and resolve claim denials and rejections
• Review claims for proper diagnosis and procedure code relationships
• Apply appropriate billing modifiers to support accurate claim adjudication
• Perform claims scrubbing and quality assurance before submission
• Submit:
  • Initial claims
  • Corrected claims
  • Secondary claims
• Follow payer-specific submission requirements
• Manage claim queues and prioritize follow-up activities
• Maintain accurate billing records, claim notes, and account documentation
• Follow up promptly on unpaid, rejected, or underpaid claims

Denial Management & Claims Follow-Up

• Investigate the root causes of denied and rejected claims
• Determine appropriate next steps for claim resolution
• Correct billing or claim information where required
• Track unresolved claims through final resolution
• Follow up consistently with insurance carriers
• Monitor claim status and reimbursement timelines
• Help reduce preventable denials and delayed payments
• Maintain clear documentation of all follow-up activities

Account Management & Insurance Follow-Up

• Research payer portals and insurance websites to resolve claim issues
• Obtain claim status and payment updates from insurance carriers
• Communicate with payers regarding billing and reimbursement inquiries
• Support client account management and respond to billing-related questions
• Monitor aging accounts and support collections activities
• Maintain consistent communication with clients and internal stakeholders
• Ensure outstanding billing issues are followed through to resolution

Quality & Compliance

• Maintain accuracy and compliance with payer guidelines and billing requirements
• Meet established:
  • Productivity targets
  • Quality standards
  • Turnaround-time expectations
• Maintain accurate and complete billing documentation
• Identify recurring billing trends and potential process issues
• Recommend practical improvements where appropriate
• Work independently while maintaining a high level of accountability and accuracy

Requirements

• Previous professional experience in Revenue Cycle Management (RCM)
• Hands-on medical billing experience in a production environment
• Strong knowledge of:
  • Claim submission
  • Denial management
  • Claims follow-up
  • Collections
• Ability to read and interpret EOBs and ERAs
• Experience reviewing diagnosis and procedure code relationships
• Knowledge of billing modifiers and claims scrubbing processes
• Experience working with insurance payer portals and medical billing systems
• Strong organizational and time-management skills
• Strong analytical and problem-solving abilities
• Excellent written and verbal English communication skills
• Ability to independently manage billing responsibilities with minimal supervision
• Ability to maintain accuracy while managing a high volume of claims
• Previous remote work experience preferred
• Availability during standard U.S. business hours

Preferred Qualifications

• Experience in high-volume medical billing environments
• Experience supporting Texas-based medical practices
• Experience with insurance verification
• Experience managing client billing accounts
• Strong background in denial resolution and collections
• Experience working directly with insurance carriers and payer portals

EHR & Practice Management Systems

Experience with one or more of the following is highly preferred:

• eClinicalWorks
• Aprima
• Medisoft
• Veradigm
• Nextech
• CureMD
• Office Practicum
• NextGen

Tools & Technology

eClinicalWorks | Aprima | Medisoft | Veradigm | Nextech | CureMD | Office Practicum | NextGen | Insurance Payer Portals | EHR Systems | Practice Management Systems | Medical Billing Platforms

What Makes You a Strong Fit

You’ll likely thrive in this role if you:

• Have extensive hands-on experience with medical billing and RCM workflows
• Can independently resolve claim denials and payment issues
• Understand the full process from claim submission through reimbursement
• Are comfortable interpreting EOBs, ERAs, codes, and payer responses
• Know how to prioritize aging and outstanding claims
• Can manage a high volume of claims without sacrificing accuracy
• Follow up persistently until billing issues are resolved
• Communicate effectively with clients, insurance providers, and internal teams
• Take ownership without requiring constant supervision
• Thrive in a remote environment and consistently meet productivity expectations

What a Typical Day Looks Like

Your day may begin by reviewing claim queues, EOBs, ERAs, and aging accounts to identify claims requiring immediate attention.

Throughout the day, you’ll submit and review claims, resolve denials, follow up with insurance carriers, research payer requirements, update billing documentation, and monitor outstanding balances across assigned accounts.

You may also communicate with clients regarding billing questions, investigate underpayments, update claim notes, and identify recurring issues that could be affecting reimbursement.

In short: you keep the revenue cycle moving by ensuring claims are accurate, denials are resolved, outstanding balances are followed up on, and payments are collected efficiently.

Key Metrics for Success

• Clean and accurate claim submissions
• Reduced claim denial and rejection rates
• Timely resolution of denied claims
• Improved claims turnaround time
• Consistent follow-up on unpaid and underpaid claims
• Aging accounts actively managed
• Improved collections and reimbursement
• Accurate account and claim documentation
• Achievement of productivity and quality targets
• Strong client account management
• Reduced outstanding claim backlog
• Consistent compliance with payer requirements

Why This Role Stands Out

• Hands-on ownership across the medical billing and RCM lifecycle
• Direct impact on reimbursement and revenue performance
• Exposure to multiple payer portals and billing systems
• Opportunity to manage client accounts independently
• Work across claims, denials, collections, and insurance follow-up
• Fully remote working environment
• Career growth opportunities into:
  • Senior Medical Billing Account Manager
  • Senior RCM Specialist
  • RCM Team Lead
  • Medical Billing Manager
  • Revenue Cycle Manager