Offer summary

Qualifications:

Minimum 1 year of experience with Athenahealth billing and credentialing., Strong knowledge of CPT, ICD-10, HCPCS codes, and insurance guidelines., Experience with Medicare, Medicaid, and commercial payers., Excellent analytical, problem-solving, and communication skills..

Key responsabilities:

Manage end-to-end Athenahealth billing processes including charge entry and claims submission.

Identify and resolve claim denials and underpayments to maximize reimbursements.

Handle provider credentialing and enrollments with insurance payers.

Train staff on Athena billing and credentialing best practices.

Job description

Job Summary:

We are seeking an experienced Athena Billing and Credentialing Expert to manage and optimize our revenue cycle operations. The ideal candidate will have in-depth knowledge of Athenahealth's billing and credentialing processes, ensuring accurate claims submission, timely reimbursements, and provider enrollment. This role requires strong analytical skills, problem-solving abilities, and a deep understanding of medical billing, coding, and insurance verification.

Key Responsibilities:

Billing & Revenue Cycle Management:

Manage end-to-end Athenahealth billing processes, including charge entry, claims submission, payment posting, and accounts receivable follow-up.
Identify and resolve claim denials, rejections, and underpayments to maximize reimbursements.
Conduct audits and analyze revenue cycle performance to improve efficiency.
Ensure compliance with HIPAA, CMS, and payer regulations.
Work with clinical teams to streamline coding and documentation processes.

Credentialing & Provider Enrollment:

Handle provider credentialing, re-credentialing, and enrollments with insurance payers, Medicare, and Medicaid.
Maintain up-to-date records for provider contracts, CAQH profiles, and NPI registrations.
Track expirations and proactively renew licenses, certifications, and payer enrollments.
Liaise with insurance companies to resolve credentialing issues and expedite approvals.

Athenahealth System Optimization:

Configure and customize Athenahealth workflows to improve efficiency and accuracy.
Train staff on Athena billing and credentialing best practices.
Monitor system updates and ensure compliance with new regulations and payer requirements.

Qualifications:

Required: Minimum 1 year of experience with Athenahealth billing and credentialing.
Strong knowledge of CPT, ICD-10, HCPCS codes, and insurance guidelines.
Experience working with Medicare, Medicaid, and commercial payers.
Proficiency in resolving denials, appeals, and compliance-related issues.
Excellent analytical, problem-solving, and communication skills.
Preferred: Certification in Medical Billing & Coding (CPC, CPB) or equivalent.

For interested applicants of referrals, please fill out this form https://forms.monday.com/forms/41e09516ba964ea359fe88460732f976?r=use1

Or send your resume/CV to recruiting@golean.health

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