Remote Medical Billing Specialist – Primary Care (Value-Based Care Experience)

• *Please note that this role is a W-2 contractor role, thus there will be no benefits or PTO. (However, it is not temporary and will be ongoing) Job Summary We are seeking an experienced Medical Billing Specialist to manage the full billing cycle for a busy primary care practice. In this role, you’ll oversee claims submission, payment posting, A/R follow-up, and denial management. You will be the practice’s primary billing contact, ensuring accurate reimbursement and strong cash flow. A key part of this position involves working with value-based care contracts (e.g., Medicare Advantage). You’ll help navigate risk-adjusted reimbursement and quality-based incentive payments alongside traditional fee-for-service billing. If you thrive on solving payer issues, reducing A/R, and collaborating with coders and providers to achieve clean claims, this is the role for you. FYI - the role will be working eastern standard times. Duties • Claims Submission: Enter and review charges, scrub claims for accuracy, and submit daily through Athenahealth (athenaOne) or paper as needed. Resolve clearinghouse rejections promptly. • Payment Posting: Post insurance payments and adjustments (ERA/EOB) and reconcile against expected amounts. Identify underpayments or discrepancies and escalate as needed. • Accounts Receivable (A/R): Monitor aging reports and work down outstanding claims, with focus on high-dollar and 90+ day buckets. Contact payers via portals and phone to secure payment. • Denial Management: Analyze denial codes, correct and resubmit claims, and prepare appeals with supporting documentation. Track denial trends and recommend process improvements. • Patient Billing Support: Generate patient statements, handle billing inquiries, and set up payment plans when needed. Provide professional, compassionate customer service. • Reporting & Compliance: Provide periodic reports on collections, A/R days, and denial rates. Ensure compliance with HIPAA, payer contracts, and current billing regulations. • Collaboration: Partner with coders and practice staff to resolve coding or documentation issues impacting billing. Communicate daily with team members to keep the revenue cycle moving smoothly. Requirements • 5+ years medical billing/accounts receivable experience (primary care or multi-specialty strongly preferred). • Proven track record reducing A/R and resolving denials in a high-volume environment. • Experience with Medicare, Medicaid, and commercial payers, including use of payer portals. • Familiarity with value-based care contracts (Medicare Advantage, ACOs, risk adjustment, quality incentives). • Proficiency with Athenahealth (athenaOne) or similar EHR/PM system. • Strong understanding of CPT/ICD-10 basics and how coding impacts billing. • Intermediate Excel/Google Sheets skills for tracking A/R and performance metrics. • Detail-oriented, organized, and able to work independently in a remote environment. • Excellent communication skills for working with payers, providers, and patients. Why Join Us? • Remote, long-term contract role with consistent full-time hours. • Work at the intersection of primary care and value-based care — a fast-growing part of healthcare. • Collaborate with a supportive team that values accuracy, transparency, and outcomes. Job Types: Full-time, Contract Pay: $23.00 per hour Application Question(s): • How many years of experience do you have with AthenaHealth EMR? • How many years of primary care practice medical billing/accounts receivable experience do you have? • In your most recent role, what were your average Days in A/R (DSO) and your clean claim rate (%)? • How many years of direct experience with CMS “Incident To” billing and compliance requirements do you have? • Are you able to work full-time EST hours, remotely, with a HIPAA-compliant workspace? • What is your internet download/upload speed? (via speedtest) • How many years of value-based care billing experience do you have? Work Location: Remote Apply tot his job Apply To this Job