[Hiring] Accounts Receivable Specialist @ATHENA TENNESSEE REGIONAL MSO

Role Description

As an Accounts Receivable Specialist at Athena Care, you will be the driving force behind resolving outstanding insurance claims, ensuring every balance is pursued accurately, persistently, and ethically. Your work directly supports our patients' access to care.

• Resolve Rejected and Denied Claims:
  • Review and analyze rejected or denied claims to identify the root cause of payment issues.
  • Resolve claims discrepancies and ensure claims are resubmitted accurately in a timely manner to avoid payment delays.
  • Collaborate with providers, payers, and internal teams to correct any errors and ensure proper reimbursement.
• Submit Appeals and Adjustments:
  • Prepare and submit appeals for denied claims following payer-specific guidelines, ensuring all necessary documentation and justification are included.
  • Make adjustments to claims as needed to correct billing errors, apply correct codes, or resolve underpayment or overpayment issues.
  • Ensure timely submission of appeals and adjustments to prevent delays in the reimbursement process.
• Work Payer Aging Report:
  • Review and manage payer aging reports to track the status of outstanding claims and identify accounts that are overdue or need follow-up.
  • Prioritize and resolve aged receivables by contacting payers or working with internal departments to address any open claims.
  • Monitor claim status and follow up with payers regularly to ensure payments are processed promptly.
• Report and Escalate Denial Trends and Payer Issues:
  • Identify and report recurring denial trends or issues with specific payers, documenting patterns that may affect overall revenue.
  • Collaborate with the billing and management teams to escalate persistent payer issues, including frequent claim denials, processing delays, or payment discrepancies.
  • Work with internal teams to develop and implement strategies for addressing payer-specific challenges and improving reimbursement processes.
• Maintain Accurate Documentation:
  • Maintain comprehensive records of all claims, appeals, adjustments, and communications with payers, ensuring proper documentation for auditing and compliance purposes.
  • Update internal databases and systems to track the progress of claims and ensure accurate reporting.
• Compliance and Quality Assurance:
  • Ensure compliance with all relevant healthcare billing regulations, payer-specific requirements, and internal policies.
  • Assist in maintaining accurate and up-to-date information on payer policies and procedures to ensure consistent billing and claim management.

This is a full-time, 8-hour shift position. Shifts are scheduled between 7:30 AM and 5:00 PM Central Time, Monday through Friday.

Qualifications

• High school diploma or GED required; Associate’s degree or certification in healthcare billing, accounting, or a related field is preferred.
• Proven experience in accounts receivable, medical billing, or revenue cycle management, preferably in a healthcare setting required. Minimum of 3 years of experience.
• Experience with payer aging reports, appeals, adjustments, and claims follow-up.
• Experience working with eClinicalWorks (eCW) strongly preferred.

Requirements

• Knowledge of insurance billing processes, claim rejection and denial codes, and payer policies.
• Strong understanding of CPT, ICD-10, and HCPCS codes, and their relevance to billing and claim processing.
• Excellent problem-solving skills with the ability to identify and resolve issues in a timely manner.
• Proficiency in using billing software, accounts receivable systems, and Microsoft Office (Excel, Word, etc.).
• Attention to detail, organization, and the ability to manage multiple priorities effectively.
• A strong and empathetic communicator — assertive and effective with insurers, while remaining patient-centered and compassionate in every interaction.
• A collaborative spirit and genuine investment in the success of teammates and the patients we serve.

Benefits

• Be part of a mission-driven organization where your work has real, tangible impact on patient care.
• Join a team that lives its values of Accountable, Team, Helpful, Empathetic, Nurture, Integrity, Analytical, Nimble in everything we do.
• Work with a talented and dynamic team of clinicians and support/administrative professionals who are working toward our shared goal of delivering the highest standard of mental health care.