Are you experienced in physician billing, insurance follow-up, and accounts receivable management? Northwest Mississippi Regional Medical Center (NWMRMC) is seeking a detail-oriented and motivated Athena Billing & Follow-Up Specialist to join our team.
In this role, you will support the physician practice revenue cycle by working directly within Athenahealth to manage outstanding insurance claims, resolve billing issues and denials, perform payer follow-up, review payment activity, and help ensure timely reimbursement.
The Athena Billing & Follow-Up Specialist plays an important role in maintaining a healthy revenue cycle by identifying issues that delay payment, taking appropriate corrective action, and following assigned accounts through final resolution.
About Us
At Northwest Mississippi Regional Medical Center, we are committed to providing high-quality, sustainable healthcare to the citizens of Northwest Mississippi. We believe in a collaborative work environment where each team member plays an integral role in supporting our patients, providers, and communities.
Why Join Us?
- Mission-Driven Work: Support a community-focused healthcare organization dedicated to improving lives.
- Professional Growth: Opportunities for training, development, and career advancement.
- Collaborative Environment: Work alongside experienced clinical, administrative, and revenue-cycle professionals.
- Meaningful Impact: Help strengthen the financial health of our physician practices by ensuring claims are accurately billed, followed, and resolved.
Essential Duties and Responsibilities
- Work assigned Athenahealth billing, accounts receivable, and insurance follow-up work queues on a consistent basis.
- Review physician practice claims for accuracy, completeness, and appropriate billing information.
- Identify and resolve claim edits, holds, billing exceptions, rejections, and other issues that may delay reimbursement.
- Review patient demographics, insurance information, provider information, CPT/HCPCS codes, diagnosis codes, modifiers, and other required billing elements.
- Correct billing-related errors and initiate rebilling or corrected claims as appropriate.
- Monitor claim activity to ensure claims are successfully submitted and accepted by payers.
- Perform timely follow-up on outstanding insurance balances.
- Research claim status using Athenahealth, payer websites, electronic portals, telephone follow-up, and other approved methods.
- Review accounts receivable aging and prioritize accounts based on age, dollar amount, timely filing requirements, and payer guidelines.
- Identify unpaid, underpaid, denied, rejected, or incorrectly processed claims and initiate appropriate corrective action.
- Follow up on claims pending for medical records, authorization, referrals, eligibility, coordination of benefits, medical necessity, credentialing, or other payer requirements.
- Document all insurance follow-up and account activity clearly and accurately in Athenahealth.
- Review insurance denials and determine the appropriate next steps.
- Correct and resubmit claims when appropriate.
- Prepare reconsiderations and appeals with supporting documentation as needed.
- Monitor appeal and timely filing deadlines to minimize avoidable write-offs.
- Review EOBs, ERAs, payer correspondence, and payment information as necessary.
- Identify potential underpayments, incorrect adjustments, contractual discrepancies, or other payment concerns.
- Escalate complex accounts requiring coding, credentialing, authorization, provider, or management intervention.
- Identify recurring denial and billing trends and communicate findings to the Director of Revenue Cycle Management.
- Collaborate with clinic registration, clinical, coding, authorization, credentialing, and revenue-cycle staff to resolve reimbursement issues.
- Maintain patient confidentiality and comply with HIPAA requirements at all times.
- Meet established productivity, quality, and account follow-up expectations.
- Perform other related duties as assigned by the Director of Revenue Cycle Management or organizational leadership.
Education and Work Experience Requirements
- High school diploma or GED required.
- Associate degree in healthcare administration, business, medical billing and coding, or a related field preferred.
- Previous physician practice billing, medical billing, insurance follow-up, or healthcare revenue-cycle experience required.
- Athenahealth/Athena billing and insurance follow-up experience strongly preferred.
- Two or more years of physician practice billing and/or insurance follow-up experience preferred.
- Knowledge of professional claim billing, including CMS-1500 claim requirements.
- Working knowledge of Medicare, Medicaid, managed care, and commercial insurance billing.
- Experience working physician accounts receivable and aging reports preferred.
- Knowledge of claim denials, rejections, appeals, reconsiderations, and timely filing requirements.
- Working knowledge of CPT, HCPCS, ICD-10-CM, and modifiers sufficient to identify potential billing concerns.
- Ability to read and interpret EOBs and ERAs.
- Experience using insurance payer websites and portals.
- Strong computer and data-entry skills.
- Strong organizational and time-management skills.
- Ability to manage a high volume of accounts while maintaining accuracy.
- Strong problem-solving and research skills.
- Ability to communicate professionally with insurance companies, patients, providers, coworkers, and leadership.
- Ability to work independently and follow assigned accounts through final resolution.
- Strong attention to detail and commitment to accurate documentation.
Licensure/Certifications
Healthcare revenue-cycle certification such as the following is preferred but not required:
- Certified Professional Biller (CPB)
- Certified Professional Coder (CPC)
- Certified Revenue Cycle Representative (CRCR)
- Comparable medical billing or revenue-cycle certification
What We Offer
- Competitive salary and benefits package
- Health, dental, and vision insurance
- Company-paid basic life and AD&D insurance
- Company-paid long-term disability insurance
- Retirement plan options
- Generous paid time off (PTO)
- Supportive and collaborative work environment
- Opportunities for professional development and career growth
- The opportunity to play an important role in the financial health and continued success of our organization
Be a Part of Something Bigger!
At NWMRMC, every role contributes to our ability to provide quality healthcare to the communities we serve. As an Athena Billing & Follow-Up Specialist, your expertise will help ensure our physician practices receive accurate and timely reimbursement so our providers can remain focused on delivering excellent patient care.
If you are an experienced revenue-cycle professional who enjoys researching accounts, resolving billing challenges, and seeing claims through to successful resolution, we encourage you to apply.
Take the next step in your career and join the Northwest Mississippi Regional Medical Center team today!
Northwest Mississippi Regional Medical Center (NWMRMC) is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by applicable law.
