Independent Medical Biller/Coder, Part Time, Work From Home (athenahealth Expert)

Job Title: Independent Medical Biller/Coder, Part Time, Work From Home (athenahealth Expert)

Job Type: 1099 Independent Contractor (Part-Time, Fractional)

Hours: Estimated 20 hours/month (with potential to scale as our practice expands)

Location: 100% Remote (US-Based Only; Texas-experienced preferred)

About the Practice

We are a Family Medicine practice based in Texas with a current patient panel of approximately 2,000 patients. We are just beginning an exciting transition to a HYBRID / Direct Primary Care (DPC) model. As we roll out our direct care cash-pay option, we are keeping a curated insurance panel consisting of Medicare, Tricare, and select commercial payers (BCBS Texas, Aetna, Cigna, UHC).

Our Growth Vision: We are actively looking to expand our practice by bringing on additional physicians and non-physician clinicians. To make this expansion possible, we must maximize our practice revenue through highly effective, meticulous billing. We are seeking a medical billing professional who doesn't just re-submit claims, but acts as a revenue partner to help fuel our growth.

The Role This is a fractional, long-term contracting role ideal for a certified professional seeking an uncomplicated side-panel in a hybrid environment. You will operate entirely within our existing athenaOne platform to manage our Medicare, Tricare, and insurance volume and collaborate directly with the physician/owner to maximize practice efficiency and revenue capture.

Key Responsibilities

• Physician Coding Feedback: Audit and review completed patient encounter documentation to provide direct, constructive feedback to the physician/owner. Identify opportunities to improve coding accuracy, ensure full compliance, and optimize legitimate revenue capture to support our clinic's expansion.

• Hold Bucket Management: Systematically work the "Hold" and "Uncollectible" buckets in athenaOne to ensure timely filing and accurate corrections.

• Denial Resolution & Appeals: Investigate and resolve complex denials, navigating the specific rules and quirks for Novitas/Medicare, Tricare, and our Texas commercial networks (BCBS TX, Aetna, Cigna, UHC).

• Claim Scrubbing: Monitor athena's internal rules engine pre-clearinghouse to proactively correct coding discrepancies, diagnosis pointers, or demographic errors.

• Payment Posting & A/R Follow-up: Ensure accurate posting of ERAs and manual checks, and monitor aging A/R to maintain a healthy cash flow on the insurance side of our hybrid panel.

Requirements

• Certification: Active CPB (Certified Professional Biller) or CPC (Certified Professional Coder) through AAPC.

• Experience: Minimum 3 years of medical billing experience, with at least 2 years of recent experience using athenaOne (athenahealth).

• Specialty & Regional Knowledge: Strong understanding of Family Medicine/Primary Care coding guidelines (including E/M documentation guidelines), with specific familiarity handling Texas payers (especially BCBS TX prompt pay guidelines and Novitas Medicare solutions).

• Communication Skills: Strong collaborative approach with the ability to provide clear, actionable feedback to a physician regarding documentation and coding optimization.

• Compliance: Must complete our standard trainings including HIPPA, cybersecurity, etc (paid, online, provided by practice)

Compensation & Onboarding

• Rate: $27+/hour (Negotiable based on experience).

• Platform: Onboarding, W-9 collection, time tracking, and direct-deposit payments will be managed seamlessly via Gusto. No staffing agency fees or platform middlemen taking a cut of your earnings.

• Trial Period: We will begin with a 10-hour paid trial/audit of our current rolling claims to ensure a good mutual fit.

To Apply: Please submit your resume, your AAPC member ID (for verification), and a brief note answering this specific question: "In athenahealth, how do you typically approach a claim that has failed the internal rules engine before re-submitting?"