Job Title: Healthcare Medical Biller & AR Denial Specialist

Location: Knoxville, TN (On-site)

Pay Rate: $20.00 – $23.00/hour

Schedule: Full-Time, Monday – Friday | 8:00 AM – 4:30 PM (Fixed Schedule)

Position Type: Contract-to-Hire (4-month contract conversion path)

Position Overview

We are seeking an experienced Medical Billing & Accounts Receivable Specialist to join a premier, fast-paced Centralized Business Office (CBO) in Knoxville. This role focuses on resolving complex commercial and government claim denials, performing root-cause analysis, and delivering top-tier patient customer service.

If you thrive in a self-directed environment, have hands-on experience navigating payor portals, and enjoy bringing order to high-volume workflows, this is an excellent opportunity to expand your expertise in specialized specialty billing.

Key Responsibilities

• Denial Resolution & Appeals: Perform manual review, root-cause analysis, and resubmissions/appeals for complex commercial and government claim denials (BlueCross ~30%, Medicare/Medicare Advantage ~30%, Humana, etc.).

• Practice Management System Navigation: Utilize enterprise billing software (Athena IDX) to review clinical notes, correct ICD-10/CPT codes, apply appropriate modifiers, and drive clean claim resolution.

• Payor Communication: Work directly through payor portals and phone lines to investigate and resolve unpaid or rejected claims.

• Patient Services: Answer incoming patient phone calls regarding billing inquiries, statement balances, and payment arrangements during standard office hours.

• Production Standards: Maintain a consistent target production goal of working roughly 50 tasks or accounts per day.

Required Qualifications

• Experience: Minimum 2+ years of hands-on healthcare AR collections and claim denial management experience.

• Financial Knowledge: Proven ability to read and interpret Remittance Advice (RA) and Explanation of Benefits (EOB), as well as write formal appeals.

• Coding & Compliance: Working knowledge of ICD-10, CPT codes, modifiers, and medical necessity rules.

• Customer Service: Comfortable taking inbound patient phone calls regarding account balances with a compassionate, resolution-focused mindset.

• Core Competencies: High accountability, self-starter mentality, and strong verbal communication skills.

Preferred Qualifications

• Direct hands-on experience operating within Athena IDX (Candidates with Athena experience will be prioritized).

• Prior experience with specialty medical billing, particularly Oncology, Hematology, or Infusion.

• Background working in a Centralized Business Office (CBO) or physician practice group environment.

Why Join Us?

• Growth Potential: Clear contract-to-hire pathway into a leading regional healthcare practice.

• Specialty Experience: Gain high-value experience in complex oncology billing and enterprise software systems.

• Culture: Collaborative, supportive management team committed to team success and professional development.

• Equipment Provided: Full hardware provided on-site.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.