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)

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).

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.

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 athena

One platform to manage our Medicare, Tricare, and insurance volume and collaborate directly with the physician/owner to maximize practice efficiency and revenue capture.

• 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 athena
  
  One 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.

• 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 athena
  
  One (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)

• 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.