ABOUT THE ROLE
Our organization operates in a payer-contracted services model — delegated services, in-home assessments, HEDIS gap closure, and risk adjustment visits — billed through Athena in a mix of penny-claim/encounter-reporting and full-cost claim arrangements. Because Athena's default logic is built for traditional fee-for-service billing, our claims regularly get flagged, held, or underpaid in ways that don't reflect actual problems.
We're hiring a Billing & Claims Analyst to be the day-to-day set of eyes on our claims: tracking what's been submitted, what's stuck, what's been paid, and what's been invoiced separately — and flagging patterns to the Revenue Cycle & Claims Operations Lead so they can be fixed at the source.
KEY RESPONSIBILITIES
Reporting & Reconciliation
Claims Monitoring & First-Line Troubleshooting
Support for Systemic Fixes
REQUIRED QUALIFICATIONS
PREFERRED QUALIFICATIONS
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