About this role
<p><strong>Medical Billing Account Manager – Revenue Cycle Management (RCM) | Remote</strong></p><p><strong>Position Type:</strong> Full-Time, Remote<br><strong>Working Hours:</strong> Standard U.S. Business Hours</p><h3>About the Role</h3><p>At <a href="https://himalayas.app/companies/pavago">Pavago</a>, one of our clients is hiring an experienced <strong>Medical Billing Account Manager</strong> to support day-to-day <strong>Revenue Cycle Management (RCM)</strong> operations across medical billing, claims processing, denial management, insurance follow-up, collections, and client account management.</p><p>This is an execution-focused role for someone with hands-on medical billing experience who can independently manage a high volume of claims while maintaining accuracy, compliance, and timely reimbursement.</p><p>You’ll review <strong>EOBs and ERAs, investigate denials, submit and correct claims, work with insurance carriers, monitor aging accounts, and maintain accurate billing documentation</strong> across assigned client accounts.</p><p>If you understand the medical billing lifecycle, can troubleshoot claim and payment issues independently, and thrive in a fast-paced remote environment, this role is a strong fit.</p><h3>What You’ll Own</h3><h3><strong>Medical Billing & Revenue Cycle Management</strong></h3><ul>
<li>Review <strong>Explanation of Benefits (EOBs)</strong> and <strong>Electronic Remittance Advices (ERAs)</strong> to identify:</li>
<ul>
<li>Payment discrepancies</li>
<li>Claim denials</li>
<li>Rejections</li>
<li>Underpayments</li>
<li>Non-payment reasons</li>
</ul>
<li>Analyze, investigate, and resolve claim denials and rejections</li>
<li>Review claims to ensure proper diagnosis and procedure code linkage</li>
<li>Apply appropriate billing modifiers to support accurate claim adjudication</li>
<li>Perform claims scrubbing and quality assurance before submission</li>
<li>Submit:</li>
<ul>
<li>Initial claims</li>
<li>Corrected claims</li>
<li>Secondary claims</li>
</ul>
<li>Follow payer-specific submission requirements and guidelines</li>
<li>Manage claim queues and prioritize follow-up activities</li>
<li>Maintain accurate billing records, account documentation, and claim notes</li>
<li>Follow up promptly on unpaid, rejected, or underpaid claims</li>
</ul><h3><strong>Denial Management & Claims Follow-Up</strong></h3><ul>
<li>Investigate the root cause of denied or rejected claims</li>
<li>Research payer requirements and determine appropriate corrective actions</li>
<li>Correct claim issues and support timely resubmission</li>
<li>Follow outstanding claims through payment or resolution</li>
<li>Monitor claim status and reimbursement timelines</li>
<li>Maintain clear documentation of actions taken and next steps</li>
<li>Help reduce unnecessary delays throughout the revenue cycle</li>
</ul><h3><strong>Account Management & Insurance Follow-Up</strong></h3><ul>
<li>Research payer portals and insurance websites to resolve claim issues and obtain billing updates</li>
<li>Coordinate directly with insurance carriers regarding:</li>
<ul>
<li>Claim status</li>
<li>Payment inquiries</li>
<li>Denials</li>
<li>Rejections</li>
<li>Outstanding balances</li>
</ul>
<li>Support client account management and respond to billing-related questions as needed</li>
<li>Monitor aging accounts and assist with collections activities</li>
<li>Maintain consistent communication with clients, payers, and internal stakeholders</li>
<li>Ensure assigned accounts receive timely and accurate follow-up</li>
</ul><h3><strong>Quality & Compliance</strong></h3><ul>
<li>Maintain accuracy and compliance with payer guidelines and billing regulations</li>
<li>Meet established productivity, quality, and turnaround-time expectations</li>
<li>Maintain complete and accurate billing documentation</li>
<li>Identify recurring billing or denial trends</li>
<li>Recommend process improvements where appropriate</li>
<li>Work independently while maintaining a high level of accuracy and accountability</li>
</ul><h3>Requirements</h3><ul>
<li>Previous professional experience in <strong>Revenue Cycle Management (RCM)</strong>
</li>
<li>Hands-on <strong>medical billing experience in a production environment</strong>
</li>
<li>Strong knowledge of:</li>
<ul>
<li>Claim submission</li>
<li>Denial management</li>
<li>Claims follow-up</li>
<li>Collections</li>
</ul>
<li>Ability to read and interpret <strong>EOBs and ERAs</strong>
</li>
<li>Experience reviewing diagnosis and procedure code relationships</li>
<li>Knowledge of billing modifiers and claims scrubbing processes</li>
<li>Experience working with insurance payer portals and billing systems</li>
<li>Strong organizational, analytical, and problem-solving skills</li>
<li>Excellent written and verbal English communication skills</li>
<li>Ability to independently manage assigned billing workflows with minimal supervision</li>
<li>Ability to maintain accuracy while handling a high volume of claims</li>
<li>Availability during <strong>standard U.S. business hours</strong>
</li>
</ul><h3>Preferred Qualifications</h3><ul>
<li>Experience in high-volume medical billing environments</li>
<li>Experience supporting <strong>Texas-based medical practices</strong>
</li>
<li>Experience with insurance verification and account management</li>
<li>Previous experience working remotely</li>
</ul><h3>EHR & Practice Management Systems</h3><p>Experience with one or more of the following systems is highly preferred:</p><p><strong>eClinicalWorks | Aprima | Medisoft | Veradigm | Nextech | CureMD | Office Practicum | NextGen</strong></p><h3>What Makes You a Strong Fit</h3><p>You’ll likely thrive in this role if you:</p><ul>
<li>Have extensive hands-on experience managing medical billing and RCM workflows</li>
<li>Can independently resolve claim denials and payment issues with minimal supervision</li>
<li>Understand how to interpret EOBs, ERAs, claim statuses, and payer responses</li>
<li>Are highly organized and comfortable managing a high volume of claims</li>
<li>Maintain accuracy even when working across multiple accounts and priorities</li>
<li>Follow unpaid and denied claims consistently until resolution</li>
<li>Communicate professionally with clients, insurance carriers, and internal teams</li>
<li>Take ownership of billing outcomes rather than simply completing tasks</li>
<li>Thrive in a remote environment and consistently meet productivity expectations</li>
</ul><h3>What a Typical Day Looks Like</h3><p>You may start your day by reviewing claim queues, outstanding balances, denials, and accounts requiring immediate follow-up.</p><p>Throughout the day, you’ll review claim submissions, interpret EOBs and ERAs, resolve denials, follow up with insurance carriers, research payer requirements, submit corrected claims, update billing documentation, and monitor aging accounts.</p><p>You’ll also support assigned client accounts, investigate payment issues, and ensure claims continue progressing toward reimbursement.</p><p>In short: <strong>you help keep the revenue cycle moving by ensuring claims are accurate, denials are resolved, outstanding balances are followed up on, and reimbursement happens as efficiently as possible.</strong></p><h3>Key Metrics for Success</h3><ul>
<li>Claim submission accuracy</li>
<li>Denial and rejection resolution rate</li>
<li>Claims turnaround time</li>
<li>Reduction in aging accounts receivable</li>
<li>Collections and reimbursement performance</li>
<li>Timeliness of insurance follow-up</li>
<li>Accuracy of billing and account documentation</li>
<li>Productivity across assigned claim queues</li>
<li>Compliance with payer requirements</li>
<li>Client account satisfaction</li>
</ul><h3>Why This Role Stands Out</h3><ul>
<li>Direct impact on reimbursement and revenue-cycle performance</li>
<li>Hands-on ownership of medical billing and claims resolution</li>
<li>Exposure to multiple EHR and Practice Management systems</li>
<li>Opportunity to strengthen expertise across RCM, denial management, collections, and account management</li>
<li>Fully remote working environment</li>
<li>Opportunity to support established U.S. medical practices</li>
<li>Career growth opportunities into:</li>
<ul>
<li>Senior Medical Billing Specialist</li>
<li>RCM Account Manager</li>
<li>Revenue Cycle Operations</li>
<li>Medical Billing Team Lead</li>
<li>RCM Management</li>
</ul>
</ul><h3>Interview Process</h3><ol>
<li>Initial Application</li>
<li><strong>Spark Hire One-Way Video Interview</strong></li>
<li>Recruiter Screening</li>
<li>Client Interview</li>
<li>Offer Stage</li>
</ol><h3>Spark Hire Video Interview – Required</h3><p>As part of the application process, <strong>all candidates are required to complete a one-way video interview through Spark Hire</strong>.</p><p>After completing the first step of your application, you’ll receive a <strong>Spark Hire invitation by email</strong> with instructions to record and submit your video responses.</p><p>Completion of the Spark Hire video is <strong>required to be considered for the next stage</strong>. Please check your inbox as well as your spam or junk folder for the invitation.</p><h3>What Happens After You Apply</h3><p>After submitting your application and completing the required Spark Hire video interview, our recruitment team will review your experience and qualifications.</p><p>Candidates whose backgrounds closely match the requirements will be contacted to discuss their <strong>medical billing and Revenue Cycle Management experience</strong> in greater detail.</p><p>During the hiring process, you may be asked about your experience with medical billing software, denial management, claims follow-up, collections, payer communication, and the EHR or Practice Management systems you’ve used.</p><p>Candidates with experience supporting <strong>high-volume medical billing operations, particularly Texas-based practices,</strong> will receive strong consideration.</p><h3>Apply Now</h3><p>If you have hands-on experience in <strong>medical billing and Revenue Cycle Management</strong>, can independently manage claims and denials, and understand what it takes to drive timely reimbursement, we’d love to hear from you.</p><p>Apply today and bring your expertise in <strong>RCM, claims processing, denial management, insurance follow-up, and collections</strong> to a fast-moving remote environment.</p><p><strong>#MedicalBilling #MedicalBillingAccountManager #RevenueCycleManagement #RCM #MedicalBillingSpecialist #ClaimsManagement #DenialManagement #AccountsReceivable #HealthcareJobs #HealthcareBilling #EHR #RemoteJobs #RemoteWork</strong></p><p>Originally posted on <a href="https://himalayas.app">Himalayas</a></p>