Medical Billing and AR Specialist

📋 Description

• • Own the heartbeat of Abby Care’s revenue cycle. As our Medical Billing and AR Specialist you will be the last line of defense between the care we deliver and the dollars that keep us growing. Every payment you post, every variance you catch, and every report you generate directly funds our ability to train and pay more family caregivers across the United States.
• • Post with surgical precision. Each morning you will download 200-400 ERAs/EOBs from payers such as Aetna, UnitedHealthcare, and state Medicaid plans, interpret complex remittance advice, and post payments, adjustments, and denials into our billing platform (currently Athena, with Epic in pilot). You will apply contractual allowances down to the penny, flag underpayments within 24 hours, and ensure that every patient responsibility balance is correctly transferred to the secondary or patient bucket.
• • Reconcile like a forensic accountant. You will perform same-day reconciliation between bank deposits and the payment batches you just posted, investigating any variance above $25 and documenting root-cause findings in a shared tracker. Monthly, you will lead a three-way match among the general ledger, bank statements, and aged-receivables report to certify that Abby Care’s books are audit-ready.
• • Turn denials into dollars. You will build and maintain a denial-reason taxonomy, run weekly SQL queries to identify top denial codes by payer and provider, and partner with our prior-auth and coding teams to implement fixes that lift first-pass acceptance rates above 97 %. When a high-dollar claim is denied, you will own the appeal—from drafting the letter to tracking the resubmission—until cash is collected.
• • Deliver board-ready insights. Using Excel pivot tables and Google Looker Studio, you will create daily flash reports on cash posted, weekly payer-scorecards on days-to-pay, and monthly AR aging summaries sliced by region, payer, and caregiver. Your dashboards will be reviewed by the CFO every Monday and will influence decisions on staffing, payer negotiations, and product roadmap priorities.
• • Champion compliance without slowing us down. You will maintain HIPAA-compliant folders in SharePoint, ensure that every ERA file is encrypted at rest, and prepare clean, traceable documentation for our annual SOC-2 and state Medicaid audits. When auditors arrive, you will walk them through the payment trail in under 30 minutes.
• • Level-up our tech stack. You will beta-test new RPA bots that auto-post standard ERA files, recommend rule-based edits that reduce manual touches by 40 %, and document SOPs in Notion so that new team members reach full productivity in two weeks or less.
• • Collaborate across oceans and time zones. Based in Manila, you will join a 15-person global revenue-cycle squad spanning Austin, Denver, and Cebu. Daily Slack huddles at 8 a.m. PHT keep us synchronized; monthly virtual game nights keep us human. Your voice will shape how we scale from 5,000 to 50,000 paid caregivers over the next three years.
• • Bring heart to healthcare finance. At Abby Care we measure success not only in dollars collected but in caregivers empowered. You will see the impact of your work every time a mother in Texas receives her first paycheck for caring for her autistic son—because the claim you posted yesterday cleared overnight.