Position Type: Full-Time | Remote
Working Hours: Must overlap with U.S. Mountain Time business hours for at least 4 hours per day

About the Role

We are looking for an experienced Billing Specialist to manage the full professional claims cycle in eClinicalWorks (eCW), from charge review and claim submission through payment posting, denial resolution, and final claim closure. The immediate priority for this role is clearing the $0 remit (zero-payment ERA) backlog. The ideal candidate has hands-on eCW billing experience, understands Medicare Part B professional claims, and can investigate payment issues, document findings, and move claims toward the appropriate resolution.

Key Responsibilities

Full Claims Cycle Management

• Manage the complete claim cycle in eCW, including charge review, claim submission, clearinghouse rejections, claim status follow-up, denial management, corrected claims, and resubmissions.
• Investigate claim issues and determine the appropriate next steps to resolve outstanding balances.
• Prepare redeterminations and appeals while carefully tracking submission deadlines and timely filing requirements.

Payment Posting & ERA Management

• Post ERAs and EOBs accurately, including Medicare takebacks and payer recoupments.
• Ensure payment remittances are fully processed and never left partially posted.
• Review 835 ERA files and interpret CARC/RARC codes to understand payment adjustments and denials.

$0 Remit Backlog Resolution

• Investigate zero-payment remittances and identify the reason for each zero-pay outcome, including denials, recoupment offsets, deductibles, or another payer being primary.
• Post each remit correctly and determine the appropriate next action, such as rebilling, filing an appeal, or requesting a write-off.
• Maintain clear documentation of findings and actions taken.

Documentation & Communication

• Maintain accurate and detailed claim notes in eCW so other team members can easily understand claim status and next steps.
• Provide clear written updates on outstanding claims, payment issues, and resolution progress.
• Follow established billing procedures and escalate complex issues when necessary.

Required Experience & Skills

• Hands-on experience with eClinicalWorks (eCW) billing, including claims, payment posting, and claim status management.
• Experience with Medicare Part B professional billing.
• Ability to read and interpret 835 ERA files and CARC/RARC adjustment codes.
• Experience handling denials, corrected claims, resubmissions, and appeals.
• Strong understanding of timely filing requirements and payer follow-up procedures.
• Strong written English communication skills for claim notes and updates.
• Excellent attention to detail and the ability to manage billing work accurately and independently.

Preferred Experience

• Experience working with Noridian and Medicare Jurisdiction F.
• Familiarity with Medicare takebacks, recoupments, and zero-payment remittances.
• Experience managing provider services billing and professional claims.

Work Arrangement & Compliance Requirements

• Full-time remote position.
• Must have at least 4 hours of daily overlap with U.S. Mountain Time business hours.
• eCW access and training will be provided through secure remote access only.
• Must complete HIPAA training and sign a business associate agreement with Pavago.
• Must pass a background check.
• Patient data must not be stored on personal devices.

Interview Process

1. AI Screening
2. Client Interview
3. Offer Stage

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