Job Description

Job Description As a Claims Resolution Specialist at Caduceus Health, you’ll play a key role in ensuring timely and accurate resolution of claims for our expansive network of multi-specialty, multi-site healthcare providers across the U.S. Your expertise will help maximize reimbursement and streamline processes within the Athena billing platform. What You’ll Do

• Work claims and denials using Athena (experience within the past 2 years required).
• Conduct A/R follow-up from front-end scrubs to back-end denials.
• Scrub charges, launch appeals, and review/edit registration, insurance, and charge issues.
• Accurately interpret EOBs and denials from all payers.
• Manage appeals processing end-to-end across all insurance types.
• Differentiate appeal strategies, coding reviews, credentialing, and adjustments.
• Engage with insurance companies via phone and web portals for eligibility, payments, and remittance.
• Track and communicate recurring issues and trends.
• Consistently meet or exceed daily productivity benchmarks.

What You Bring

• 3+ years of experience in claims resolution or medical billing.
• 2+ years of recent Athena Health platform experience.
• Strong understanding of CPT, ICD-10 , and medical terminology.
• End-to-end A/R and revenue cycle knowledge, especially in physician billing .
• Detail-oriented with excellent communication skills.
• Proficient in Microsoft Word and Excel .

We are committed to equal employment opportunity. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religion, age, sex, sexual orientation, transgender, national origin, disability, genetic information, veteran, or marital status, or any other characteristic protected by law. SELF-ATTESTATION :I certify that I have read and understand the applicant instructions included with this application and that the answers given by me to the foregoing questions and statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application, whether on this document or not, may result in rejection of my application or discharge at any time during my employment. I understand that this application form is intended for use in evaluating my qualifications for employment and that this application is not an offer of employment. I further understand that if hired, my employment will be considered "at-will" and that my employment may be terminated for any reason, with or without cause or notice, at any time by me or the Company and that this application is not intended to constitute a contract of continued employment.

Company Description

Since 1997, CaduceusHealth® has helped physicians and healthcare providers analyze their business processes and discover new ways to create efficient and compliant workflows within their practices. An early adopter of the athenahealth platform, CaduceusHealth® provides fully outsourced on shore revenue cycle, staffing, coding and analytic solutions for thousands of providers nationally, operational in hospital owned, affiliated or private equity backed, single and multi-specialty practices. With on shore only operations, we partner closely with our clients to achieve better outcomes.

Company Description

Since 1997, CaduceusHealth® has helped physicians and healthcare providers analyze their business processes and discover new ways to create efficient and compliant workflows within their practices. An early adopter of the athenahealth platform, CaduceusHealth® provides fully outsourced on shore revenue cycle, staffing, coding and analytic solutions for thousands of providers nationally, operational in hospital owned, affiliated or private equity backed, single and multi-specialty practices. With on shore only operations, we partner closely with our clients to achieve better outcomes. Apply To this Job