Medical Billing Account Manager

Medical Billing Account Manager – Revenue Cycle Management (RCM) | Remote

Position Type: Full-Time, Remote
Working Hours: Standard U.S. Business Hours
About the Role

At Pavago , one of our clients is hiring an experienced Medical Billing Account Manager to support day-to-day Revenue Cycle Management (RCM) operations across medical billing, claims processing, denial management, insurance follow-up, collections, and client account management.

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.

You’ll review EOBs and ERAs, investigate denials, submit and correct claims, work with insurance carriers, monitor aging accounts, and maintain accurate billing documentation across assigned client accounts.

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.
What You’ll Own
Medical Billing & Revenue Cycle Management

- Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to identify:

- Payment discrepancies

- Claim denials

- Rejections

- Underpayments

- Non-payment reasons

- Analyze, investigate, and resolve claim denials and rejections

- Review claims to ensure proper diagnosis and procedure code linkage

- Apply appropriate billing modifiers to support accurate claim adjudication

- Perform claims scrubbing and quality assurance before submission

- Submit:

- Initial claims

- Corrected claims

- Secondary claims

- Follow payer-specific submission requirements and guidelines

- Manage claim queues and prioritize follow-up activities

- Maintain accurate billing records, account documentation, and claim notes

- Follow up promptly on unpaid, rejected, or underpaid claims

Denial Management & Claims Follow-Up

- Investigate the root cause of denied or rejected claims

- Research payer requirements and determine appropriate corrective actions

- Correct claim issues and support timely resubmission

- Follow outstanding claims through payment or resolution

- Monitor claim status and reimbursement timelines

- Maintain clear documentation of actions taken and next steps

- Help reduce unnecessary delays throughout the revenue cycle

Account Management & Insurance Follow-Up

- Research payer portals and insurance websites to resolve claim issues and obtain billing updates

- Coordinate directly with insurance carriers regarding:

- Claim status

- Payment inquiries

- Denials

- Rejections

- Outstanding balances

- Support client account management and respond to billing-related questions as needed

- Monitor aging accounts and assist with collections activities

- Maintain consistent communication with clients, payers, and internal stakeholders

- Ensure assigned accounts receive timely and accurate follow-up

Quality & Compliance

- Maintain accuracy and compliance with payer guidelines and billing regulations

- Meet established productivity, quality, and turnaround-time expectations

- Maintain complete and accurate billing documentation

- Identify recurring billing or denial trends

- Recommend process improvements where appropriate

- Work independently while maintaining a high level of accuracy and accountability

Requirements

- Previous professional experience in Revenue Cycle Management (RCM)

- Hands-on medical billing experience in a production environment

- Strong knowledge of:

- Claim submission

- Denial management

- Claims follow-up

- Collections

- Ability to read and interpret EOBs and ERAs

- Experience reviewing diagnosis and procedure code relationships

- Knowledge of billing modifiers and claims scrubbing processes

- Experience working with insurance payer portals and billing systems

- Strong organizational, analytical, and problem-solving skills

- Excellent written and verbal