Billing Rules Client Solutions Associate
Athena Health
- Boston, MA
- Permanent
- Full-time
The Billing Rules Client Solutions Associate is responsible for resolving client cases by understanding client and industry requirements for billing rules, claim formatting, and defining additions or updates to athena’s billing rules engine. The Associate will become an expert in healthcare insurance claim formatting and in athena’s billing rules engines. The position requires analytical thinking, superior attention to detail, effective communication skills, and ability to balance multiple issues at once.Essential Functions (Duties and Responsibilities):Manage client cases (20%)Communicate clearly through written and verbal updates with clients and internal stakeholdersCommunicate complex issues or scenarios in a clear and concise mannerComplete required steps to document case details for reporting purposesManage/monitor about 25 cases at a time, each in a different stagePrioritize own work across several task management systems dailyProvide timely updates and resolutionsDefine Business Requirements and Technical Solutions (60%)Become a subject matter expert in one or more types of healthcare claim submission and billing logicUse your knowledge of healthcare billing, athenaNet, and billing rules to troubleshoot client issues and determine root cause of the problemUnderstand the context and business reason behind client requirementsValidate payer requirements using payer documentation and phone calls to payersUse team guidelines and best practices, compliance requirements, and own judgement to determine whether client requests should be implemented in the billing rules engineCollaborate with colleagues, including developers, to create high-quality billing rule engine updates that meet client needs and payer guidelinesDesign quality solutions by synthesizing large amounts of complex information into clear logic statementsDefine and execute test plans to validate that technical solutions meet client needsBe an active participant in athena’s teaching and learning culture (20%)Seek out opportunities to grow your knowledge in assigned areasIdentify opportunities for process improvement. Provide feedback to managementParticipate in case retrospective reviews to learn from experiencesSupport teammates by sharing your process and subject matter expertiseParticipate in team-wide efforts to improve knowledge management and trainingEducation & Experience Required:College Degree or 3-5 years of relevant experienceExperience working in a corporate setting populated by diverse backgroundsFamiliarity and comfort around web/software applications and a basic understanding of cloud-based SaaSInterest in solving complex Healthcare billing problemsCertified Professional Coder certification is a plusKnowledge & Skills:Demonstrates analytical thinking: systematic, logical approach to managing complex, high volumes and/or contradictory informationExcellent organizational skills and strong attention to detailManage multiple projects with competing prioritiesClearly frame a problem statement, research and troubleshootClearly communicate complex industry requirements to clientsAnticipate and balance the needs of multiple stakeholdersComfortable learning new programs/tools/applicationsAbility to instruct others, especially peers and clients to explain process workflow conceptsProven ability to work both independently on projects and as part of a larger teamFlexibility to take on new tasks and challengesAbout athenahealthHere’s our vision: To create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.What’s unique about our locations?
From an historic, 19th century arsenal to a converted, landmark power plant, all of athenahealth’s offices were carefully chosen to represent our innovative spirit and promote the most positive and productive work environment for our teams. Our 10 offices across the United States and India — plus numerous remote employees — all work to modernize the healthcare experience, together.Our company culture might be our best feature.
We don't take ourselves too seriously. But our work? That’s another story. athenahealth develops and implements products and services that support US healthcare: It’s our chance to create healthier futures for ourselves, for our family and friends, for everyone.Our vibrant and talented employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our goal. We continue to expand our workforce with amazing people who bring diverse backgrounds, experiences, and perspectives at every level, and foster an environment where every athenista feels comfortable bringing their best selves to work.Our size makes a difference, too: We are small enough that your individual contributions will stand out — but large enough to grow your career with our resources and established business stability.Giving back is integral to our culture. Our athenaGives platform strives to support food security, expand access to high-quality healthcare for all, and support STEM education to develop providers and technologists who will provide access to high-quality healthcare for all in the future. As part of the evolution of athenahealth’s Corporate Social Responsibility (CSR) program, we’ve selected nonprofit partners that align with our purpose and let us foster long-term partnerships for charitable giving, employee volunteerism, insight sharing, collaboration, and cross-team engagement.What can we do for you?
Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces — some offices even welcome dogs.In addition to our traditional benefits and perks, we sponsor events throughout the year, including book clubs, external speakers, and hackathons. And we provide athenistas with a company culture based on learning, the support of an engaged team, and an inclusive environment where all employees are valued.We also encourage a better work-life balance for athenistas with our flexibility. While we know in-office collaboration is critical to our vision, we recognize that not all work needs to be done within an office environment, full-time. With consistent communication and digital collaboration tools, athenahealth enables employees to find a balance that feels fulfilling and productive for each individual situation.athenahealth is committed to a policy of equal employment opportunity—that’s why we recruit and hire applicants without regard to race, color, religion, sex (including pregnancy), national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. We’re happy to provide a reasonable accommodation, for those with a disability, to complete any part of the application process. If you are unable to access or use this online application process and need an alternative method for applying, please contact us at for assistance.