Billing & Claims Analyst
PorterCloud Deployment/PaaS/DevOps company
Pompano Beach, United StatesMid
FirstMark Capital
Y Combinator
Venrock
Soma Capital
Translink Investment
Operations & Strategy
About the role
TL;DR
Monitor and reconcile claims submitted through Athena, ensuring accuracy and resolving issues.
- •Our organization operates in a payer-contracted services model
- •delegated services, in-home assessments, HEDIS gap closure, and risk adjustment visits
- •billed through Athena in a mix of penny-claim/encounter-reporting and full-cost claim arrangements.
- •Key Responsibilities Build and maintain recurring reports in Athena covering claim submission status, hold/edit queues, and payment status.
- •Reconcile claims sent to payers against invoices sent separately for encounter/penny-claim arrangements, confirming amounts match and nothing has fallen through the cracks.
- •Track partial payments and underpayments, flagging cases where Athena has applied a standard allowable amount or co-insurance deduction that conflicts with the actual contracted rate.
- •Maintain claim-aging reports so nothing sits in a hold queue unnoticed.
- •Monitor daily/weekly claim submission activity to confirm claims are actually reaching payers, not just leaving Athena.
- •Requirements 1-3+ years of experience in medical billing, claims processing, or revenue cycle operations.
- •Working proficiency in Athena (or comparable EMR/RCM system)
- •running reports, navigating claim status and hold queues, and pulling claim-level detail.
- •Strong Excel skills (pivot tables, VLOOKUP/XLOOKUP, basic reconciliation building); SQL or other data-query experience is a plus but not required.
- •High attention to detail and comfort with repetitive reconciliation work
- •this role lives in the data, not just the summary.
- •Clear written communication for documenting issues and escalations.
Required skills
AthenaExcel
Nice-to-have skills
SQL
Domain expertise
healthcare
Tech stack
Athena