Billing and Claims Analyst
porter· Finance
About this role
Porter is hiring a Billing & Claims Analyst to join our Team!
Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter’s Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member’s specific needs, and directs Porter’s team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.
ABOUT THE ROLE
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. Because Athena's default logic is built for traditional fee-for-service billing, our claims regularly get flagged, held, or underpaid in ways that don't reflect actual problems.
We're hiring a Billing & Claims Analyst to be the day-to-day set of eyes on our claims: tracking what's been submitted, what's stuck, what's been paid, and what's been invoiced separately — and flagging patterns to the Revenue Cycle & Claims Operations Lead so they can be fixed at the source.
KEY RESPONSIBILITIES
Reporting & Reconciliation
- 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.
Claims Monitoring & First-Line Troubleshooting
- Monitor daily/weekly claim submission activity to confirm claims are actually reaching payers, not just leaving Athena.
- Review current holds in Athena, distinguish routine/expected holds from ones tied to our known penny-claim or allowable-amount issues, and route the latter for escalation.
- Perform basic first-line correction on claims where the fix is known and documented, escalating anything new or ambiguous.
Support for Systemic Fixes
- Document recurring issues (e.g., a specific hold code affecting a specific payer or claim type) with enough detail for the Operations Lead to escalate to Athena or the payer.
- Support testing and validation whenever a new custom rule or workflow change is implemented in Athena, confirming it behaves as expected across a sample of claims.
- Contribute claim-level detail to the 90-day Athena assessment and any future EMR evaluation.
REQUIRED QUALIFICATIONS
- 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.
PREFERRED QUALIFICATIONS
- Prior exposure to value-based care, risk adjustment, HEDIS, or delegated/capitated billing models.
- Experience with encounter data reporting or non-standard (non-FFS) claim types.
- Familiarity with payer portals for claim status verification.
Frequently Asked Questions
What is the salary for the Billing and Claims Analyst role at porter?
The listed salary for this Billing and Claims Analyst position at porter is USD 58K–75K. This is an Full Time role.
Where is the Billing and Claims Analyst position at porter located?
This Billing and Claims Analyst role at porter is based in Annapolis, MD. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Billing and Claims Analyst role at porter full-time or part-time?
This is listed as a Full Time position. It is posted as a Billing and Claims Analyst role in the Finance department at porter.
Which team or department does the Billing and Claims Analyst at porter belong to?
This Billing and Claims Analyst position is part of the Finance department at porter. See the full job description for more information about the team structure and responsibilities.
How do I apply for the Billing and Claims Analyst position at porter?
Click the "Apply Now" button on this page. You will be redirected to porter's official application portal hosted on lever where you can submit your application directly.
When was the Billing and Claims Analyst job at porter posted?
This Billing and Claims Analyst position at porter was posted on Aug 5, 2026. Apply as soon as possible — early applications are often reviewed first.
Billing and Claims Analyst
porter · 💰 USD 58K–75K
You'll be redirected to porter's official application page on Lever.