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This is a remote opportunity; however, candidates must reside in one of the following states: Arizona, Arkansas, Florida, Iowa, Illinois, Indiana, Michigan, Missouri, North Carolina, Nevada, Ohio, Oregon, Pennsylvania, Tennessee, or Texas.
Our Billing Specialists are responsible for answering patient inquiries, reviewing outstanding or denied insurance claims, submitting insurance appeals, and maintaining assigned accounts receivables per clinic policies.
Assist in the processing of insurance claims including worker’s compensation (if assigned) for all financial classes
Communicate with insurance companies to ensure that claims are paid; identify and correct account and/or insurance error; and post all actions and maintain permanent record of patient accounts
Oversee claims appeals and reviews; review claims aging status and follow up on open claims
Answer phones, patient questions, inquiries, and concerns regarding their accounts; verify balances and refunds for accuracy
Understand, and stay up to date with, clinic and insurance industry contract policies/procedures and medical terminology
Participate in professional development efforts to stay current with health care best practices and trends
Actively participate in the company’s efforts to create innovative data and analytics solutions for the modern orthopedic business office
Other duties as assigned
Required Skills:
Minimum of 2+ years of medical billing and accounts receivable follow-up experience preferred
Orthopedic billing experience strongly preferred
Knowledge of commercial insurance, Medicare, Medicaid, worker’s compensation, and managed care payers
Understanding of EOBs, denials, appeals, adjustments, authorizations, and payment posting processes
Ability to interpret payer guidelines and identify billing discrepancies or claim issues
Familiarity with CPT, ICD-10, and HCPCS coding terminology
Experience working within EMR/EHR systems and insurance payer portals
Strong understanding of claim aging, denial management, and timely filing requirements
Ability to prioritize workload and manage multiple accounts efficiently in a high-volume environment
Strong attention to detail and organizational skills
Excellent written and verbal communication skills
Ability to work independently while maintaining productivity and accountability in a remote work environment
Proficient computer skills including Microsoft Outlook, Excel, and Teams
Strong problem-solving and critical thinking skills
Ability to maintain confidentiality and comply with HIPAA regulations
Dependable attendance, responsiveness, and follow-through on assigned responsibilities
Ability to adapt to changing workflows, client needs, and process improvements
Preferred Skills:
CPC, CPB, or other AAPC certification preferred but not required
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