[Hiring] Medical Billing Specialist @Orthos

Role Description

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.

Essential Duties & Responsibilities:

• 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 errors; and post all actions and maintain a 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.

Qualifications

• 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.

Requirements

• CPC, CPB, or other AAPC certification preferred but not required.