Medical Billing and Insurance Recovery Specialist

Job Description

Job Description

Orthopaedic Associates offers the expertise and experience of Board-certified specialists. With care and compassion, our surgeons take the time to get to know our patients, to carefully diagnose the source of the problem and to develop a treatment and recovery plan specific to your needs. Our surgeons are trained in minimally invasive techniques, including joint replacements and arthroscopic procedures on the shoulder, elbow, hip and knee, foot and ankle, wound care, and small-incision approaches for fracture care. Minimally invasive techniques help speed recovery and generally result in minimized pain.

We are a diverse, inclusive and equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, ancestry, national origin, religion, creed, age (40+), disability status, sex, gender, sexual orientation, gender identity, gender expression, medical condition, genetic information, marital status, protected military or veteran status, or any other characteristic protected by law.

JOB SUMMARY

The Medical Billing and Insurance Recovery Specialist is responsible for managing all incoming and outgoing payments related to patient care. This role includes communicating with patients regarding outstanding balances, processing payments, and handling all administrative functions related to insurance billing.

Key responsibilities include managing patient and insurance accounts, submitting and tracking insurance claims, sending invoices, following up on unpaid balances, resolving billing discrepancies, reconciling accounts, and ensuring accurate data entry for timely cash flow. The position requires strong communication skills, attention to detail, and the ability to analyze financial information to minimize outstanding debt and support the overall financial health of the practice.

ESSENTIAL JOB RESPONSIBILITIES

Seeking an experienced Billing and Insurance Recovery Specialist for a busy orthopedic group. Must have 2 years of full-time experience as a Billing and Insurance Recovery Specialist. Must be knowledgeable in medical codes to determine how much is owed and whether any outside insurance covers part or all of their balance.

• Knowledge of HCPCS coding system.
• Must have knowledge of ICD-10 and CPT Coding.
• Familiar with local insurance payers a plus and knowledgeable as far as what different insurance companies require when billing / submitting claims.
• Knowledgeable in workman's compensation claims required
• Knowledge of Medicare insurance guidelines, requirements, and systems.
• Knowledge of EOB breakdowns for accurate postings.
• Knowledge of payment and adjustment posting.
• Effective communication abilities for phone contacts with insurance payers to resolve issues.
• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
• A calm manner and patience working with insurers, peers, and others.
• Knowledge of medical terminology likely to be encountered in medical claims.
• Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act (HIPAA).
• Orthopedic (and Spine), Podiatry, and Surgery billing experience a "big" plus.
• Must have experience obtaining prior authorizations and knowledge of processes.
• Other duties as assigned.

SKILLS & ABILITIES

EDUCATION

EXPERIENCE