Job Description: Medical Biller and Coder, Orthopedics

Job Summary: This individual is responsible for all aspects of the revenue medical billing cycle including claim submission, appeals, collections, and analytics

• Individual must: have strong attention to detail and problem solving skills; be organized, self-motivated, and able to multi-task; work independently but also work well as a team; have strong oral and communication skills; have the ability to adapt well to changes with their daily responsibilities
• Individual will need to provide their own transportation to and from work

Responsibilities:

• Data entry and patient demographics verification
• Ensure authorizations are obtained as necessary for upcoming appointments, surgeries, and therapy
• Handle payment posting and charge entry for physical therapy and physician charges
• Submit electronic and paper claims to insurance companies
• Daily reconciliation of billing and reimbursements
• Ensure that all coding is compliant with current coding guidelines and regulations
• Read and understand all explanation of benefits, and process as necessary
• Understand appeals
• Manage denials and claims resubmission
• Remedy any previously approved insurance claim that has subsequently been denied
• Oversee collection process
• Manage account receivables over 0, 30, 60, and 90 days, seeing that over-due accounts are addressed by following up with all insurances and patient balances
• Initiate and respond to telephone inquiries.
• Assist patients with questions regarding insurance and/or account balances..
• Handle patient complaints regarding billing in a timely and consistent manner
• Coordinate all patient and insurance refunds
• Analyze AR for trends in denials to identify issues that impact AR adjudication
• Good communication skills with patients is a must

Experience:

• Experienced and accomplished in the entire medical revenue billing cycle
• A full understanding of healthcare billing and collections, with the ability to effectively communicate with patients and payers
• Proven experience as a Medical Biller or in a similar role.
• 2 year minimum in medical billing and coding.
• Good computer skills
• Working knowledge of medical billing software and EHR- Allscripts used in house
• Strong knowledge of medical terminology and anatomy
• Excellent knowledge of Medicare rules and regulations and CPT and ICD-10 coding
• Understanding of private insurance rules and regulations
• Cash inflow and bad debt issues
• Customer service experience
• Orthopedic experience preferred.
• Strong attention to detail and accuracy in coding and billing processes.
• Excellent communication skills to effectively interact with insurance companies, patients, and healthcare providers.
• Ability to work independently and meet deadlines in a fast-paced environment.

Note: Certification in medical coding (e.g., CPC) is preferred but not required.

This is an excellent opportunity for a detail-oriented individual with strong coding skills to join our team as an Orthopedic Medical Biller. We offer competitive compensation and benefits packages, including health insurance, paid time off, and opportunities for professional growth. If you meet the requirements listed above, please submit your resume for consideration.

Job Type: Full-time

Benefits:

• 401(k)
• Health insurance
• Paid time off

Schedule:

• Monday to Friday

Experience:

• ICD-10: 2 years (Preferred)

Work Location: In person