Position Summary/Scope of Responsibility

The Centers for Advanced Orthopaedics LLC (CAO) is one of the nation’s largest Orthopaedics practices, owned and operated by physicians, with over 60 locations across Maryland, Northern Virginia, and the District of Columbia. With approximately 2,000 employees, working in 28 Divisions, CAO is a growing business with revenues of approximately $250 Million. CAO is committed to be the Orthopaedics provider of choice for our patients; partner of choice for payors and health systems; and employer of choice by attracting and retaining a talented workforce.

The Billing Representative is responsible for accurate capture and posting of patient payments and adjustments. The Billing Representative will work with guidance, collaboration, and education from the assigned clinical leader and central billing office to ensure proper and efficient billing functions. Responsibilities also include collecting and updating patient data, developing payment plans, and preparing invoices. 

Duties include, but are not limited to:

1. Prepares and submits billing data and medical claims to insurers and Medicare/Medicaid.
2. Examines patient bills for accuracy and requests any missing information. Including collecting and reviewing referrals and pre-authorizations.
3. Investigates and appeals denied claims, coordinating with the central billing office as necessary.
4. Assists patients when needed in developing payment plans.
5. Maintains updated and accurate billing information in EMR software by updating all relevant information including rate changes, personal patient information, cash spreadsheets, and current collection reports.
6. Monitors and follows-up with late/missed payments, discrepancies, and outstanding balances.
7. Posts all patient payments received.
8. Creates electronic deposit and reconciliation reports.
9. Communicated with patients regularly in-person and via in/outbound calls to discuss and collect invoices and payments.
10. Researches and resolves unapplied and/or unidentified cash receipts.
11. Performs other duties as assigned.

Required Education & Experience

• High school diploma.
• Medical billing certifications and education highly preferred.
• Proficiency with Microsoft Office suite of products.
• Minimum of 2 years of experience working with EMR/EHR software, preferably in a musculoskeletal billing environment.
• Knowledge of insurance, benefits, medical terminology, and medical billing.

Competencies/Required Skills & Abilities

• Strong Interpersonal Skills - Ability to develop relationships and collaborate and influence in a decentralized organization. 
• Strong leadership skills with a focus on employee development and engagement.
• Confident, independent thinker and strong decision-making ability when circumstances warrant such action.
• Demonstrated ability to organize, prioritize, and manage multiple tasks in a dynamic environment with a proven track record of results. 
• Strong oral and written communication skills with excellent self-discipline and patience. 
• Able to work independently. 
• Exudes professionalism in presentation.
• Must be able to read, write, speak, understand, and communicate in the English language.

Physical Demands

• Must be able to sit for long periods of time and lift up to 25 pounds.
• Must be able to use appropriate body mechanics techniques when performing desk duties.
• Requires frequent bending, reaching, repetitive hand movements, standing, walking, squatting, and sitting.
• Adequate hearing to perform duties in person and over telephone.
• Must be able to communicate clearly to patients in person and over the telephone.
• Visual acuity adequate to perform job duties, including reading materials from printed sources and computer screens.