Billing Specialist - Insurance Collections

Elite Sports Orthopedics is seeking a detail-oriented and motivated Billing Specialist – Insurance Collections to join our team. This position is responsible for managing insurance accounts receivable, researching and resolving outstanding claims, following up on unpaid and denied claims, and supporting timely and accurate reimbursement.

The ideal candidate is organized, persistent, and comfortable working independently while communicating effectively with both internal teams, insurance payers, and patients.

This position will become FULLY-REMOTE after training however until training is complete the position will train at the 2004 Hayes Street Suite 200 location in Nashville, TN. 

MINIMUM ESSENTIAL JOB REQUIREMENTS

• Work insurance aging with a primary focus on accounts 61 days and older, prioritizing timely and consistent follow-up.
• Review, communicate, and accurately document insurance denials within the practice management system.
• Follow established practice management system guidelines for claim follow-up, including reason codes and designated follow-up dates.
• Submit timely and appropriate appeals for denied claims and monitor their status through resolution.
• Research and resolve outstanding claim issues, including missing information, processing errors, payer issues, and other barriers to payment.
• Identify underpayments or payments that do not meet the contracted or allowed amount and communicate findings to the appropriate supervisor.
• Review payer-specific communications, policies, and updates and communicate relevant information to appropriate team members and departments.
• Identify trends or recurring issues related to denials, underpayments, or claim processing and communicate findings to management.
• Respond professionally and accurately to written and telephone billing inquiries from patients.
• Maintain accurate and thorough documentation of account activity and follow-up efforts.
• Collaborate with internal departments and team members to resolve billing and insurance-related issues.
• Participate in weekly team meetings and contribute to department goals and process improvement.
• Maintain confidentiality of patient and financial information in accordance with applicable policies and regulations.
• Perform other miscellaneous duties and responsibilities as assigned by management.

KNOWLEDGE, SKILL AND COMPETENCY REQUIREMENTS

• High school diploma required
• College education or trade school preferred 
• Experience working in a physician office or hospital billing-type position preferred
• Orthopedic claims experience is preferred
• Proven record of discussing financial responsibilities and establishing payment plans when necessary
• Comfortable using email and interacting various applications
• Knowledge of Billing and Collections procedures
• Knowledge of CPT and ICD-1O CM coding
• Knowledge of MS Office Suite, especially Word, Excel and Outlook
• Excellent written and verbal communication abilities
• Goal-oriented and strong attention to details
• Knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement
• Proven knowledge of Explanation of Benefits forms, claim forms and insurance billing process

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, sexual orientation, age, disability, gender identity, marital or veteran status, or any other protected class.