What are the responsibilities and job description for the Medical Biller position at ORTHOPAEDIC INSTITUTE OF HENDERSON, L.L.P.?
Location: Henderson, Nevada (On-site at Orthopaedic Institute of Henderson) Employment Type: Full-Time
About Orthopaedic Institute of Henderson (OIH): For over 25 years, the Orthopaedic Institute of Henderson has provided exceptional orthopedic care to the Henderson and greater Las Vegas communities. Our board-certified surgeons specialize in orthopedic surgery, arthroscopy, sports medicine, joint replacements, and more. We are committed to high-quality, compassionate patient care and are seeking a detail-oriented Medical Biller to join our growing team.
Job Summary: We are looking for an experienced Medical Biller to help manage the revenue cycle for our busy orthopedic practice. The ideal candidate will handle accurate claim submission, payment posting, denial management, and patient billing inquiries to ensure timely reimbursements from insurance carriers, including Medicare, Medicaid, commercial payers, and workers' compensation.
Key Responsibilities:
- Prepare, review, and submit clean electronic and paper claims to insurance companies (primary focus on orthopedic procedures, E/M visits, injections, DME, and imaging services).
- Verify patient insurance eligibility, benefits, and authorization requirements prior to services.
- Post payments, adjustments, and denials accurately in the practice management system.
- Research and resolve claim denials, rejections, and underpayments; appeal denied claims as needed with supporting documentation.
- Follow up on outstanding accounts receivable (A/R) aging over 30/60/90 days.
- Handle patient billing inquiries, explain statements, set up payment plans, and process patient payments.
- Maintain compliance with HIPAA, CMS guidelines, and payer-specific billing rules.
- Reconcile payments and prepare reports on billing metrics for management.
- Collaborate with front office, clinical staff, and providers to resolve coding/billing issues.
Qualifications:
- High school diploma or equivalent required; certification (e.g., CPB, CPC, CMRS, or equivalent) preferred.
- Minimum 2 years of medical billing experience, preferably in orthopedics, surgery, or multi-specialty practices.
- Strong knowledge of CPT, ICD-10, HCPCS coding, and modifiers commonly used in orthopedics.
- Experience with electronic health record (EHR) and practice management systems (Mod Med)
- Familiarity with major payers including Medicare, Medicaid, Blue Cross, UnitedHealthcare, and workers' compensation.
- Excellent attention to detail, organizational skills, and ability to multitask in a fast-paced environment.
- Proficient in Microsoft Office (Excel, Word) and typing speed of 45 WPM.
- Strong communication skills for interacting with patients, insurers, and team members.
Preferred Skills:
- Certification as a Certified Professional Biller (CPB) or Certified Professional Coder (CPC).
- Experience with orthopedic-specific billing (e.g., joint replacements, arthroscopy, fracture care, DME).
- Knowledge of Nevada-specific payer requirements and regulations.
What We Offer:
- Competitive pay and performance-based bonuses.
- Comprehensive benefits package (health, dental, vision, 401(k), paid time off).
- Supportive team environment in a well-established practice.
- Opportunities for professional growth and continuing education.