Insurance Billing Coordinator - KOC Central Business Office

Knoxville Orthopaedic Clinic (KOC) is seeking a detail-oriented and organized Insurance Billing Coordinator to join our Revenue Cycle team. This position plays an important role in ensuring insurance claims are prepared, reviewed, and submitted accurately and on time to support efficient reimbursement and overall Revenue Cycle operations.

The Insurance Billing Coordinator reviews claim information for accuracy, resolves billing edits and rejections, coordinates corrections and missing documentation, and monitors claims through payer and clearinghouse systems. This position works closely with Coding, Charge Entry, Patient Access, providers, and other Revenue Cycle Team Members to promote clean claims and timely reimbursement.

The ideal candidate has healthcare billing or Revenue Cycle experience, strong attention to detail, and the ability to research and resolve claim issues while managing a high-volume workload.

What You'll Do

• Review charges and insurance claim information for completeness and accuracy prior to submission.

• Prepare and submit electronic and paper claims to commercial, governmental, workers' compensation, and other assigned payers.

• Monitor clearinghouse reports, claim-edit work queues, payer acknowledgements, and rejection reports to ensure claims are successfully accepted.

• Research and correct claim edits, rejections, and billing holds involving insurance coverage, authorizations, coding, registration, provider information, claim formatting, or documentation.

• Work with Coding, Charge Entry, Patient Access, clinical Team Members, and providers to obtain corrections and information necessary for claim submission.

• Review and follow payer-specific billing requirements, including authorizations, referrals, modifiers, attachments, medical records, and electronic submission requirements.

• Prepare corrected and replacement claims, voids, attachments, and supporting documentation according to payer requirements.

• Maintain accurate account notes and billing records documenting claim status, corrections, submission dates, payer responses, and necessary follow-up.

• Monitor assigned billing work queues and unresolved claims to ensure timely submission and resolution.

• Identify claims requiring additional denial follow-up, payment research, credentialing action, patient-account review, or payer escalation and route them appropriately.

• Maintain patient confidentiality and comply with HIPAA, payer requirements, billing regulations, and KOC policies.

• Meet established productivity, accuracy, clean-claim, and turnaround-time expectations.

• Identify recurring claim edits, rejection patterns, payer changes, and workflow concerns and communicate trends to leadership.

• Participate in training, cross-training, quality reviews, audits, system updates, and process-improvement initiatives.

What We're Looking For

• High school diploma or equivalent required.

• Previous experience in medical billing, insurance claims, healthcare Revenue Cycle, patient accounts, or a comparable detail-oriented healthcare environment.

• Working knowledge of insurance claim submission, clearinghouse processes, payer requirements, timely filing, claim edits, rejections, and common medical billing terminology.

• Strong attention to detail, organization, research, and problem-solving skills.

• Ability to review and interpret detailed claim and account information accurately.

• Strong written and verbal communication skills.

• Ability to prioritize and manage high-volume work queues while meeting recurring deadlines.

• Ability to appropriately handle confidential patient and financial information.

• Proficiency with electronic health records, practice-management systems, clearinghouse platforms, payer portals, spreadsheets, email, and common office applications.

Preferred Experience

• Previous billing experience within a multi-site physician practice, orthopaedic organization, or other complex healthcare environment.

• Experience with NextGen, Experian, electronic claim clearinghouses, payer portals, or similar Revenue Cycle systems.

• Knowledge of CPT, ICD-10-CM, HCPCS, modifiers, authorizations, and provider enrollment.

• Familiarity with commercial and governmental payer billing requirements.

Join the KOC Team

At Knoxville Orthopaedic Clinic, our Revenue Cycle Team Members help ensure the work happening throughout our clinics is accurately reflected throughout the billing and reimbursement process. As an Insurance Billing Coordinator, you will have the opportunity to use your attention to detail, research skills, and healthcare billing knowledge to help keep claims moving efficiently from submission to resolution.

If you enjoy problem-solving, working with detailed information, researching claim issues, and contributing to an effective Revenue Cycle team, we encourage you to apply and become part of KOC.

Knoxville Orthopaedic Clinic is an Equal Employment Opportunity (EEO) employer. We are committed to providing a positive work environment where all individuals are treated with respect and dignity. We do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status, or any other characteristic protected by law.