Overview: We are seeking an experienced and detail-oriented Accounts Receivable Specialist to join our orthopedic practice. The Accounts Receivable Specialist will be responsible for managing the billing and collection processes, ensuring timely reimbursement, and reducing accounts receivable delinquency. This role requires a thorough understanding of medical billing procedures, strong analytical skills, and the ability to communicate effectively with patients and insurance companies.

Responsibilities:

• Billing and Claims Submission:
• Generate and submit accurate medical claims for orthopedic services rendered to patients.
• Verify claim accuracy, including patient demographics, insurance information, CPT codes, and modifiers.
• Ensure compliance with insurance company requirements and billing regulations.
• Address any claim errors or rejections promptly and resubmit as necessary.
• Accounts Receivable Management:
• Monitor accounts receivable aging reports and follow up on outstanding balances.
• Identify and resolve billing discrepancies, denials, and unpaid claims in a timely manner.
• Communicate with insurance companies to resolve claim issues, including appeals and inquiries.
• Review and reconcile insurance payments, adjustments, and patient balances.
• Payment Reconciliation:
• Identify and investigate discrepancies between expected and received payments.
• Ensure proper allocation of payments, adjustments, and write-offs according to billing policies.
• Patient Communication:
• Communicate with patients regarding billing inquiries, insurance coverage, and financial responsibilities.
• Provide explanations of benefits (EOBs) and assist patients in understanding their statements.
• Coordinate payment arrangements and financial assistance programs as needed.
• Reporting and Analysis:
• Generate and analyze financial reports related to accounts receivable, billing, and collections.
• Identify trends, patterns, and opportunities for process improvement.
• Collaborate with management to develop strategies for optimizing revenue cycle performance.

Qualifications:

• High school diploma or equivalent required; associate’s or bachelor’s degree preferred.
• Minimum of 2-3 years of experience in medical billing and accounts receivable, preferably in an orthopedic or healthcare setting.
• Proficiency in medical billing software and electronic health record (EHR) systems.
• Strong understanding of medical billing processes, including CPT and ICD-10 coding, insurance claims submission, and reimbursement procedures.
• Excellent communication and interpersonal skills, with the ability to interact professionally with patients, insurance representatives, and colleagues.
• Detail-oriented with strong analytical and problem-solving abilities.
• Ability to prioritize tasks, meet deadlines, and work effectively in a fast-paced environment.
• Knowledge of healthcare regulations and compliance standards related to billing and reimbursement.

Job Type: Full-time

Pay: From $18.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Paid time off
• Vision insurance

Experience level:

• 2 years

Schedule:

• Day shift
• Monday to Friday

Supplemental pay types:

• Overtime pay

Work Location: In person