Medical Billing and Insurance Recovery Specialist

Orthopaedic Associates offers the expertise and experience of Board-certified specialists. With care and compassion, our surgeons take the time to get to know our patients, to carefully diagnose the source of the problem and to develop a treatment and recovery plan specific to your needs. Our surgeons are trained in minimally invasive techniques, including joint replacements and arthroscopic procedures on the shoulder, elbow, hip and knee, foot and ankle, wound care, and small-incision approaches for fracture care. Minimally invasive techniques help speed recovery and generally result in minimized pain.

We are a diverse, inclusive and equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, ancestry, national origin, religion, creed, age (40 ), disability status, sex, gender, sexual orientation, gender identity, gender expression, medical condition, genetic information, marital status, protected military or veteran status, or any other characteristic protected by law.

JOB SUMMARY

The Billing and Insurance Recovery Specialist manages incoming and outgoing payments for medical treatment. Their role is to communicate with patients about their outstanding balance and handling the administrative responsibilities of billing insurance and processing payments.

ESSENTIAL JOB RESPONSIBILITIES

Seeking an experienced Billing and Insurance Recovery Specialist for a busy orthopedic group. Must have 2 years of full-time experience as a Billing and Insurance Recovery Specialist. Must be knowledgeable in medical codes to determine how much is owed and whether any outside insurance covers part or all of their balance.

• Knowledge of HCPCS coding system.
• Must have knowledge of ICD-10 and CPT Coding.
• Familiar with local insurance payers a plus and knowledgeable as far as what different insurance companies require when billing/submitting claims.
• Knowledgeable in workman's compensation claims required
• Knowledge of Medicare insurance guidelines, requirements, and systems.
• Knowledge of EOB breakdowns for accurate postings.
• Knowledge of payment and adjustment posting.
• Effective communication abilities for phone contacts with insurance payers to resolve issues.
• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
• A calm manner and patience working with insurers, peers, and others.
• Knowledge of medical terminology likely to be encountered in medical claims.
• Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act (HIPAA).
• Orthopedic (and Spine), Podiatry, and Surgery billing experience a "big" plus.
• Must have experience obtaining prior authorizations and knowledge of processes.
• Other duties as assigned.

SKILLS & ABILITIES

• Very strong verbal and written communication skills
• DME experience a plus
• Must have excellent grammar and spelling
• Willingness to learn and show initiative at all times

• A calm manner and patience working with insurers, peers, and others.
• Competent use of computer systems

• Strong patient service and interpersonal skills as we are high on customer service
• Excellent organizational and time management skills
• Excellent work ethics and ability to treat documents with confidentiality

• Ability to work well in a team environment while being able to prioritize, accept feedback, and manage conflict in a reasonable fashion
• Ability to multi-task efficiently in a fast-paced environment

• Have experience with medical terminologies, diagnostic procedures
• Strong communication and customer service skills
• Ability to learn quickly and work under pressure in a fast-paced environment

EDUCATION

• High school graduate or equivalent

EXPERIENCE

• Minimum two years full-time clinical experience in a healthcare facility in billing and insurance recovery required. Bilingual a plus and orthopedic experience a big plus (but not required)

COVID-19 considerations: To keep our employees as safe as possible, we have installed clear plastic and glass barriers, provide masks, and hand sanitizer. Face coverings/masks are a requirement in a health care facility, all persons entering our building are required to wear masks.

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