Orthopedic Billing & Accounts Receivable Specialist

Overview:
Agility Orthopedics is seeking a skilled Orthopedic Billing and AR Specialist to join our team. This position plays a critical role in ensuring the timely and accurate billing and collection of accounts receivable for our orthopedic practice. The ideal candidate will have experience in medical billing, specifically within the orthopedic specialty, and a strong understanding of insurance guidelines and reimbursement processes.

Responsibilities:

• Billing:
• Generate and submit claims to insurance companies, Medicare, Medicaid, and other payers accurately and in a timely manner.
• Review claims for accuracy and completeness before submission.
• Follow up on unpaid claims, denials, and rejected claims, and resubmit claims as necessary.
• Resolve billing discrepancies and issues with insurance companies and patients.
• Accounts Receivable Management:
• Monitor and manage accounts receivable aging reports to ensure timely payment.
• Identify delinquent accounts and initiate collections procedures.
• Work with patients and insurance companies to resolve outstanding balances and disputes.
• Update patient accounts with payment information and maintain accurate records of financial transactions.
• Insurance Verification and Authorization:
• Verify patient insurance coverage and obtain pre-authorizations for orthopedic procedures and services.
• Communicate with insurance companies to confirm coverage, obtain authorization, and resolve coverage-related issues.
• Coding Support:
• Assist with medical coding tasks as needed, ensuring accurate assignment of ICD-10, CPT, and HCPCS codes.
• Compliance and Documentation:
• Stay current with industry regulations, coding updates, and billing guidelines to ensure compliance with healthcare laws and regulations.
• Maintain thorough documentation of billing and collection activities, adhering to HIPAA regulations.

Qualifications:

• Minimum of 2 years of experience in medical billing and accounts receivable, preferably in orthopedic billing.
• Proficiency in medical billing software and electronic health records (EHR) systems.
• EPIC experience REQUIRED.
• Strong understanding of medical coding (ICD-10, CPT, HCPCS) and insurance billing procedures.
• Excellent communication and interpersonal skills, with the ability to effectively communicate with patients, insurance companies, and other healthcare professionals.
• Detail-oriented with strong analytical and problem-solving abilities.
• Ability to work independently and prioritize tasks effectively in a fast-paced environment.
• Knowledge of healthcare regulations, including HIPAA and insurance guidelines.
• Certification in medical billing and coding (e.g., CPC, CPB) is a plus.

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Retirement plan
• Vision insurance