Billing Specialist - Insurance Collections Focused

Elite Sports Medicine + Orthopedics is seeking a Billing Specialist focused on insurance collections. The role involves working on aging reports, managing denials, and ensuring proper documentation in the practice management system.

Responsibilities

• Work Insurance Aging with a focus of 61 days and older aged accounts
• Working Work Comp
• Properly communicate and document denials in the practice management system
• Follow the guidelines set in the practice management system for follow up on reason codes and follow up dates
• Submit appeals for denied claims
• Research and resolve outstanding claim issues
• Identify any payments not being paid at the allowed/contract amount and communicate to your supervisor
• Review payer specific communication and update necessary team members and departments
• Identify trends in denials and communicate to your supervisor
• Respond to written and telephone billing inquiries from patients
• Participate in weekly team meetings
• Other miscellaneous tasks delegated by management

Skills

• High school diploma required
• Work Insurance Aging with a focus of 61 days and older aged accounts
• Working Work Comp
• Properly communicate and document denials in the practice management system
• Follow the guidelines set in the practice management system for follow up on reason codes and follow up dates
• Submit appeals for denied claims
• Research and resolve outstanding claim issues
• Identify any payments not being paid at the allowed/contract amount and communicate to your supervisor
• Review payer specific communication and update necessary team members and departments
• Identify trends in denials and communicate to your supervisor
• Respond to written and telephone billing inquiries from patients
• Participate in weekly team meetings
• Other miscellaneous tasks delegated by management
• Knowledge of Billing and Collections procedures
• Knowledge of CPT and ICD-10 CM coding
• Knowledge of MS Office Suite, especially Word, Excel and Outlook
• Excellent written and verbal communication abilities
• Goal-oriented and strong attention to details
• Knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement
• Proven knowledge of Explanation of Benefits forms, claim forms and insurance billing process
• College education or trade school preferred
• Experience working in a physician office or hospital billing-type position preferred
• Orthopedic claims experience is preferred
• Proven record of discussing financial responsibilities and establishing payment plans when necessary
• Comfortable using email and interacting various applications

Benefits

• Three Medical Plans Options (your choice of a PPO or HDHP)
• Dental and Vision Coverage
• Health Savings Account (with HDHP)
• Employee Assistance Program
• Company Provided Basic Life, AD&D and Long-Term Disability
• Voluntary Life and Short-Term Disability
• PTO Accrual
• Paid Holidays
• 401(k) + employer match

Company Overview