Orthopedic Medical Biller & A/R Specialist

Job Description

Job Description

Position Title : Medical Biller and Accounts Receivable Specialist
Location : Rocky Hill, CT
Type: Full-time, In-house

About Us :
Orthopedic Surgical Partners is a premier healthcare group dedicated to delivering exceptional orthopedic care. Our mission is to provide the highest standards of quality and efficiency, ensuring the best possible outcomes for our patients. We are committed to excellence in all areas of patient care and are seeking an enthusiastic and detail-oriented Medical Biller and AR Specialist to join our team.

Position Overview :
We are seeking a highly motivated Medical Biller and Accounts Receivable Self-Pay Specialist with a proactive, solutions-oriented approach to support and optimize our billing and self-pay accounts receivable operations. The ideal candidate will have 2 or more years of experience in medical billing and will be responsible for ensuring accurate billing, follow-up on unpaid claims, EFT payment posting, mail and patient payment posting, and more. You will play a key role in maintaining effective communication with insurance companies, patients, and healthcare providers. A positive, professional demeanor and strong multitasking abilities are essential for success in this role.

Key Responsibilities :

• Accurately post payments and charges into the billing system.
• Follow up on unpaid claims, resolve discrepancies, and ensure timely reimbursement from insurance companies.
• Communicate with insurance carriers, patients, and healthcare providers to address billing inquiries and concerns.
• Prepare and submit appeals to insurance carriers for disputed claims.
• Obtain pre-authorization for medical procedures as required.
• Interpret Explanation of Benefits (EOBs) and adjudication codes to ensure proper billing.
• Set up and manage payment plans for patients as needed.
• Maintain accurate records in compliance with healthcare and insurance guidelines.
• Ensure compliance with insurance billing practices and relevant regulations.

Qualifications :

• Minimum of 1-2 years of experience in medical billing.
• Proficient in medical billing software and computer systems.
• Knowledge of medical codes: ICD-10-CM, CPT, and HCPCS.
• Strong understanding of insurance billing guidelines and practices.
• Excellent verbal and written communication skills.
• Ability to prioritize, multitask, and manage a high-volume workload.
• Experience in writing appeals to insurance carriers is preferred.
• Friendly, professional demeanor with strong customer service skills.

Education :

• High school diploma or equivalent required.
• Additional certifications in medical billing or coding (CPC) are a plus.

• Health Insurance (Medical, Dental, and Vision coverage)

• 401(k) Retirement Plan

• Paid Time Off (PTO)

We believe that every member of our team plays a vital role in providing the highest quality care to our patients. If you are a dedicated and detail-oriented professional looking to make an impact in the orthopedic healthcare field, we encourage you to apply!