Reimbursement Specialist

Reimbursement Specialist – Liability

A well-established healthcare organization specializing in orthopedic and specialty medical services. The team is dedicated to delivering exceptional patient care while maintaining efficient and accurate revenue cycle operations.

The Reimbursement Specialist is responsible for managing liability accounts receivable, including working with attorneys and insurance carriers to resolve claims efficiently. This role requires strong analytical skills, persistence in follow-ups, and the ability to clearly communicate billing information. The position offers a hybrid work arrangement with occasional in-office responsibilities.

Key responsibilities include:

• Responding to incoming calls from patients, attorneys, and insurance representatives, providing clear account guidance
• Tracking and following up on outstanding liability claims to ensure timely payment
• Maintaining thorough documentation of account activity for compliance and tracking purposes
• Reviewing and reconciling account balances, ensuring accuracy based on fee schedules and agreements
• Compiling and submitting required documentation to support claim processing
• Investigating claim denials and coordinating appeals with appropriate supporting information
• Explaining billing statements and insurance coverage details in a professional and understandable manner
• Communicating with insurance carriers to resolve unpaid or delayed claims
• Supporting additional tasks and projects as needed

Qualifications include:

• Minimum of 3 years of primary liability accounts receivable or collections experience
• Experience working with major liability payors (e.g., auto insurance carriers)
• Strong understanding of revenue cycle processes, preferably within orthopedics or related specialties
• Knowledge of medical billing components such as procedures, modifiers, and claim requirements
• Experience negotiating with attorneys or legal representatives
• Familiarity with practice management systems (Athena experience preferred but not required)
• High school diploma or GED required

Additional details include:

• Onsite training required for approximately 2–3 weeks (based on individual progress)
• Hybrid role with occasional in-office requirements (approximately twice per month or as needed)
• Candidates must reside within a reasonable commuting distance to the office
• Dedicated work-from-home setup required
• Professional attire expected during onsite work

Perks include:

• Flexible start times for improved work-life balance
• Hybrid work model with remote flexibility
• Opportunity to work in a fast-paced, collaborative environment
• Exposure to complex liability claims and advanced revenue cycle processes
• Career growth potential within a specialized healthcare setting

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.