Reimbursement Specialist

Reimbursement Specialist – LiabilityA 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 guidanceTracking and following up on outstanding liability claims to ensure timely paymentMaintaining thorough documentation of account activity for compliance and tracking purposesReviewing and reconciling account balances, ensuring accuracy based on fee schedules and agreementsCompiling and submitting required documentation to support claim processingInvestigating claim denials and coordinating appeals with appropriate supporting informationExplaining billing statements and insurance coverage details in a professional and understandable mannerCommunicating with insurance carriers to resolve unpaid or delayed claimsSupporting additional tasks and projects as neededQualifications include:Minimum of 3 years of primary liability accounts receivable or collections experienceExperience working with major liability payors (e.g., auto insurance carriers)Strong understanding of revenue cycle processes, preferably within orthopedics or related specialtiesKnowledge of medical billing components such as procedures, modifiers, and claim requirementsExperience negotiating with attorneys or legal representativesFamiliarity with practice management systems (Athena experience preferred but not required)High school diploma or GED requiredAdditional 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 officeDedicated work-from-home setup requiredProfessional attire expected during onsite workPerks include:Flexible start times for improved work-life balanceHybrid work model with remote flexibilityOpportunity to work in a fast-paced, collaborative environmentExposure to complex liability claims and advanced revenue cycle processesCareer growth potential within a specialized healthcare settingAddison 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.