Out of Network Front,MA,Billing Coordinators

Job Description

Job Description

Full-Time Front Desk Coordinator – Orthopedic & Sports Medicine Practice
Location: Nutley, NJ
Schedule: Full-Time

Orthopaedic & Sports Medicine Institute is seeking an experienced, organized, and patient-focused Full-Time Front Desk Coordinator to join our growing orthopedic practice.

This is a fast-paced position requiring excellent communication, attention to detail, professionalism, and the ability to manage multiple responsibilities throughout the day.

Responsibilities include:

• Answer and manage incoming patient phone calls
• Schedule new patient, follow-up, post-operative, injection, and other appointments
• Confirm upcoming appointments
• Schedule follow-up appointments and coordinate patient care
• Process and register new patients
• Obtain and verify patient demographics and insurance information
• Verify insurance eligibility and benefits, including out-of-network benefits
• Communicate patient financial responsibility when appropriate
• Monitor and process incoming faxes
• Obtain medical records, imaging reports, and other documentation needed for appointments
• Collect and accurately process patient payments
• Maintain accurate payment documentation
• Prepare superbills for upcoming patient visits
• Assist with daily chart preparation
• Maintain accurate information within the practice management/EHR system
• Communicate effectively with the Medical Assistant, Billing Department, providers, and management
• Assist with additional administrative duties as needed

Preferred Qualifications:

• Previous medical front desk experience strongly preferred
• Orthopedic or specialty practice experience is a plus
• Experience verifying out-of-network insurance benefits strongly preferred
• Knowledge of insurance terminology including deductibles, coinsurance, copays, eligibility, and patient responsibility
• Experience with EHR/practice management systems; ModMed/EMA experience is a plus
• Excellent phone etiquette and customer service skills
• Strong organizational and multitasking abilities
• High attention to detail
• Dependable, punctual, and able to work effectively in a fast-paced environment

We are looking for someone who takes ownership of their responsibilities, communicates well with patients and coworkers, and understands that accurate front-end processes are essential to both patient care and the revenue cycle.

Job Type: Full-Time
Work Location: In Person – Nutley, NJ

Full-Time Medical Assistant – Orthopedic & Sports Medicine Practice
Primary Location: Nutley, NJ
Satellite Location: Somerset, NJ – Approximately 1–2 Times Per Month
Schedule: Full-Time

Orthopaedic & Sports Medicine Institute is seeking an experienced and highly organized Full-Time Medical Assistant to work directly with our orthopedic physician and support both clinical and administrative operations.

The ideal candidate is comfortable working in a fast-paced orthopedic environment and understands the importance of complete documentation, efficient patient flow, and communication between the clinical, front desk, and billing teams.

Clinical Responsibilities:

• Room patients and prepare them for examination by the physician
• Obtain and document patient histories and visit information
• Perform patient intake and accurately update the medical record
• Assist the physician during examinations and procedures
• Respond to patient questions regarding their clinical treatment and coordinate questions requiring provider review
• Obtain outside imaging, imaging reports, medical records, and other clinical documentation
• Ensure necessary imaging and documentation are available for the physician before and during patient visits
• Process physician orders and prescriptions for:

• • MRI
  • CT scans
  • Physical therapy
  • Diagnostic testing
  • Other ordered services
• Coordinate follow-up care and clinical instructions
• Upload and properly organize clinical notes, reports, imaging documentation, and other patient records
• Ensure documentation related to the patient’s visit is complete
• Process superbills following patient visits
• Ensure completed superbills and required documentation are sent to the billing team for claim processing
• Assist with injections, procedures, and other orthopedic clinical services as appropriate
• Maintain examination rooms and clinical supplies

Administrative/Cross -Coverage Responsibilities:

On days when the physician is not seeing patients in the office, the Medical Assistant will assist the Front Desk and administrative team as needed, including:

• Answering phones
• Scheduling patients
• Obtaining records and imaging
• Processing patient documentation
• Assisting with chart preparation
• Supporting other office workflows

Travel Requirement:

The Medical Assistant must be willing and able to travel to our Somerset, NJ satellite location approximately 1–2 times per month .

Preferred Qualifications:

• Previous Medical Assistant experience required
• Orthopedic or musculoskeletal experience strongly preferred
• Experience working directly with physicians in a specialty practice preferred
• Knowledge of MRI, CT, PT, and other orthopedic orders
• Experience obtaining outside imaging and medical records
• Familiarity with EHR systems; ModMed/EMA experience is a plus
• Strong clinical documentation skills
• Excellent patient communication skills
• Ability to multitask and maintain organization in a high-volume environment
• Comfortable performing both clinical and administrative responsibilities
• Dependable, punctual, professional, and team-oriented

Job Type: Full-Time
Primary Work Location: Nutley, NJ
Travel: Somerset, NJ approximately 1–2 times monthly

Revenue Cycle Coordinator – Out-of-Network Medical Billing
2 Full-Time Positions Available
Location: Nutley, NJ
Schedule: Full-Time

Orthopaedic & Sports Medicine Institute is seeking two experienced Full-Time Revenue Cycle Coordinators with a strong understanding of the complete medical billing and revenue cycle process.

Out-of-Network billing experience is strongly preferred.

These are not entry-level billing positions. Candidates should understand the revenue cycle from charge entry and claim submission through payment posting, appeals, accounts receivable follow-up, patient billing, and reconciliation.

Responsibilities include:

• Review documentation and superbills for billing accuracy and completeness
• Perform charge entry
• Review coding and identify potential billing discrepancies
• Prepare, scrub, and submit clean claims
• Review claim rejections and correct and resubmit claims
• Monitor claims through adjudication
• Perform insurance accounts receivable follow-up
• Work unpaid, underpaid, denied, and incorrectly processed claims
• Submit medical records and supporting documentation to insurance carriers
• Prepare and submit claim reconsiderations and appeals
• Appeal underpaid out-of-network claims to pursue appropriate/maximized allowed amounts
• Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs)
• Post insurance and patient payments accurately
• Identify contractual, adjustment, posting, and payment discrepancies
• Reconcile payments and deposits
• Generate and send patient statements
• Communicate with patients regarding balances
• Establish and maintain approved patient payment plans
• Document all billing and collection activity accurately
• Follow claims through the entire revenue cycle until appropriately resolved
• Maintain organized A/R follow-up and identify accounts requiring escalation
• Assist management with reporting and reconciliation of billing activity

Candidates should have working knowledge of:

• Out-of-Network (OON) Billing
• Commercial Insurance
• Motor Vehicle Accident (MVA) Claims
• Personal Injury Protection (PIP)
• Letters of Protection (LOP)
• BMI/Student Athlete Insurance
• No Surprises Act (NSA)
• Claim submission and clearinghouse workflows
• Charge entry
• Claim corrections and resubmissions
• Denial management
• Appeals and reconsiderations
• Medical record submissions
• Out-of-network reimbursement
• Accounts Receivable (A/R)
• Patient statements and balances
• Payment plans
• Payment posting
• ERA/EOB review
• Reconciliation

Preferred Qualifications:

• Prior medical billing/revenue cycle experience required
• Out-of-network billing experience strongly preferred
• Orthopedic or surgical billing experience is a major plus
• Strong understanding of the complete revenue cycle
• Experience handling denials, underpayments, appeals, and A/R
• Familiarity with commercial, MVA, PIP, LOP, BMI, and NSA claims
• Experience with EHR/practice management and clearinghouse systems
• ModMed/EMA and TriZetto experience is a plus
• Strong analytical and problem-solving skills
• Excellent attention to detail
• Ability to independently manage assigned A/R and follow claims through resolution
• Strong written and verbal communication skills

We are specifically looking for individuals who understand that revenue cycle management does not end when a claim is submitted. The successful candidate will take ownership of accounts from charge entry through final payment and reconciliation .

Job Type: Full-Time
Number of Positions: 2
Work Location: In Person – Nutley, NJ