Medical Billing Accounts Receivable Specialist

Benefits:

401(k)

401(k) matching

Dental insurance

Health insurance

Paid time off

Vision insurance

Position Summary

We are seeking a skilled Medical Billing Accounts Receivable (A/R) Specialist with hands-on experience in AdvancedMD and a solid background in A/R. This role focuses on ensuring accurate reimbursement by managing outstanding claims, resolving denials, working insurance aging reports, and maintaining healthy revenue cycle performance. The ideal candidate is proactive, analytical, and highly familiar with Orthopedic Spine Surgery payer requirements.

Key Responsibilities

Manage and work daily insurance A/R aging reports within AdvancedMD, prioritizing timely claim resolution.

Investigate and resolve unpaid, underpaid, or denied orthopedic claims quickly and accurately.

Correct and resubmit claims with updated coding, modifiers, or documentation as needed.

Conduct follow-ups with insurance carriers via portals, phone, or clearinghouse to ensure payment.

Analyze denial trends and escalate recurring issues to management.

Post adjustments and ensure accurate account reconciliation in AdvancedMD.

Prepare appeals with appropriate documentation for orthopedic procedures.

Communicate with patients regarding claim status and outstanding balances as needed.

Maintain up-to-date knowledge of orthopedic-specific coding, payer policies, and industry regulations (HIPAA, CMS, Workers’ Compensation guidelines).

Qualifications

2+ years of A/R experience in medical billing, preferably within an Orthopedic practice.

AdvancedMD experience is preferred (billing, claim tracking, reporting, and A/R workflows).

Strong understanding of insurance follow-up, denial management, and appeals.

Knowledge of ICD-10, CPT, HCPCS, and orthopedic coding concepts.

Familiarity with commercial insurance, Medicare, Medicaid, Workers’ Compensation, and auto accident claims.

Excellent problem-solving, documentation, and communication skills.

Ability to work independently, prioritize tasks, and meet aging and productivity targets.

Billing or coding certification (CPC, CRC, CBCS, etc.) is a plus but not mandatory.