Job Description

Position Overview: 

Our Billing Specialists are responsible for answering patient inquiries, reviewing outstanding or denied insurance claims, submitting insurance appeals, and maintaining assigned accounts receivables per clinic policies.

Essential Duties & Responsibilities: 

• Assist in the processing of insurance claims including worker’s compensation (if assigned) for all financial classes 

• Communicate with insurance companies to ensure that claims are paid; identify and correct account and/or insurance error; and post all actions and maintain permanent record of patient accounts 

• Oversee claims appeals and reviews; review claims aging status and follow up on open claims 

• Answer patient questions, inquiries, and concerns regarding their accounts; verify balances and refunds for accuracy 

• Understand, and stay up to date with, clinic and insurance industry contract policies/ procedures and medical terminology

• Participate in professional development efforts to stay current with health care best practices and trends 

• Actively participate in the company’s efforts to create innovative data and analytics solutions for the modern orthopedic business office 

• Other duties as assigned

Required Skills: 

• High school diploma or equivalent, college courses or certificate preferred 

• Excellent communication skills, especially phone skills, that encourage the establishment and maintenance of cooperative, positive relationships with both internal and external stakeholders (patients, physicians, colleagues, etc.)

• Ability to efficiently gather, organize, and comprehend insurance information, including contracted fee schedules 

• Proficient computer skills with a demonstrated ability to navigate and comprehend computer software systems in an office setting, prefer 50wpm typing skill 

• Knowledge of, or a demonstrated capacity to learn, insurance industry practices and medical terminology in a clinic setting 

• Strong analytical skills and a demonstrated desire to be part of building innovative solutions that challenge the status quo 

• Ability to learn quickly and contribute ideas that make the team, processes, and solutions better 

• Share our values: resilience, altruism, communication, achievement, and determination 

Preferred Skills: 

• Two years of billing experience in a hospital and/or surgical setting 

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