Medical Biller – Orthopedic

This is a fully remote position, open to applicants in United States.

📋 Description

• Manage prior authorizations for surgical procedures.

• Confirm patient eligibility and insurance benefits.

• Process claims and ensure the submission of clean claims.

• Address denials and manage accounts receivable.

• Record payments accurately.

• Secure authorization approval prior to surgical procedures.

• Resolve issues with denied or unpaid claims.

• Provide support to a single-provider orthopedic spine surgery practice.

• Independently oversee multiple patient accounts.

• Communicate with payers and patients via telephone.

⛳️ Requirements

• Minimum of 2 years of experience in U.S. healthcare insurance.

• Practical medical billing experience in an orthopedic or spine surgery setting, including prior authorizations for surgical cases.

• Knowledge of commercial insurance and government health plans.

• Proficiency in using payer portals and insurance websites.

• Strong verbal and written English skills, including the ability to engage with payers and patients over the phone.

• Exceptional attention to detail and follow-up abilities.

• Capable of working independently and managing multiple patient accounts.

• Reliable internet connection and a suitable remote working environment.

• Must be available during business hours in Eastern Time.

• Preferred: Experience in supporting spine surgery, orthopedic surgery, or pain management practices.

• Preferred: Experience with surgical prior authorizations through delegated review vendors like Carelon or eviCore.

• Preferred: Familiarity with workers' compensation billing and authorization processes.

• Preferred: Knowledge of surgical global periods, modifiers, and add-on codes relevant to spine procedures.

• Preferred: Understanding of Georgia insurance plans, including Medicare (Palmetto GBA), Georgia Medicaid and CMOs, and TRICARE East.

• Preferred: Eagerness to learn a new EHR and practice management system.

🏝️ Benefits

• Part-time position for 90 days, approximately 20 hours per week (4 hours per day), with the potential to transition to full-time thereafter.

• Flexible remote work arrangement.

• Opportunity to gain experience with a new EHR and practice management system.