Billing & Collections Specialist
About The Position
Union County Orthopaedic Group, a division of OrthoNJ, LLC, is a fast-paced, patient-centered practice specializing in orthopaedics, pain management, and podiatry across three convenient New Jersey locations. We are looking for a detail-oriented, experienced Billing & Collections Specialist to join our billing team and play a key role in the financial health of our practice. The Billing & Collections Specialist is responsible for the timely follow-up of rejected claims, unpaid insurance balances, and patient accounts receivable. This role requires a strong understanding of the revenue cycle in a physician group practice setting, the ability to build productive relationships with commercial payors, and a commitment to accuracy, confidentiality, and professionalism.
Requirements
- Minimum 2 years of revenue cycle experience in a physician group practice billing department — required
- Orthopaedic billing experience — required
- Commercial insurance billing experience (e.g., BCBS, Aetna, Cigna, UHC) — required
- Familiarity with CPT and ICD-10-CM coding for orthopaedic, podiatry, and pain management procedures
- Working knowledge of practice management systems and electronic medical records (ModMed/EMA experience a plus)
- Strong analytical skills with exceptional attention to detail
- Excellent verbal and written communication skills
- Knowledge of HIPAA and OSHA guidelines
- HS diploma or GED required
Nice To Haves
- Bilingual (English/Spanish) a plus — our patient population includes Spanish-speaking patients and the ability to communicate in both languages is highly valued
- Ability to work collaboratively with physicians, clinical staff, patients, and insurance representatives
Responsibilities
- Follow up on rejected and unpaid insurance claims using EOB forms, aged A/R reports, and payor portals; initiate follow-up on claims 45+ days outstanding
- Reprocess paper and electronic claims for assigned carriers; review and resolve clearinghouse edit reports daily
- Post adjustments, withholds, deductibles, and coinsurance transfers; submit balanced payment batches daily
- Appeal payments that do not align with contractual agreements; partner with the Billing Manager on persistent payor issues and denial language
- Manage patient accounts, including payment plan setup, statement processing, collection letter generation, and outside agency referrals
- Respond to written and phone inquiries from patients and insurance carriers with professionalism and accuracy
- Verify patient eligibility and benefits; ensure all account information is current and accurate
- Monitor monthly payor policy/guideline updates and report relevant changes to the Billing Manager
- Scan and document all correspondence, appeals, and actions taken in the practice management system
- Process requests for insurance and patient refunds, submitting to the Billing Manager for approval
- Support the team with payment posting (including in-absence coverage) and general billing office functions
Benefits
- full-time employees are eligible for standard benefits package including paid time off, medical, dental, vison and retirement plan
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
11-50 employees
