Billing Specialist - Outpatient
About The Position
We are seeking a detail-oriented and experienced Biller to join our Ambulatory Surgery Center (ASC) team. The ideal candidate has strong knowledge of orthopedic coding, ASC-specific billing practices, and payer regulations. Duties and Responsibilities Demonstrate our core values of being patient centered, team focused, service driven, accountable, and innovative every day. Accurately review and abstract information from operative and clinical documentation to assign appropriate diagnosis and procedure codes for surgical cases. Ensure coding and billing practices comply with CMS guidelines, payer policies, and ASC-specific coding regulations. Manage billing functions for surgical procedures, including claim creation, submission, and follow-up for payment resolution. Communicate with providers and team members to clarify documentation and ensure code accuracy. Monitor and respond to coding-related denials, rejections, and edits; assist with appeals and identify areas for process improvement. Collaborate with the billing team and other departments to resolve discrepancies and optimize revenue cycle performance. Participate in internal audits, meet coding accuracy benchmarks, and stay current with coding regulations, payer updates, and orthopedic-specific policies. Answer incoming phone calls regarding billing and coding inquiries from patients, providers, team members, and external vendors, delivering clear, courteous, and professional assistance. Evolve in your role when performing supplemental responsibilities as assigned.
Requirements
- High School diploma or GED required; Associate degree preferred.
- Minimum of 1 year of experience in medical billing, preferably in an orthopedic or ASC setting.
- Familiarity with EHR/EMR systems and coding software; experience with SIS or Waystar is a plus.
- Strong knowledge of medical terminology related to orthopedics, physical therapy, and podiatry preferred.
- Excellent communication, organizational, and analytical skills.
- Ability to work independently while contributing to a collaborative team environment.
- Computer skills required with minimum proficiency in Microsoft Word, Excel, Outlook, and Teams.
Nice To Haves
- Associate degree preferred.
- Familiarity with EHR/EMR systems and coding software; experience with SIS or Waystar is a plus.
- Strong knowledge of medical terminology related to orthopedics, physical therapy, and podiatry preferred.
Responsibilities
- Accurately review and abstract information from operative and clinical documentation to assign appropriate diagnosis and procedure codes for surgical cases.
- Ensure coding and billing practices comply with CMS guidelines, payer policies, and ASC-specific coding regulations.
- Manage billing functions for surgical procedures, including claim creation, submission, and follow-up for payment resolution.
- Communicate with providers and team members to clarify documentation and ensure code accuracy.
- Monitor and respond to coding-related denials, rejections, and edits; assist with appeals and identify areas for process improvement.
- Collaborate with the billing team and other departments to resolve discrepancies and optimize revenue cycle performance.
- Participate in internal audits, meet coding accuracy benchmarks, and stay current with coding regulations, payer updates, and orthopedic-specific policies.
- Answer incoming phone calls regarding billing and coding inquiries from patients, providers, team members, and external vendors, delivering clear, courteous, and professional assistance.
- Evolve in your role when performing supplemental responsibilities as assigned.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
101-250 employees
