Billing Specialist

GEORGIA SPINE & ORTHOPAEDICS•Roswell, GA

10d

About The Position

Georgia Spine & Orthopaedics is a comprehensive spine and orthopedics care provider in Georgia, with locations in Atlanta, Columbus, Gwinnett, Marietta, Tucker, Stockbridge, Roswell, and the Surgery Center of Roswell. The organization provides cutting-edge treatment with a conservative approach and describes its team as friendly and ambitious, focused on exceptional patient care and working well together. The Workers' Compensation Billing Specialist helps optimize revenue recognition across the organization. Under the direction and supervision of the Billing Manager, the specialist works with the Workers' Compensation Coordinator, Intake/Front Office, and Care Coordinators to ensure Workers' Compensation data is complete and accurate. The role reviews and scrubs revenue-cycle data so charges are billed correctly and promptly, alerts the Billing Manager to trends in pended or denied claims and other reimbursement issues, and challenges inaccurate payments or denials.

Requirements

Demonstrated understanding of healthcare billing specific to Workers' Compensation.
Familiarity with ICD-10 and CPT coding and Workers' Compensation fee schedules.
Ability to understand Workers' Compensation rules, regulations, and required forms, including pre-certification, prior authorization, and requests to change or add a provider of care.
Ability to review charge, demographic, and financial data for completeness and accuracy.
Demonstrated ability to post charges, payments, and write-offs.
Ability to collaborate with Workers' Compensation case managers, attorneys, insurance adjusters, and employer groups to support client satisfaction and revenue capture.
Ability to review and challenge payment reductions or denials.
Collaboration, teamwork, and problem-solving skills.
Written and verbal communication and listening skills.
Ability to provide excellent customer service.
Integrity and trustworthiness in handling confidential information.
Develop skills under the office manager's direction to provide constructive staff feedback and corrective action when necessary.
Develop skills to hold staff accountable to expectations.

Responsibilities

Ensure patient and payment information is accurate, complete, and entered into the software systems promptly.
Enter charge data daily.
Notify the appropriate team about missing or incomplete data that needs correction.
File invoices or claims as directed by the Billing Manager.
Monitor invoices and claims for timely payment or notice of denial.
Enter payments and record write-offs according to company policy for each payer.
Challenge payments that do not comply with company agreements or contracts.
Serve as a point of reference for coding, billing, pricing, and payment issues.
Cross-train to cover appropriate roles during staffing shortages.
Prepare daily, weekly, and monthly reports as requested by the leadership team.
Coordinate with the Central Business Office Team and other areas of the company.
Assist medical providers with issues and projects as needed.
Help maintain a positive work environment.
Answer incoming office calls regarding revenue-cycle issues as required.
Perform other duties as requested.
Learn the listed duties and responsibilities, which may then be delegated to the assistant office manager at the office manager's discretion.