Medical Billing and Insurance Recovery Specialist

Orthopaedic Associates Medical Clinic•Visalia, CA

28d

About The Position

The Medical Billing and Insurance Recovery Specialist is responsible for managing all incoming and outgoing payments related to patient care. This role includes communicating with patients regarding outstanding balances, processing payments, and handling all administrative functions related to insurance billing. Key responsibilities include managing patient and insurance accounts, submitting and tracking insurance claims, sending invoices, following up on unpaid balances, resolving billing discrepancies, reconciling accounts, and ensuring accurate data entry for timely cash flow. The position requires strong communication skills, attention to detail, and the ability to analyze financial information to minimize outstanding debt and support the overall financial health of the practice. Seeking an experienced Billing and Insurance Recovery Specialist for a busy orthopedic group.

Requirements

Must have 2 years of full-time experience as a Billing and Insurance Recovery Specialist.
Must be knowledgeable in medical codes to determine how much is owed and whether any outside insurance covers part or all of their balance.
Knowledge of HCPCS coding system.
Must have knowledge of ICD-10 and CPT Coding.
Familiar with local insurance payers a plus and knowledgeable as far as what different insurance companies require when billing/submitting claims.
Knowledgeable in workman's compensation claims required
Knowledge of Medicare insurance guidelines, requirements, and systems.
Knowledge of EOB breakdowns for accurate postings.
Knowledge of payment and adjustment posting.
Effective communication abilities for phone contacts with insurance payers to resolve issues.
Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
A calm manner and patience working with insurers, peers, and others.
Knowledge of medical terminology likely to be encountered in medical claims.
Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act (HIPAA).
Must have experience obtaining prior authorizations and knowledge of processes.
Very strong verbal and written communication skills
Must have excellent grammar and spelling
Willingness to learn and show initiative at all times
A calm manner and patience working with insurers, peers, and others.
Competent use of computer systems
Strong patient service and interpersonal skills as we are high on customer service
Excellent organizational and time management skills
Excellent work ethics and ability to treat documents with confidentiality
Ability to work well in a team environment while being able to prioritize, accept feedback, and manage conflict in a reasonable fashion
Ability to multi-task efficiently in a fast-paced environment
Have experience with medical terminologies, diagnostic procedures
Strong communication and customer service skills
Ability to learn quickly and work under pressure in a fast-paced environment
High school graduate or equivalent
Minimum two years full-time clinical experience in a healthcare facility in billing and insurance recovery required.

Nice To Haves

Orthopedic (and Spine), Podiatry, and Surgery billing experience a "big" plus.
DME experience a plus
Bilingual a plus and orthopedic experience a big plus (but not required)

Responsibilities

Managing patient and insurance accounts
Submitting and tracking insurance claims
Sending invoices
Following up on unpaid balances
Resolving billing discrepancies
Reconciling accounts
Ensuring accurate data entry for timely cash flow
Phone contacts with insurance payers to resolve issues
Interacting with patients regarding medical claims and payments
Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act (HIPAA).
Obtaining prior authorizations and knowledge of processes
Other duties as assigned