Medical Billing Specialist

Monarch Medical Management•Metairie, LA

3d•Onsite

About The Position

Monarch Medical Management, a multispecialty medical management organization, is seeking an experienced Medical Billing Specialist with strong expertise in orthopedics, neurology, pain management, physical therapy, and chiropractic services. This role is essential to ensuring accurate charge capture, clean claim submission, denial resolution, and overall revenue integrity. We’re looking for someone detail‑driven, proactive, and highly knowledgeable in CPT, ICD‑10, HCPCS, payer rules, and documentation requirements.

Requirements

CPC or CCS certification required.
3–5 years of billing and/or coding experience in orthopedics, neurology, pain management, PT, or chiropractic services.
Proficiency with EHR and medical billing software.
Strong analytical skills, attention to detail, and effective communication.

Responsibilities

Review daily charges for accuracy, completeness, and supporting clinical documentation.
Validate CPT, ICD‑10, HCPCS, modifiers, units, laterality, and provider documentation requirements.
Submit clean claims for: Orthopedic evaluations and procedures, Physical therapy services, Chiropractic services, Interventional pain injections and procedures, Neurology office visits, diagnostics, and procedures.
Ensure claims meet payer‑specific billing rules, medical necessity edits, and authorization requirements.
Identify missing documentation prior to claim submission.
Review operative reports, procedure notes, therapy notes, chiropractic treatment plans, and neurology diagnostic documentation.
Interpret surgical and procedure terminology to ensure accurate charge capture.
Review injection reports, fluoroscopy guidance, nerve blocks, EMG/NCV, EEG, and other specialty diagnostics.
Confirm documentation supports billed levels of service and procedural coding.
Communicate documentation deficiencies to providers, MAs, therapists, and clinic leadership.
Work denied, rejected, and underpaid claims promptly.
Investigate denial causes including coding errors, authorization issues, medical necessity, timely filing, COB, bundling edits, and documentation gaps.
Prepare appeals with supporting medical records and operative notes.
Track payer trends and escalate recurring denial patterns.
Maintain assigned AR buckets within company expectations.
Review EOBs/ERAs for payment accuracy.
Identify underpayments, payer discrepancies, and contractual variances.
Assist with credit balances and refund review.
Ensure correct allocation of payments by specialty and rendering provider.
Support leadership in identifying revenue leakage opportunities.
Assist with month‑end close and unresolved aging review.
Work closely with Providers, Clinical teams, Front desk, Authorization department, Workers’ compensation teams, Medical records, Call center, Revenue cycle leadership.
Communicate payer updates, documentation requirements, and support workflow improvements that increase clean claim rates.