Medical Billing Specialist - Orthopedic Care
About The Position
Icon Health is a leading provider of value-based musculoskeletal (MSK) care, collaborating with payers and providers to enhance outcomes and experience for individuals. The company partners with health plans and risk-bearing providers to assume accountability for reduced total cost of care. By combining technology-enabled MSK providers with proactive care coordination and decision support services, Icon Health delivers multidisciplinary, evidence-based care. We founded Icon Health on the conviction that every patient should be genuinely delighted with their care experience. By prioritizing patient-centered practices, ensuring clear care goals across the entire clinical team, and placing clinicians at the heart of care delivery, we aim to transform a fragmented system into one that truly serves patients. Our model uses a team-based approach to care, integrating musculoskeletal expertise and primary care to achieve better patient outcomes. At Icon Health, we foster a culture that embraces bold thinking, rapid iteration, and practical problem-solving. We seek team members who relish challenging the status quo and thrive in vertically integrated roles—where ideas can swiftly move from concept to execution without layers of red tape. Above all, we value individuals who are eager to roll up their sleeves, tackle obstacles head-on, and create innovative solutions that improve the lives of our patients and our clinical partners. We are seeking a highly organized and detail-oriented Medical Billing Specialist with deep expertise with claim submission, copays, payment posting, insurance guidelines, and revenue cycle workflows that ensure we are reimbursed accurately and on time.
Requirements
- Deep expertise with claim submission, copays, payment posting, insurance guidelines, and revenue cycle workflows.
Nice To Haves
- Degree, certificate, or diploma in medical billing, health information management, or healthcare administration preferred
- Completion of a medical billing training program preferred.
- Certified Professional Biller (CPB) a major plus.
- Exceptional communication skills to interact with patients, healthcare providers, and insurance companies
- Unmatched attention to detail to ensure claims are processed timely and correctly, and that payments are received.
- Ability to manage multiple tasks and prioritize effectively
- Ability to use multiple digital tools for billing, record keeping and patient care directive
Responsibilities
- Ensure that all Reimbursements for medical services or supplies are provided to a qualified beneficiary, medically reasonable and necessary, performed by a qualified practitioner (within the scope of their practice) and coded accurately (procedures and diagnosis) in accordance with the documented medical record.
- Determine the root cause of billing errors and act to prevent any recurrence, retrain on coding practices as needed and review policies and procedures for clarity of expectations and requirements.
- Provide timely overpayment refunds to the payor in compliance with associated federal or state funded healthcare program payor requirements. Continuously enhance skills and knowledge in compliance coding and billing training to minimize potential risk of receiving improper payments.
- Participate in coding reviews and monitoring of coding practices. Regularly participate in internal audits to verify that billing updates have been properly integrated and adhered to across all claims and address discrepancies with corrective actions as needed.
- Stay up-to-date on coding, reimbursement, and regulatory changes to ensure accurate claims, compliance, and efficient revenue management.
- Ensure that collections and accounts receivable (AR) management processes adhere to federal and state regulations, safeguard patient information, and maintain financial integrity
- Maintain and enforce a billing and receivables framework that maintains compliance, ensures accurate reimbursement, protects patient privacy, and optimizes cash flow.
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
Mid Level
Education Level
Associate degree
