Medical Billing Specialist

Ortho Sport and Spine Physicians•Atlanta, GA

69d•Onsite

About The Position

Medical Billing Specialist Location: Atlanta, GA 30327 | Full-Time | In-Person Join Our Team at Ortho Sport & Spine Physicians Ortho Sport & Spine Physicians is seeking an experienced and detail-oriented Medical Billing Specialist to join our growing Revenue Cycle team. In this role, you will help ensure claims are submitted accurately and timely, follow up on outstanding accounts, resolve claim rejections and denials, and work with insurance carriers to support appropriate reimbursement. We are looking for someone who understands the full medical billing cycle, is comfortable working high-volume accounts, and knows how to identify and resolve issues before they delay payment.

Requirements

Minimum 2+ years of medical billing and/or revenue cycle experience, preferably in a physician practice or specialty healthcare environment.
Strong understanding of the medical billing and claims lifecycle.
Experience with insurance claim submission, follow-up, denials, rejections, and accounts receivable.
Knowledge of commercial insurance, Medicare, Medicaid, and payer-specific billing requirements.
Familiarity with CPT, ICD-10-CM, HCPCS, and modifiers as they relate to claim submission and reimbursement.
Ability to read and interpret EOBs and ERAs.
Strong attention to detail and ability to identify billing discrepancies.
Excellent organizational, analytical, and problem-solving skills.
Ability to independently manage a high-volume workload while meeting productivity expectations.
Strong written and verbal communication skills.

Nice To Haves

Previous experience in orthopedics, spine, pain management, or another procedural specialty.
Experience with eClinicalWorks (eCW).
Experience with denial management, appeals, and insurance accounts receivable.
Familiarity with claim scrubbers, clearinghouses, and electronic claim submission.
Experience working within a high-volume, multi-location healthcare organization.

Responsibilities

Submit clean and accurate claims to commercial insurance carriers, Medicare, Medicaid, and other payers.
Review claims for accuracy and completeness prior to submission.
Work claim scrubber edits, rejected claims, and outstanding encounters.
Follow up on unpaid, underpaid, and denied claims.
Research denial reasons and take appropriate action to obtain reimbursement.
Correct and resubmit claims when necessary.
Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs).
Work insurance accounts receivable and follow up on aging claims.
Identify payer-specific billing requirements and ensure claims meet submission guidelines.
Verify that appropriate documentation and coding information are present to support billing.
Communicate with insurance companies regarding claim status, payment discrepancies, denials, and appeals.
Assist with appeals and reconsiderations when appropriate.
Maintain accurate notes and documentation within patient accounts.
Identify recurring denial or payment trends and escalate issues appropriately.
Collaborate with coding, clinical, authorization, and other Revenue Cycle teams to resolve billing issues.
Help improve clean claim rates, reduce denials, and decrease accounts receivable aging.
Maintain compliance with HIPAA and all applicable federal, state, payer, and organizational requirements.