Orthotics & Prosthetics Billing Specialist

Shriners Children's•Tampa, FL

About The Position

The Orthotics & Prosthetics Billing Specialist is responsible for Orthotics & Prosthetics (O&P) billing, processing of EOB's, processing statements, posting of payments (including batch payments), reconciling of payments to the appropriate ledgers, following up on submitted claims, monitoring unpaid claims, initiating tracers, resubmitting claims as necessary, and assisting with appeals processing. This position is also responsible for researching and responding by telephone and in writing to all patient and payer inquiries regarding billing issues and problems, as well as understanding any technology applications utilized for O&P Billing. The person in this role will be responsible for working in conjunction with other departments to ensure the accuracy of the Billing Tool through periodic audits.

Requirements

3 yrs of healthcare billing, claims and insurance experience
Knowledge of insurance EOB’s
Experience interacting with patients and providers via phone and email in a courteous and professional manner
Strong oral and written communication skills

Nice To Haves

3 yrs of DME or O&P billing insurance experience

Responsibilities

Processes O&P Billing to third party payers and patients; maintaining supporting documentation files.
Processes patient statements, keys data, posts transactions, and verifies accuracy of input to reports generated.
Researches and responds to all patient and/or payer inquiries regarding O&P billing issues and problems. Refers all patient related issues and concerns to the office that patient was seen and (when necessary) to the practitioner who provided the care.
Follows up on all submitted claims, monitors unpaid claims, initiates tracers, and resubmits claims, as needed.
Will receive third party reimbursements and will post and reconcile payments to patient accounts.
Balance daily batch payments and reports.
Maintains payer and patient demographic information and data collection.
Under the direction of the O&P Billing Supervisor and Director of O&P will assist with the development of organization procedures and update of forms and manuals pertaining to billing of O&P devices.
May assist (pending detailed direction of Legal and the O&P Billing Supervisor) in preparing documentation and responses for legal inquires and litigation.
Ensures strict confidentiality of patient and financial records according to all SHC Policies and Procedures.
Work collaboratively and closely with management, executives, hospitals, staff and leadership to ensure effective and compliant O&P Billing.
This position will be responsible for the tasks outlined above with the understanding that the position must demonstrate flexibility to perform job functions, tasks and projects in an evolving organizational landscape at the direction of the National Director of Orthotics & Prosthetics.