Orthotics & Prosthetics Billing Specialist

Shriners Hospitals for Children•Tampa, FL

20h

About The Position

Shriners Children’s is seeking an Orthotics & Prosthetics (O&P) Billing Specialist to join their team. This role is responsible for the comprehensive billing process for O&P services, including processing Explanation of Benefits (EOBs), statements, and payments. The specialist will reconcile payments, follow up on outstanding claims, initiate tracers, and resubmit claims as needed. They will also assist with appeals processing and research/respond to patient and payer inquiries regarding billing issues. Understanding of O&P billing technology applications is essential. The position involves working with other departments to ensure the accuracy of the Billing Tool through periodic audits and maintaining strict confidentiality of patient and financial records. Collaboration with management, executives, hospitals, staff, and leadership is key to ensuring effective and compliant O&P billing. This role requires flexibility to perform various tasks and projects as directed by the National Director of Orthotics & Prosthetics.

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.
Receives 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.
Assists with the development of organization procedures and update of forms and manuals pertaining to billing of O&P devices.
May assist in preparing documentation and responses for legal inquiries 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.
Demonstrates flexibility to perform job functions, tasks and projects in an evolving organizational landscape at the direction of the National Director of Orthotics & Prosthetics.