Medical Billing and Collections Specialist Premier Orthopaedics & Sports Medicine - 1.0 Teaneck, NJ Job Details Full-time $24.84 - $29.91 an hour 1 day ago Benefits Health savings account Health insurance Dental insurance Paid time off Employee assistance program Vision insurance 401(k) matching Qualifications Appeals Record keeping Spanish Customer communication Medicare Medical insurance coverage verification Customer service Regulatory compliance in claims processing Medical coding experience in physician offices Insurance medical billing Electronic health record (EHR) management for billing and coding Problem-solving Medical billing and coding communication with insurance companies Health information regulatory compliance Medical explanation of benefits reviews Patient interaction Health information management Managing patient records Medical terminology Documentation review Patient collections management DRG Full Job Description Job Overview We are seeking a dedicated and detail-oriented Medical Billing and Collections Specialist with a strong background in orthopaedic practice billing and insurance follow-up. The ideal candidate will be responsible for managing accounts receivable, following up on outstanding claims, resolving claim denials, and maximizing reimbursement while ensuring compliance with healthcare regulations and payer guidelines. Duties Review and follow up on unpaid and underpaid insurance claims to ensure timely reimbursement. Investigate, appeal, and resolve claim denials, rejections, and payment discrepancies. Contact commercial insurance carriers, Medicare, Medicaid, Workers' Compensation, personal injury carriers, and patients regarding outstanding balances. Analyze explanation of benefits (EOBs) and electronic remittance advices (ERAs) to identify payment issues. Submit corrected claims, appeals, and supporting documentation as needed. Work collaboratively with physicians, coders, front desk staff, and billing team members to resolve claim issues. Identify billing trends and recurring payer issues and recommend process improvements. Maintain accurate documentation of collection activities and account status within the practice management system. Ensure compliance with HIPAA, payer policies, and federal and state healthcare regulations. Assist in reducing accounts receivable aging and achieving departmental collection goals. Stay current on insurance policies, reimbursement guidelines, and orthopaedic billing requirements. Requirements Proven experience in medical billing, collections, or healthcare claims management within a medical office environment. Strong knowledge of medical terminology, medical coding (CPT, ICD-9, ICD-10), DRG classifications, and healthcare claims processing. Familiarity with billing software platforms, EMR (Electronic Medical Records), and EHR (Electronic Health Records) systems. Excellent customer service skills with the ability to communicate clearly and professionally with patients and insurance representatives. Understanding of health insurance policies, benefits verification, and medical records management. Ability to interpret complex medical documentation accurately while adhering to regulatory standards. Join our team as a Medical Billing and Collections Specialist to play a crucial role in ensuring efficient revenue cycle management while delivering exceptional service to our patients and healthcare partners.

Pay:

$24.84 - $29.91 per hour

Benefits:

401(k) matching Dental insurance Employee assistance program Health insurance Health savings account Paid time off Vision insurance

Language:

Spanish (Preferred) Ability to

Commute:

Teaneck, NJ 07666 (Required)

Work Location:

In person