Medical Biller Genesis Orthopaedic and Spine - 5.0 West Orange, NJ Job Details Full-time $25.00 - $29.50 an hour 10 hours ago Benefits Health insurance 401(k) 401(k) matching Retirement plan Qualifications Health insurance authorizations Accounts receivable management Medical coding guidelines eClinicalWorks Personal injury law High school diploma or GED Certified Professional Coder Electronic health record (EHR) management for billing and coding Insurance claims litigation Medical billing Medical insurance appeals management Centers for Medicare & Medicaid Services (CMS) billing regulations Medical claims submission Medical Billing Certification Orthopedics Bodily injury claims Auto insurance knowledge Clinical documentation standards Document management systems Insurance claims appeal handling Personal injury case experience Medical terminology Full Job Description No-Fault/PIP Medical Biller Genesis Orthopaedic and Spine -

West Orange, NJ Pay:

$25-$29.50 per hour, based on experience

Job Type:

Full-time Schedule:

Monday through Friday; no weekends

Work Location:

In person

Expected Hours:

40 hours per week About the Position Genesis Orthopaedic and Spine is a growing multi-specialty orthopedic, spine, pain management, and sports medicine practice seeking an experienced No-Fault/PIP Medical Biller for our West Orange office. This is not an entry-level position . The ideal candidate will have several years of direct experience managing automobile-accident medical claims, particularly New Jersey PIP (majority of claims are NJ), New York No-Fault, and Pennsylvania first-party auto claims . Experience billing automobile claims in additional states is a plus. The selected candidate will manage claims from initial setup and submission through payment follow-up, denial resolution, appeals, arbitration or litigation support, attorney coordination, and final account closure. Experience in orthopedics, spine, pain management, surgery, or another procedure-based specialty is strongly preferred. Systems Used eClinicalWorks for electronic medical records and practice management Jopari for No-Fault/PIP automobile claim submission Waystar for commercial insurance and Medicare claims Direct experience with eClinicalWorks and Jopari is strongly preferred. Waystar experience is a plus. Responsibilities Establish and maintain complete No-Fault/PIP claim files, including accident, carrier, policy, claim, adjuster, coverage, benefit, and attorney information. Obtain and review assignments of benefits, PIP or No-Fault applications, insurance information, coverage letters, benefit-exhaustion notices, and attorney correspondence. Review provider documentation for completeness, medical necessity, accident-related diagnoses, CPT coding, ICD-10-CM coding, HCPCS codes, and modifiers. Submit accurate automobile claims electronically through Jopari and by paper when required. Monitor clearinghouse rejections, carrier responses, filing deadlines, appeal deadlines, and outstanding documentation. Manage New Jersey PIP requirements, including treatment notices, Decision Point Review or precertification requests, appeals, fee-schedule review, and disputed claims. Manage New York No-Fault claims, including required forms, assignments of benefits, verification requests, denials, fee-schedule issues, and arbitration support. Manage Pennsylvania first-party automobile medical claims, including coverage, payment, underpayment, and medical-necessity disputes. Review EOBs, ERAs, denials, and underpayments and take appropriate corrective action. Aggressively pursue aging accounts receivable, particularly high-dollar procedure and surgical claims. Communicate directly with insurance adjusters, carrier representatives, patients, providers, and attorneys. Prepare complete billing and medical-documentation files for PIP or No-Fault arbitration, litigation, or outside counsel. Assist with medical liens, letters of protection, settlement balances, lien-reduction requests, and attorney-held medical balances when applicable. Post or reconcile insurance payments, settlements, arbitration awards, adjustments, and approved write-offs. Maintain detailed account notes in eClinicalWorks and provide regular accounts-receivable and claim-status reports. Collaborate with providers, clinical staff, authorization staff, payment-posting staff, and other members of the billing team. Maintain HIPAA compliance and patient confidentiality. Required Qualifications At least three years of direct No-Fault/PIP or automobile medical billing and accounts-receivable experience. Hands-on experience with New Jersey PIP claims . Experience with New York No-Fault and Pennsylvania automobile medical claims is strongly preferred. Experience managing claims through submission, follow-up, denial resolution, appeals, payment, and final closure. Experience working with insurance adjusters and attorneys regarding disputed automobile claims. Experience preparing documentation for PIP or No-Fault arbitration, litigation, or legal collection. Knowledge of assignments of benefits, state-specific filing requirements, precertification, fee schedules, appeals, and timely filing deadlines. Working knowledge of CPT, ICD-10-CM, HCPCS, modifiers, medical terminology, and

CMS-1500

claim forms. Experience billing orthopedic, spine, pain management, surgical, or other procedure-based services. Proficiency with eClinicalWorks and experience using Jopari. Strong organizational, analytical, communication, and follow-up skills. Ability to independently manage a high-volume workload and meet multiple deadlines. Ability to work full-time, in person, at our West Orange office. Preferred Qualifications Five or more years of No-Fault/PIP medical billing experience. Experience with New Jersey PIP dispute resolution or Forthright matters. Experience with New York No-Fault arbitration or AAA matters. Experience with medical liens, letters of protection, settlement negotiations, or attorney-held balances. Experience using Waystar for commercial insurance or Medicare claims. Experience billing automobile claims in states beyond New Jersey, New York, and Pennsylvania. CPC, CPB, or another billing or coding credential. Experience with orthopedic and spine surgery, injections, interventional pain procedures, EMG/NCS testing, or other high-value services. Benefits Paid time off Health insurance eligibility after the applicable waiting period Employer contribution toward employee health-insurance coverage Monday through Friday schedule with no weekends Compensation will be based on the candidate's directly relevant No-Fault/PIP experience, state-specific billing knowledge, orthopedic and spine experience, attorney and arbitration experience, and proficiency with eClinicalWorks, Jopari, and Waystar. Genesis Orthopaedic and Spine is an equal opportunity employer. Employment decisions are based on qualifications, merit, and the needs of the practice.

Pay:

$25.00 - $29.50 per hour Expected hours: 40.0 per week

Benefits:

401(k) 401(k) matching Retirement plan

Education:

High school or equivalent (Required)

Experience:

Medical billing: 5 years (Required) Personal injury law: 3 years (Preferred)

License/Certification:

Certified Professional Coder (Preferred) Ability to

Commute:

West Orange, NJ 07052 (Required)

Work Location:

In person