Find & Apply For Billing Clerk / Specialist Jobs in West Orange, New Jersey

Medical Billing Specialist Genesis Orthopaedic and Spine - 5.0 West Orange, NJ Job Details Full-time $25.00 - $29.50 an hour 1 day ago Benefits Health insurance Dental insurance 401(k) Paid time off Vision insurance 401(k) matching 403(b) Paid sick time Qualifications Availity Collaborate with healthcare professionals Appeals Medicare Accounts receivable management Provider enrollment for medical credentialing Blue Cross Blue Shield health insurance eClinicalWorks Workers' compensation insurance knowledge High school diploma or GED Certified Professional Coder Medicare regulations Medical billing Medical insurance appeals management Centers for Medicare & Medicaid Services (CMS) billing regulations Medical explanation of benefits reviews Medical claims submission Orthopedics Auto insurance knowledge Clinical documentation standards Insurance claims appeal handling Healthcare coding investigations Medical terminology Medical debt collection accounts Waystar Patient collections management Medical billing and coding experience in orthopedics Full Job Description Medical Biller Genesis Orthopaedic and Spine -

West Orange, NJ Pay:

$25-$29.50 per hour

Job Type:

Full-time Schedule:

Monday through Friday; no weekends

Work Location:

In person About the Position Genesis Orthopaedic and Spine is a growing multi-specialty Orthopedic, Spine, Pain Management, and Sports Medicine practice located in West Orange, New Jersey. We are seeking an experienced full-time Medical Biller to join our team. This is not an entry-level position. The ideal candidate will have several years of hands-on, full-cycle medical billing experience and be comfortable independently managing claims from coding and submission through payment, denial resolution, appeal, and final account closure. Candidates must have experience with Commercial insurance (BCBS, Aetna, CIGNA, UHC) and Medicare billing, as well as New Jersey and New York auto, workers' compensation, and Department of Labor claims. Direct billing experience in orthopedics, spine, pain management, or another procedure-based related specialty is strongly preferred. Responsibilities Review provider documentation for coding accuracy, completeness, and medical necessity. Assign and validate CPT, ICD-10-CM, HCPCS, and modifier usage in accordance with current coding guidelines and payer requirements. Submit accurate claims electronically and on paper when required. Work claim rejections, edits, and clearinghouse reports promptly. Manage commercial insurance claims, including BCBS, Aetna, Cigna, UnitedHealthcare, and other major payers. Manage Medicare claims and understand Medicare coverage, coding, documentation, and medical-necessity requirements.

Process and follow up on:

New Jersey PIP and No-Fault auto claims New York No-Fault auto claims New Jersey and New York workers' compensation claims Federal Department of Labor and OWCP claims Aggressively pursue aging accounts receivable and resolve outstanding balances. Identify denial and underpayment reasons, correct billing issues, and resubmit claims when appropriate. Prepare, submit, and track first- and second-level appeals. Monitor timely filing limits and appeal deadlines. Post insurance and patient payments from ERAs, EOBs, checks, and electronic transactions. Review payments to ensure reimbursement is consistent with contracted rates, payer policies, and applicable fee schedules. Identify underpayments and pursue additional reimbursement when appropriate. Review coding edits, bundling issues, global-period rules, payer-specific policies, and modifier requirements. Verify insurance benefits and communicate coverage or billing issues to appropriate team members. Coordinate with providers and clinical staff to obtain missing documentation, corrected notes, or additional information needed for claim submission or appeal. Generate weekly accounts-receivable, denial, payment, and productivity reports as requested. Manage patient statements, patient balances, and billing-related telephone calls. Explain insurance processing and patient financial responsibility professionally and accurately. Maintain complete account notes and documentation of all billing follow-up activity. Protect patient confidentiality and follow HIPAA, compliance, and practice policies. Perform additional revenue-cycle duties as assigned by management. Required Qualifications Current Certified Professional Coder (CPC) credential (preferred not required). At least three years of full-cycle medical billing and accounts-receivable experience. Direct experience billing orthopedic, spine, pain management, sports medicine, or other procedure-based services. Strong experience with commercial insurance and Medicare billing. Hands-on experience with New Jersey PIP/No-Fault and New York No-Fault auto claims. Hands-on experience with New Jersey and New York workers' compensation claims. Experience processing Department of Labor or OWCP claims. Proficiency with eClinicalWorks . Experience using both Waystar and Jopari clearinghouses. Strong knowledge of CPT, ICD-10-CM, HCPCS, modifiers, medical terminology, and payer-specific billing requirements. Experience reviewing ERAs, EOBs, denials, rejections, fee schedules, and contractual adjustments. Demonstrated success resolving aging accounts receivable, denials, appeals, and underpayments. Strong organizational, analytical, and problem-solving skills. Excellent written and verbal communication skills. Ability to manage a high-volume workload, meet deadlines, and follow claims through final resolution. Ability to work independently while collaborating effectively with providers, clinical staff, and administrative team members. Ability to work full-time, in person, at our West Orange office. Preferred Qualifications Five or more years of medical billing experience. Advanced experience with orthopedic surgery, spine procedures, interventional pain management, injections, diagnostic testing, and other procedure-based claims. Familiarity with payer portals, electronic remittance processing, claim-scrubbing tools, and revenue-cycle reporting. Experience with credentialing, payer enrollment, or authorization workflows. Experience creating and analyzing accounts-receivable and denial-management reports. Compensation will be based on experience, qualifications, coding knowledge, and familiarity with the insurance programs and billing platforms required for this position. 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 403(b) Dental insurance Health insurance Paid sick time Paid time off Vision insurance

Education:

High school or equivalent (Required)

Experience:

Medical billing: 5 years (Required)

License/Certification:

Certified Professional Coder (Preferred) Ability to

Commute:

West Orange, NJ 07052 (Required)

Work Location:

In person