Job Description

Job Description

Annual Salary: $60k-$85k (varies depending on years of experience)

An established orthopedic and spine surgery practice is seeking an experienced Medical Biller with a strong background in out-of-network billing and spine-related claims. This role is responsible for managing the full revenue cycle with a focus on accurate claims submission, payment resolution, and reimbursement optimization.

Key Responsibilities

• Manage end-to-end medical billing and accounts receivable for orthopedic and spine surgical cases.
• Submit and track out-of-network claims to commercial payers.
• Handle the Independent Dispute Resolution (IDR) process including documentation preparation, submissions, and follow-up.
• Review, correct, and resubmit denied or underpaid claims in a timely manner.
• Post payments, reconcile explanations of benefits (EOBs), and identify discrepancies.
• Follow up aggressively on unpaid or delayed claims to ensure maximum reimbursement.
• Communicate with insurance carriers regarding claim status, appeals, and payment disputes.
• Work closely with the clinical and administrative teams to resolve coding and documentation issues.
• Maintain strict compliance with HIPAA and billing regulations.
• Generate A/R aging reports and participate in revenue cycle performance discussions.
• Maintain accurate patient account records and billing documentation.

Required Qualifications

• Proven experience as a Medical Biller / A/R Specialist in a physician practice or surgical specialty.
• Orthopedic and spine billing experience is required.
• Out-of-network billing experience is required.
• Independent Dispute Resolution (IDR) experience is required.
• Strong understanding of commercial insurance reimbursement processes.
• Excellent attention to detail, organization, and follow-through.
• Ability to work independently in a fast-paced, high-volume environment.
• Strong communication skills for payer and internal team interactions.

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