Medical Claims Processor and Insurance Follow-up Expert

6 days ago


Plainview, United States The Central Orthopedic Group, LLP Full time
Job Summary

We are seeking a highly skilled Medical Biller and WC/NF Claims Specialist to join our team at The Central Orthopedic Group, LLP. As a key member of our medical billing and collections team, you will be responsible for resolving denied or underpaid claims and following up with insurance providers to collect reimbursements.

Key Responsibilities
  • Resolve denied or underpaid claims and follow up with insurance providers to collect reimbursements
  • Process and manage medical claims for both in-network and out-of-network patients
  • Work with Workers Compensation and No-Fault claims for surgeries and in-office procedures
  • Resubmit claims and perform other duties related to medical billing and collections
  • Develop and maintain strong relationships with insurance providers and patients
Requirements
  • High school diploma or equivalent; Associate's degree or certification in medical billing and coding preferred
  • At least 2 years of experience in medical claims processing or medical billing and coding
  • Thorough understanding of medical terminology, ICD-10, and CPT coding
  • Strong analytical and problem-solving skills
  • Excellent communication and customer service skills
  • Ability to work independently and manage multiple tasks and deadlines
Preferred Qualifications
  • Experience with orthopedic healthcare claims processing
  • Knowledge of Medical Terminology, ICD10, CPT codes, and the correct use of modifiers
  • Experience with Medicare, Commercial, Worker's Comp, and No Fault claims follow-up
  • Ability to handle patient inquiries regarding billing issues and insurance guidelines


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