Orthotics & Prosthetics Billing Specialist

Shriners Children’s is an organization that respects, supports, and values each other. Named as the 2025 best mid-sized employer by Forbes, we are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced-based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience define us as leaders in pediatric specialty care for children and their families. With 20+ hospitals, outpatient clinics, ambulatory care centers, and outreach locations across the globe, we provide excellent care to children up to age 18 regardless of their family’s ability to pay or insurance status.

About the role

The Orthotics & Prosthetics Billing Specialist is responsible for O&P billing, processing of EOBs, processing statements, posting payments (including batch payments), reconciling payments to the appropriate ledgers, following up on submitted claims, monitoring unpaid claims, initiating tracers, resubmitting claims as necessary, and assisting with appeals processing. This position also researches and responds by telephone and in writing to all patient and payer inquiries regarding billing issues and problems, as well as understanding any technology applications utilized for O&P billing. The role works in conjunction with other departments to ensure the accuracy of the Billing Tool through periodic audits.

Responsibilities

• Processes O&P billing to third-party payers and patients; maintains supporting documentation files.
• Processes patient statements, keys data, posts transactions, and verifies accuracy of input to reports generated.
• Researches and responds to all patient and/or payer inquiries regarding O&P billing issues and problems. Refers all patient-related issues and concerns to the office where the patient was seen and (when necessary) to the practitioner who provided the care.
• Follows up on all submitted claims, monitors unpaid claims, initiates tracers, and resubmits claims as needed.
• Receives third-party reimbursements and posts and reconciles payments to patient accounts.
• Balances daily batch payments and reports.
• Maintains payer and patient demographic information and data collection.
• Assists with the development of organizational procedures and updates of forms and manuals pertaining to billing of O&P devices under the direction of the O&P Billing Supervisor and Director of O&P.
• May assist (pending detailed direction of Legal and the O&P Billing Supervisor) in preparing documentation and responses for legal inquiries and litigation.
• Ensures strict confidentiality of patient and financial records according to all SHC Policies and Procedures.
• Works collaboratively and closely with management, executives, hospitals, staff, and leadership to ensure effective and compliant O&P billing.
• Demonstrates flexibility to perform job functions, tasks, and projects in an evolving organizational landscape at the direction of the National Director of Orthotics & Prosthetics.

Requirements

• 3 years of healthcare billing, claims, and insurance experience.
• Knowledge of insurance EOBs.
• Experience interacting with patients and providers via phone and email in a courteous and professional manner.
• Strong oral and written communication skills.

Qualifications

• 3 years of DME or O&P billing insurance experience (preferred).

Pay

Compensation is determined based on years of relevant experience and departmental equity.