Revenue cycle specialist

About Our Client

This organization specializes in supporting orthopedic practices with complex billing and reimbursement processes, particularly focusing on out-of-network billing challenges. It addresses the need for expertise in navigating insurance claim submissions and payment collections, advocating for providers to recover appropriate revenue.

About the Opportunity

The Revenue cycle specialist role is designed to manage the complete insurance billing process for orthopedic medical services. This position plays a critical role in ensuring accurate claim submission, effective follow-up on payments, and resolving denials to optimize reimbursement for providers.

Responsibilities

• Submit and manage insurance claims from initiation to resolution
• Follow up on unpaid and underpaid claims
• Research and resolve claim denials
• Communicate with insurance carriers about reimbursement issues
• Collaborate with the team to maximize collections for orthopedic providers
• Maintain accurate documentation and ensure timely claim resolution

Requirements

• 1-3 years of orthopedic medical billing experience
• Knowledge of commercial insurance billing, claim submission, payment posting, and accounts receivable follow-up
• Understanding of CPT, ICD-10, HCPCS coding, modifiers, and payer-specific billing guidelines
• Experience with appeals, denials, and insurance follow-up
• Familiarity with surgery and orthopedic procedures preferred
• Excellent communication, organizational, and problem-solving skills
• Ability to manage multiple priorities with accuracy and attention to detail
• Experience with out-of-network billing preferred
• Knowledge of Independent Dispute Resolution and No Surprises Act is a plus
• Experience in high-volume orthopedic or ambulatory surgery practices is advantageous

Benefits

• 401(k)
• Employee discounts
• Health insurance

Note: RemoteHunter is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.