Spire Orthopedic Partners
Out-of-Network Billing Specialist
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Job Description
- Req#: 122385
Employer Industry: Orthopedic Healthcare Services
Why consider this job opportunity:
- Salary range of $23.15 - $28.70 per hour
- Excellent growth and advancement opportunities within the organization
- Dynamic work environment with access to a diverse network of practitioners
- Comprehensive benefits package including health, dental, vision, and 401(k)
- Generous paid time off (PTO) policy
What to Expect (Job Responsibilities):
- Prepare, submit, and follow up on professional orthopedic spine claims to insurance companies
- Review and analyze denied or underpaid claims, implementing corrective actions as needed
- Monitor and manage accounts receivable aging reports for outstanding claims
- Maintain compliance with HIPAA and other regulatory standards while documenting billing activities
- Liaise with clinical staff, patients, and insurance companies to resolve claim-related issues
What is Required (Qualifications):
- Minimum of 5 years of experience in out-of-network billing, denial management, and accounts receivable follow-up within professional orthopedic spine billing
- Proficiency in medical billing software, coding systems (CPT, ICD-10), and electronic health records (EHR)
- Strong understanding of out-of-network reimbursement practices, payer policies, and industry regulations
- Ability to analyze denial trends and accounts receivable reports for process improvement
- Excellent verbal and written communication skills, with effective negotiation abilities
How to Stand Out (Preferred Qualifications):
- Experience working in a management services organization (MSO) or similar healthcare setting
- Familiarity with HIPAA compliance and billing documentation standards
- Advanced skills in data analysis and reporting related to billing processes
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