About the Opportunity
Our client, an established orthopedic and spine surgery practice in Orange County, New York, 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.
The annual base salary range is $65,000 to $85,000. Actual compensation offered to the successful candidate may vary from posted hiring range based upon geographic location, work experience, education, and/or skill level, among other things. Details about eligibility for bonus compensation (if applicable) will be finalized at the time of offer.
Job 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
Job Requirements
- 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
