Surgery Biller - Facilities

OptiClaim; India; On-site; INR 1,200,000 - 1,800,000; Full time

Job summary

OptiClaim LLP in India is seeking a Senior Surgical / Operating Room Biller to own facility billing for surgical encounters at a US hospital client. The role requires deep knowledge of OR charge capture and hospital billing practices.

You will reconstruct and bill from documentation, enter charges, prepare claims, resolve issues, and drive accounts to completion. You will collaborate with EMR and billing-system developers to explain charge triggers and mappings, test changes, and ensure accurate

Qualifications

• Hands-on experience with hospital surgery billing and OR charge capture.
• Ability to independently produce and reconcile surgical claims.
• Strong understanding of UB-04/837I institutional billing.
• Excellent attention to detail and ownership.
• Ability to learn new EMRs quickly.

Responsibilities

• Independently perform facility billing for surgical and OR encounters.
• Review OR time charges, procedure-room charges, units, supplies, implants, devices, medications.
• Understand OR charging methodologies and revenue codes for surgical services.
• Identify missing charges and perform manual billing and reconciliation.
• Review UB-04/837I claims for accuracy.
• Collaborate with EMR and billing-system teams to improve charge capture.
• Track productivity and provide feedback for improvement.
• Take ownership of incomplete surgical accounts to release accurate claims.

Skills

Hospital billing

Surgical/OR billing

Charge capture knowledge

Revenue codes mastery

Independent claim production

Tools

EMR systems

Billing software

Job description

OptiClaim provides medical coding, billing and revenue cycle services to US healthcare providers. We are hiring a Senior Surgical / OR Biller to own facility billing for surgical encounters at a US hospital client.

Position Summary

We are seeking a highly experienced Senior Surgical / Operating Room Biller with deep knowledge of hospital surgery billing and operating-room charge capture. This is a hands-on production role requiring the individual to independently determine how each surgical encounter should be billed, identify and enter all required facility charges, prepare and produce accurate claims, resolve billing issues, and drive assigned accounts to completion. The successful candidate must be able to reconstruct and bill a surgical encounter from the available documentation when needed, while also identifying workflow or system gaps and providing clear, practical feedback that improves charge capture and billing accuracy.

Key Responsibilities

• Independently perform facility billing for surgical and operating-room encounters across a broad range of surgical specialties and procedures, including determining, entering, validating, and reconciling the charges required to produce a complete claim.
• Review OR time charges, procedure-room charges, surgical levels, units, supplies, implants, devices, medications, anesthesia-related facility components, recovery/PACU services, and other applicable facility charges for completeness.
• Understand OR charging methodologies and the revenue codes and charge structures commonly used for surgical services.
• Review medication and supply charging associated with surgical encounters and identify items that failed to post, posted incorrectly, or require manual intervention.
• Understand how operative documentation, procedure coding, charge capture, revenue codes, units, time, supplies, medications, and facility claim generation connect.
• Recognize missing or inconsistent charges by reviewing the surgical record and available clinical/operational documentation rather than relying solely on automated charge drops.
• Perform manual charge entry, claim preparation, billing correction, and account reconciliation whenever required to ensure surgical accounts are billed completely and accurately.
• Review UB-04/837I surgical facility claims for accurate revenue-code placement, units, dates, charges, claim fields, and other institutional billing requirements.
• Identify charge‑capture leakage, duplicate charges, incorrect units or time, missing medications/supplies, mapping problems, and system configuration gaps before claim submission.
• Take ownership of incomplete or inaccurate surgical accounts and obtain or resolve the information necessary to complete billing and release accurate claims.
• Partner directly with EMR and billing‑system developers to explain how surgical billing should function, including charge triggers, mappings, required fields, edits, interfaces, and expected claim output.
• Test system changes using real‑world surgical billing scenarios and validate that automated charge capture and claim generation are complete and accurate.
• Track productivity, recurring billing issues, system defects, and revenue‑impacting gaps and provide organized feedback for prioritization and correction.

Required Qualifications

• Extensive hands‑on healthcare billing experience in the specialty/setting described for this position; this is not an entry‑level role.
• Strong practical coding knowledge and the ability to understand how documentation, coding, charges, revenue codes, claim fields, and reimbursement connect.
• Demonstrated ability to independently produce claims, review charges, identify missing or incorrect billing elements, resolve edits, and follow claims through the billing cycle.
• Ability to work effectively when workflows are not fully automated, including performing accurate manual billing and charge review when necessary.
• Ability to learn unfamiliar EMRs and billing applications quickly and adapt to changing workflows.
• Strong written and verbal communication skills, including the ability to translate billing requirements into clear functional feedback for EMR, billing software, and development teams.
• High attention to detail, strong ownership, and the ability to work independently with limited supervision.
• Extensive hospital surgical/OR billing experience with strong knowledge of operating‑room charge capture.
• Strong understanding of OR time charging, surgical facility charges, revenue codes, medications, supplies, implants/devices, and related ancillary services.
• Strong working knowledge of UB-04/837I institutional billing for hospital surgical services.
• Ability to reconstruct or validate the expected billing of a surgical encounter when automated charge capture is incomplete.

Preferred Qualifications

• Experience participating in an EMR, practice management, patient accounting, or billing‑system implementation, conversion, build, testing, or optimization project.
• Experience creating workflow requirements, testing system functionality, identifying defects or missing functionality, and validating billing outputs.
• Experience working directly with technical, implementation, or software development teams.
• Revenue integrity, charge‑master, OR charging, or surgical charge‑reconciliation experience.
• Experience supporting multiple surgical specialties and complex hospital outpatient and/or inpatient surgical cases.
• Experience validating interfaces or charge feeds from OR, pharmacy, supply, anesthesia, or clinical systems into a patient accounting/billing platform.

What success looks like

• Surgical accounts are billed completely and accurately even when automated charge drops are still under development.
• OR time, medications, supplies, procedures, and other facility charges are reconciled before claims are released.
• Revenue leakage and system defects are identified quickly and translated into specific development requirements.
• System enhancements are validated against actual surgical billing workflows rather than theoretical requirements alone.
• The biller functions as both a high‑performing producer and a senior operational subject‑matter expert for the build team.

All work follows HIPAA. OptiClaim is an equal opportunity employer.

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