Medical Billing and Underpayment Specialist

Agility Billing Services, LLC; Town of Islip (NY); Hybrid; USD 50,000 - 70,000; Full time

Benefits offered by this job

Competitive compensation based on experience

Opportunities for professional development

Team-oriented work environment

Job summary

A medical billing service provider in New York seeks an Accounts Receivable Specialist to support billing and collections in a busy surgical practice. Candidates should have knowledge of various insurance types, including Workers' Compensation and commercial plans, alongside excellent communication skills. This is a hybrid position after a 90-day probationary period, offering competitive compensation and opportunities for professional development.

Qualifications

• Working knowledge of Workers' Compensation, No-Fault, and commercial insurance plans.
• Experience in billing for orthopedic, spine, or pain management services is preferred.
• Familiarity with out-of-network billing processes.
• Experience with workers' compensation, no‑fault, and commercial plans is helpful.

Responsibilities

• Submit and follow up on medical claims with commercial payers.
• Monitor outstanding accounts and pursue unpaid or underpaid claims.
• Review, appeal, and resolve claim denials or discrepancies.
• Maintain knowledge of payer policies, billing regulations, and coding guidelines.
• Collaborate with clinical and administrative teams to ensure accurate documentation and billing practices.
• Maintain organized records of claim activity and insurance correspondence.

Skills

Workers' Compensation knowledge

Communication skills

ICD-10 proficiency

CPT and modifier use

Problem-solving skills

Self-motivation

Education

High school diploma or equivalent

Associate’s Degree in Health Information Technology

Certificate in medical billing or coding

Tools

ICD-10 coding

CPT coding

Modifier use

Job description

Medical Billing and Underpayment Specialist

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About Us:

At Agility Billing Services, we are dedicated to providing exceptional care and service in the orthopedic/pain management field. We are looking for a skilled and motivated Accounts Receivable Specialist to join our team. The ideal candidate will have significant experience with collections, medical billing and a deep understanding of various insurance types and companies.

Position Overview

We are seeking an Accounts Receivable Specialist to join our team and support billing and collections for a busy surgical practice. The ideal candidate will have experience in medical claims follow‑up, with understanding of commercial insurance plans. Prior experience in out‑of‑network billing, orthopedic, spine, or pain management services is highly preferred. Candidates with a foundation in medical billing and a desire to develop expertise in out‑of‑network workflows are encouraged to apply.

Key Responsibilities

• Submit and follow up on medical claims with commercial payers, with a focus on specialty and surgical services.
• Monitor outstanding accounts and pursue unpaid or underpaid claims to ensure timely reimbursement.
• Review, appeal, and resolve claim denials or payment discrepancies using payer portals.
• Maintain up‑to‑date knowledge of payer policies, billing regulations, and coding guidelines.
• Collaborate with clinical and administrative teams to ensure accurate documentation and billing practices.
• Maintain organized detailed records of claim activity, account status, and insurance correspondence.

Qualifications

• Working knowledge of Workers' Compensation, No-Fault, and commercial insurance plans.
• Excellent communication skills, especially when working with insurance reps and internal teams.
• Proficient in ICD-10, CPT, and modifier use.
• Experience in billing for orthopedic, spine, or pain management services is preferred but not required.
• Familiarity with out‑of‑network billing processes and understanding of the IDR process and appeals is a plus.
• Strong problem-solving and organizational skills.
• Self‑motivation with the ability to work independently and meet deadlines.

Education and Experience

• High school diploma or equivalent required.
• Associate’s Degree in Health Information Technology or a related field preferred.
• Certificate in medical billing or coding is a plus.
• Competitive compensation with consideration for experience, skills, and growth potential.
• Opportunities for professional development and advancement in a specialty billing role.
• Supportive and team‑oriented work environment.
• Hybrid position after 90‑day probationary period.