Medical Billing Specialist - Remote

Orthos, Inc.; Indiana, Northern (PA, KY); Hybrid; USD 42,000 - 64,000; Full time

Job summary

Orthos, Inc. is seeking a remote Billing Specialist to support patient inquiries, review and submit insurance claims, and manage accounts receivable for orthopedic services. The ideal candidate has 2+ years in medical billing with strong denials management and payer knowledge.

You will work independently in a remote setting, using EMR/EHR systems and payer portals while maintaining accuracy, timeliness, and confidentiality in line with HIPAA regulations.

Qualifications

• Minimum of 2+ years of medical billing and accounts receivable follow-up experience preferred.
• Orthopedic billing experience strongly preferred.
• Knowledge of commercial insurance, Medicare, Medicaid, worker’s compensation, and managed care payers.
• Understanding of EOBs, denials, appeals, adjustments, authorizations, and payment posting processes.
• Ability to interpret payer guidelines and identify billing discrepancies or claim issues.
• Familiarity with CPT, ICD-10, and HCPCS coding terminology.
• Experience working within EMR/EHR systems and insurance payer portals.
• Strong understanding of claim aging, denial management, and timely filing requirements.
• Ability to prioritize workload and manage multiple accounts efficiently in a high-volume environment.
• Strong attention to detail and organizational skills.
• Excellent written and verbal communication skills.
• Ability to work independently while maintaining productivity and accountability in a remote work environment.
• Proficient with Microsoft Outlook, Excel, and Teams.
• Strong problem-solving and critical thinking skills.
• Ability to maintain confidentiality and comply with HIPAA regulations.
• Dependable attendance, responsiveness, and follow-through on assigned responsibilities.
• Ability to adapt to changing workflows, client needs, and process improvements.

Responsibilities

• Answer patient inquiries and review insurance claims and balances.
• Process insurance claims including appeals and maintain accounts receivable per policy.
• Communicate with insurers to ensure claims are paid and correct errors; post actions to accounts.
• Oversee claims appeals, aging, and follow up on open claims.
• Stay up to date with clinic and insurance policy terms and procedures.
• Participate in professional development and data analytics initiatives for the orthopedic office.
• Perform other duties as assigned.

Skills

Medical billing

AR follow-up

Orthopedic billing

Insurance knowledge

Payer guidelines

Coding terminology

EMR/EHR systems

Denial management

Timely filing

Attention to detail

Communication

Remote work

Microsoft Outlook

Excel

Teams

Problem solving

HIPAA

Attendance

Adaptability

Tools

EMR/EHR systems

Insurance payer portals

Microsoft Outlook

Excel

Teams

Job description

At Orthos, our most valuable resource is our team members.

We encourage you to openly contribute ideas and feedback, as we know this is how brilliant products are developed and processes streamlined.

This is a remote opportunity; however, candidates must reside in one of the following states: Arizona, Arkansas, Florida, Iowa, Illinois, Indiana, Michigan, Missouri, North Carolina, Nevada, Ohio, Oregon, Pennsylvania, Tennessee, or Texas.

Our Billing Specialists are responsible for answering patient inquiries, reviewing outstanding or denied insurance claims, submitting insurance appeals, and maintaining assigned accounts receivables per clinic policies.

Assist in the processing of insurance claims including worker’s compensation (if assigned) for all financial classes

Communicate with insurance companies to ensure that claims are paid; identify and correct account and/or insurance error; and post all actions and maintain permanent record of patient accounts

Oversee claims appeals and reviews; review claims aging status and follow up on open claims

Answer phones, patient questions, inquiries, and concerns regarding their accounts; verify balances and refunds for accuracy

Understand, and stay up to date with, clinic and insurance industry contract policies/procedures and medical terminology

Participate in professional development efforts to stay current with health care best practices and trends

Actively participate in the company’s efforts to create innovative data and analytics solutions for the modern orthopedic business office

Other duties as assigned

Required Skills:

• Minimum of 2+ years of medical billing and accounts receivable follow-up experience preferred
• Orthopedic billing experience strongly preferred
• Knowledge of commercial insurance, Medicare, Medicaid, worker’s compensation, and managed care payers
• Understanding of EOBs, denials, appeals, adjustments, authorizations, and payment posting processes
• Ability to interpret payer guidelines and identify billing discrepancies or claim issues
• Familiarity with CPT, ICD-10, and HCPCS coding terminology
• Experience working within EMR/EHR systems and insurance payer portals
• Strong understanding of claim aging, denial management, and timely filing requirements
• Ability to prioritize workload and manage multiple accounts efficiently in a high-volume environment
• Strong attention to detail and organizational skills
• Excellent written and verbal communication skills
• Ability to work independently while maintaining productivity and accountability in a remote work environment
• Proficient computer skills including Microsoft Outlook, Excel, and Teams
• Strong problem-solving and critical thinking skills
• Ability to maintain confidentiality and comply with HIPAA regulations
• Dependable attendance, responsiveness, and follow-through on assigned responsibilities
• Ability to adapt to changing workflows, client needs, and process improvements

Preferred Skills:

• CPC, CPB, or other AAPC certification preferred but not required