Medical Billing Specialist - Remote

Orthos Inc; Michigan; Remote; USD 50,000 - 70,000; Full time

Job summary

Orthos Inc. seeks a Billing Specialist to handle medical billing and accounts receivable follow-up for orthopedic clinics. You’ll review denied claims and submit appeals, liaise with insurers, and maintain patient account records in a remote-capable environment.

Ideal candidates have at least 2 years in medical billing, knowledge of CPT/ICD-10/HCPCS, and experience with EMR/EHR systems. This remote role requires residing in Michigan and offers ongoing professional development opportunities.

Qualifications

• 2+ years of medical billing and accounts receivable experience
• Orthopedic billing experience 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 with 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 in a high-volume environment
• Attention to detail and organizational skills
• Excellent written and verbal communication
• Ability to work independently in a remote work environment
• Proficient in Microsoft Outlook, Excel, and Teams
• Strong problem-solving and critical thinking
• Maintain confidentiality and HIPAA compliance
• Dependable attendance and follow-through
• Adapt to changing workflows and client needs

Responsibilities

• Answer phones, patient questions, inquiries, and concerns about accounts
• Verify balances and refunds for accuracy
• Review outstanding or denied insurance claims and submit insurance appeals
• Maintain assigned accounts receivables per clinic policies
• Process insurance claims including worker’s compensation where assigned
• Communicate with insurance companies to ensure claims are paid and correct errors
• Oversee claims appeals and review aging status with follow-up
• Stay up-to-date with clinic and insurance contract policies and medical terminology
• Stay engaged in professional development and analytics initiatives
• Perform other duties as assigned

Skills

Medical billing

Accounts receivable

Orthopedic billing

Payer knowledge

HIPAA compliance

EMR/EHR

Denial management

Attention to detail

Remote work

Microsoft Excel

Communication skills

Team collaboration

Tools

EMR/EHR portals

Job description

Are you ready for new challenges and new opportunities?

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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