O&P Billing Expert: Medicare & ADRs Specialist

CBS Medical Billing & Consulting LLC; Exeter (NH); On-site; USD 60,000 - 95,000; Full time

Job summary

CBS Medical Billing & Consulting LLC is seeking an experienced Prosthetic & Orthotic Medical Biller who thrives on precision and has hands-on experience with orthotic and prosthetic devices billing. You will manage O&P claims, ensure compliance with Medicare/Medicaid guidelines, and handle ADRs and payer audits across multiple systems.

The role emphasizes accuracy, strong documentation, and proactive communication with internal teams to support clinicians and patients in obtaining timely

Qualifications

• Hands-on experience billing orthotic and prosthetic devices.
• Knowledge of Medicare, Medicaid, and commercial insurance reimbursement guidelines.
• Familiarity with L-codes, documentation requirements, and O&P compliance standards.
• Experience handling ADRs and payer audits.
• Detail-oriented with strong organizational and documentation skills.
• Tech-savvy and comfortable working across multiple systems.
• Proactive communicator who takes ownership of their work.

Responsibilities

• Submit primary, secondary, tertiary, and corrected claims via billing software, clearinghouses, payer portals, and paper submission as needed.
• Scrub O&P claims for accuracy and compliance with Medicare, Medicaid, and commercial payer requirements.
• Prepare and submit Additional Documentation Requests (ADRs) and ensure documentation supports medical necessity.
• Monitor claim status and resolve billing discrepancies efficiently.
• Ensure proper use of L-codes, modifiers, and documentation standards.
• Accurately document all activity across billing platforms.
• Communicate billing updates, payer changes, and regulatory insights with internal teams.
• Navigate multiple billing systems and adapt to client-specific workflows and reporting tools.

Skills

Prosthetic & Orthotic billing

Medicare/Medicaid knowledge

ADR handling

Payer audits

Attention to detail

Multi-system navigation

Proactive communication

Tools

Billing software

Payer portals

Job description

CBS Medical Billing & Consulting LLC is seeking an experienced Prosthetic & Orthotic Medical Biller who thrives on precision and has hands-on experience with orthotic and prosthetic devices billing. You will manage O&P claims, ensure compliance with Medicare/Medicaid guidelines, and handle ADRs and payer audits across multiple systems.

The role emphasizes accuracy, strong documentation, and proactive communication with internal teams to support clinicians and patients in obtaining timely