Orthopedic Claims & Operations Lead (Hybrid)

Genesis Orthopedics & Sports Medicine; Chicago (IL); Hybrid; USD 65,000 - 92,000; Full time

Benefits offered by this job

Hybrid work model

Competitive compensation

Performance-based bonuses

Impactful work

Job summary

Genesis Orthopedics & Sports Medicine is seeking a Front Office Manager to direct administrative operations for six outpatient clinics in a hybrid, full-time capacity. You will lead a claims/AR team, ensure accurate claim posting, and drive payer compliance using the EPIC system.

The role emphasizes leadership, analytics, and cross-functional collaboration with billing, coding, and management. HIPAA compliance and patient-friendly service are integral to success.

Qualifications

• 3-5 years of experience in medical claims management or billing, with a strong focus on orthopedic claims.
• Hands-on leadership of a claims or AR team in a healthcare setting.
• Excellent understanding of CPT/HCPCS codes, modifiers, EOBs, ERAs, CARC/RARC codes.
• Advanced Excel skills and strong attention to detail.
• Excellent communication across billing, coding, and management teams.

Responsibilities

• Oversee daily administrative operations across 6 outpatient clinics.
• Review and validate all contractual adjustments and ensure accuracy in claim posting and payer compliance.
• Download and allocate new accounts to analysts from EPIC workqueues based on payer, aging, and priority.
• Audit processed claims for accuracy, completeness, and timeliness before submission or follow-up.
• Lead daily and weekly performance reviews, tracking productivity and accuracy metrics.
• Manage denial trends and collaborate with billing, coding, and authorization teams to resolve high-impact claims.
• Provide training and coaching to staff, ensuring HIPAA compliance and SOP adherence.

Skills

Leadership

Claims management

Analytical skills

HIPAA compliance

Communication

Tools

EPIC system

Excel

Job description

Genesis Orthopedics & Sports Medicine is seeking a Front Office Manager to direct administrative operations for six outpatient clinics in a hybrid, full-time capacity. You will lead a claims/AR team, ensure accurate claim posting, and drive payer compliance using the EPIC system.

The role emphasizes leadership, analytics, and cross-functional collaboration with billing, coding, and management. HIPAA compliance and patient-friendly service are integral to success.