Orthopedic Medical Billing & Denials Specialist

SpineSearch LLC; New York (NY); On-site; USD 40,000 - 65,000; Full time

Job summary

SpineSearch LLC in Suffolk County, NY, is seeking a medical biller to join a growing orthopedic group. The candidate will manage charge entry, submit claims, and follow up on denials to ensure timely payments.

Responsibilities include reading patient records to assign correct codes, interpreting EOBs, and communicating with payers and patients. Strong denial management and follow‑up skills are essential for accurate reimbursement.

Qualifications

• 2+ years experience in charge entry, claims submissions, follow up and denial management, preferably in Orthopedic surgery
• Knowledge of Medical Terminology, ICD10, CPT codes and the correct use of modifiers
• Experience with Medicare, Commercial, Worker's Comp and No Fault claims
• Applicant must have strong denial and insurance follow‑up management skills
• Able to read and interpret EOBs
• Able to handle patient inquiries regarding billing issues, out of network issues, explaining insurance guidelines to patients

Responsibilities

• Prepares clean claims to submitted to the clearinghouse for processing
• Working rejections from the clearinghouse to correct errors for resubmissions
• Read and analyze patient records to determine correct codes for billing to insurance provider
• Interpret EOB's for accurate payment was received
• Ensure A/R payments are current and all delinquent accounts are being followed up in a timely fashion
• Timely follow up with payers to ensure timely resolution of outstanding claims
• Handle patient and insurance inquiries pertaining to assigned accounts
• Draft appeal letters when necessary
• Verification of insurance benefits with accurate interpretation when necessary
• Assist the Revenue Cycle Manager and team leads as needed

Skills

Charge entry

Claims submissions

Denial management

Follow-up

Medical terminology

Job description

SpineSearch LLC in Suffolk County, NY, is seeking a medical biller to join a growing orthopedic group. The candidate will manage charge entry, submit claims, and follow up on denials to ensure timely payments.

Responsibilities include reading patient records to assign correct codes, interpreting EOBs, and communicating with payers and patients. Strong denial management and follow‑up skills are essential for accurate reimbursement.