Orthopedic Surgical Claims & Denials Specialist

HOPCo | Healthcare Outcomes Performance Company; West Palm Beach (FL); On-site; USD 55,000 - 85,000; Full time

Benefits offered by this job

Health benefits after 30 days

401(k) plan with company match

Paid Time Off (PTO)

Paid Holidays

Job summary

Center for Bone & Joint Surgery is seeking an experienced Insurance Follow-Up Representative specialized in surgical collections to join our Revenue Cycle team onsite in West Palm Beach, FL. The role focuses on resolving complex surgical claim denials, speeding reimbursement, and maintaining accurate patient and payer data.

The ideal candidate has 2+ years in medical billing or revenue cycle, CPC/ CCS preferred, and strong knowledge of CPT/ ICD-10 coding, with proficiency in Athena EMR and payer

Qualifications

• 2+ years in medical billing, collections, or revenue cycle management.
• Experience with orthopedic surgical billing and denial resolution.
• Knowledge of CPT/ ICD-10 coding and payer reimbursement methodologies.
• Excellent written and verbal communication with insurers, providers, and patients.

Responsibilities

• Review and resolve complex surgical claim denials, underpayments, and rejections; implement appeals.
• Analyze denied surgical claims and submit well-supported appeals to maximize reimbursement.
• Verify demographics, eligibility, and COB; update records for accurate processing.
• Maintain claim status with carriers and monitor timely payment; communicate with stakeholders.

Skills

Medical billing

Denial management

AR follow-up

Communication skills

Education

CPC or CCS certification

Tools

Athena EMR

Billing platforms

Job description

Center for Bone & Joint Surgery is seeking an experienced Insurance Follow-Up Representative specialized in surgical collections to join our Revenue Cycle team onsite in West Palm Beach, FL. The role focuses on resolving complex surgical claim denials, speeding reimbursement, and maintaining accurate patient and payer data.

The ideal candidate has 2+ years in medical billing or revenue cycle, CPC/ CCS preferred, and strong knowledge of CPT/ ICD-10 coding, with proficiency in Athena EMR and payer