Orthopedic Surgical Collections Specialist - Onsite

The CORE Institute; Florida; On-site; USD 52,000 - 78,000; Full time

Benefits offered by this job

Health benefits after 30 days of work

401(k) plan with company match

Paid Time Off (PTO)

HSA with company contributions

Job summary

Center for Bone & Joint Surgery is seeking an experienced Insurance Follow-Up Representative-Surgical Collections to join our Revenue Cycle team. The position is full-time and on-site at our Royal Palm Beach, FL location, handling complex surgical accounts receivable, denials, and appeals to maximize reimbursement.

The role requires CPC/CCS or equivalent certification and 2+ years in medical billing or collections, with strong knowledge of orthopedic billing and CPT/ ICD-10 guidelines.

Qualifications

• 2+ years in medical billing, collections, or revenue cycle management.
• Experience with orthopedic surgical billing and denial management.
• Familiarity with CPT/ ICD-10 coding and payer policies.

Responsibilities

• Review and resolve complex surgical claim denials, underpayments, and rejections by identifying root causes.
• Analyze denied and unpaid orthopedic surgical claims and submit well-supported appeals to maximize reimbursement.
• Verify patient demographic information, insurance eligibility, and coordination of benefits; update records as needed to ensure accurate claim processing.
• Confirm claim receipt with insurance carriers and monitor claim status to facilitate timely payment.
• Research and obtain all required documentation to support claim adjudication and appeals.
• Interpret and apply payer-specific reimbursement guidelines and billing policies.
• Review coding, modifiers, and claim edits to ensure compliance with CPT, ICD-10, and payer-specific rules.

Skills

Orthopedic coding

Denial management

Appeals processing

Communication skills

Analytical skills

Education

CPC/CCS certification

Tools

Athena EMR

Billing systems

Job description

Center for Bone & Joint Surgery is seeking an experienced Insurance Follow-Up Representative-Surgical Collections to join our Revenue Cycle team. The position is full-time and on-site at our Royal Palm Beach, FL location, handling complex surgical accounts receivable, denials, and appeals to maximize reimbursement.

The role requires CPC/CCS or equivalent certification and 2+ years in medical billing or collections, with strong knowledge of orthopedic billing and CPT/ ICD-10 guidelines.