Remote Orthopedic Medical Biller | AR & Payer Specialist

Scale-Up Philippines; United States; Hybrid; USD 45,000 - 70,000; Full time

Job summary

Scale Up Philippines is partnering with a progressive healthcare organization to hire a skilled Medical Biller with specialized orthopedic billing experience. This role focuses on accurate claims submission and strong revenue cycle operations to support high-quality patient care.

The ideal candidate brings deep expertise in orthopedic billing procedures, payer follow-up, and workers’ compensation claims, ensuring timely reimbursements while maintaining HIPAA compliance in a remote environment.

Qualifications

• Minimum 3 years of medical billing experience with strong orthopedic focus.
• Proven experience with payer follow-up and accounts receivable management.
• Deep knowledge of orthopedic CPT codes, modifiers, and documentation requirements.
• Proficiency with medical billing software and practice management systems.

Responsibilities

• Process and submit medical claims for orthopedic procedures with accuracy.
• Apply CPT, ICD-10, and HCPCS codes for orthopedic services.
• Ensure compliance with payer guidelines (Medicare/Medicaid/commercial).
• Conduct payer follow-up on outstanding claims and resolve denials.
• Manage AR aging and maximize collections.
• Post payments and adjustments in the practice management system.
• Track authorizations and pre-certifications for work comp cases.
• Navigate workers’ compensation billing regulations and requirements.
• Communicate with adjusters, case managers, and TPA’s as needed.
• Reconcile EOBs and ensure proper reimbursement.

Skills

Orthopedic billing experience

Payer follow-up

Accounts receivable management

HIPAA compliance

Attention to detail

Tools

AdvancedMD

Kareo

athenahealth

Job description

Scale Up Philippines is partnering with a progressive healthcare organization to hire a skilled Medical Biller with specialized orthopedic billing experience. This role focuses on accurate claims submission and strong revenue cycle operations to support high-quality patient care.

The ideal candidate brings deep expertise in orthopedic billing procedures, payer follow-up, and workers’ compensation claims, ensuring timely reimbursements while maintaining HIPAA compliance in a remote environment.