Surgical Claims Specialist: Denials, NSA & Reimbursements

NexGen Orthopedic Health and Wellness; Paramus (NJ); Vor Ort; USD 33.000 - 37.000; Vollzeit

Zusammenfassung

NexGen Orthopedic Health and Wellness in Paramus, NJ seeks a Surgical Claims Specialist to review operative reports, assign CPT/diagnosis codes, and generate accurate surgical and facility claims for management review. The role emphasizes monitoring aging claims, insurer follow-up, and NSA case handling with arbitration preparation.

The position is full-time and requires meticulous EMR documentation, proactive payer communication, and timely follow-up to maximize reimbursement and keep accounts

Qualifikationen

• Experience in surgical claims processing.
• Knowledge of NSA arbitration procedures.
• Proficient in EMR review and documentation.

Aufgaben

• Monitor aging claims (30–120+ days) and follow up with payers.
• Prepare surgical/facility claims with CPT/diagnosis codes.
• Review operative reports and ensure complete documentation before submission.
• Enter and update claims in EMR and route for approval.
• Follow up on denials and non-covered codes to maximize reimbursement.
• Communicate with insurers about status and issues.
• Maintain NSA cases and arbitration packets through resolution.
• Keep accurate claim records and ensure timely follow-up.

Kenntnisse

Medical billing

Claim processing

NSA compliance

EMR documentation

Tools

EMR system

CPT codes

Jobbeschreibung

NexGen Orthopedic Health and Wellness in Paramus, NJ seeks a Surgical Claims Specialist to review operative reports, assign CPT/diagnosis codes, and generate accurate surgical and facility claims for management review. The role emphasizes monitoring aging claims, insurer follow-up, and NSA case handling with arbitration preparation.

The position is full-time and requires meticulous EMR documentation, proactive payer communication, and timely follow-up to maximize reimbursement and keep accounts