Billing Procedure Claims Specialist

Join to apply for the Billing Procedure Claims Specialist role at Summit Spine & Joint Centers
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Summit Spine and Joint Centers is a rapidly expanding Pain Management Group with twelve ambulatory surgery centers and twenty-three clinic locations across Georgia. We are seeking an experienced Medical Billing Specialist to join our team.

• Audit and ensure claim information is complete and accurate.
• Submit claims for office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.
• Ensure accurate and timely billing of HCFA 1500 claims.
• Document files with appropriate information (date stamped, logged, signed, etc.).
• Create logs for providers of pending encounters or encounters with errors.
• Work directly with billing staff and management to meet end‑of‑month closing deadlines.
• Handle clearinghouse rejections, printing, and mailing secondaries.
• Address inquiries from insurance companies, patients, and providers.
• Understand CPT, ICD‑10, HCPCS coding, and modifiers.
• Knowledge of third‑party payers including HMOs, PPOs, Medicare, Medicaid, and Worker's Compensation.
• Knowledge of ERAs, EOBs, and payer‑specific/LCD guidelines.
• Understand health plan benefits (deductibles, copays, coinsurance) and eligibility verification.
• Proficient with spreadsheets and word‑processing applications.

• Minimum of 3 years’ experience with medical billing or revenue cycle in a medical setting.
• Experience with Medicare, Medicaid, commercial insurance plans, workers’ comp, and personal injury cases.
• Knowledge of claim submission for office visits, outpatient procedures, urinary drug screens, DME, MRI, and Chronic Care Management.
• Understanding of medical billing rules such as coordination of benefits, modifiers, and EOBs/ANSI code denials.
• Excellent knowledge of CPT coding, ICD‑10 coding, and medical pre‑certification protocols.
• Excellent computer skills and familiarity with Microsoft Office.
• Comfortable working in a growing, dynamic organization and able to navigate change.
• Self‑motivated with ability to multi‑task and prioritize work in a fast‑paced, team environment.
• Bachelor’s degree preferred.
• Experience using eClinical
  
  Works preferred.
• Experience with high‑level procedure billing and coding for pain management preferred.

The position is full‑time with competitive salary, PTO, health benefits, and 401(k) match. The ideal candidate will be located in Georgia and able to be present at our administrative office, or near Austin, Texas where other members of the billing team are located.

Mid‑Senior level

Full‑time

Accounting / Auditing and Finance;
Medical Practices