Medical Billing & A​/R Specialist – Revenue Cycle

Description

Boulder Centre for Orthopedics & Spine is seeking an experienced Medical Billing/Accounts Receivable Specialist to join our Revenue Cycle team. This position plays a key role in managing the medical billing and accounts receivable process, including insurance claim submission, claim follow-up, denial resolution, appeals, and reimbursement.

The ideal candidate will have at least three years of accounts receivable experience, including hands-on experience in medical billing or revenue cycle operations. The successful candidate will have strong knowledge of insurance claims and reimbursement processes, excellent problem-solving skills, and the ability to independently research and resolve complex billing and account issues.

At Boulder Centre for Orthopedics & Spine, you'll be part of a collaborative team dedicated to providing exceptional orthopedic care throughout the Front Range. We offer a supportive work environment, competitive compensation, comprehensive benefits, and opportunities for professional growth.

Billing

Revenue Cycle Manager

Full-Time - Hourly

$22.00 - $30.00 (commensurate with experience)
Bonus Eligibility:
No.

• Manage accounts receivable for insurance and patient accounts, including reviewing aging reports and following up on unpaid, denied, rejected, and underpaid claims.
• Review and scrub claims prior to submission to identify billing, coding, eligibility, demographic, and other issues that may delay reimbursement.
• Contact insurance companies to obtain claim status, resolve claim processing issues, and secure accurate and timely reimbursement.
• Verify insurance eligibility and benefits and identify issues that may impact claim reimbursement.
• Prepare and submit corrected claims and appeals to secure appropriate reimbursement.
• Perform charge entry and maintain accurate billing records.
• Review Explanation of Benefits (EOBs) and payer remittance information to identify payment discrepancies, denials, and underpayments.
• Post and reconcile insurance and patient payments, adjustments, and account activity to ensure accurate account balances.
• Investigate and resolve billing discrepancies and account issues.
• Answer patient billing inquiries by phone and in person with professionalism and empathy.
• Apply general ICD-10 and CPT coding knowledge to support accurate billing, claims follow-up, and reimbursement activities.
• Collaborate with providers, staff, prior authorization and coding teams, and insurance carriers to resolve billing and reimbursement issues.
• Maintain accurate documentation of account activity and follow-up efforts within designated systems.
• Maintain compliance with HIPAA, Medicare regulations, and organizational policies.
• Perform other duties as assigned.

• High school diploma or GED.
• Minimum of 3 years of accounts receivable experience, including at least 2 years of medical billing or revenue cycle experience.
• Hands-on experience managing insurance claims and accounts receivable, including claim submission, claim follow-up, denials, corrected claims, appeals, and reimbursement.
• Experience reviewing insurance eligibility and benefits and resolving issues that may impact claim reimbursement.
• Strong customer service, communication, and organizational skills.
• Ability to prioritize tasks and manage multiple responsibilities effectively.
• Ability to independently research and resolve billing, claim, and reimbursement issues.

• College degree.
• Experience in orthopedic, surgical, specialty, or physician practice billing.
• Experience working with commercial insurance, Medicare, and/or Medicaid.
• Knowledge of CPT and ICD-10 coding.
• Athena One or other healthcare practice management/EHR experience.
• Familiarity with managed care networks and insurance carriers.
• Experience working with prior authorizations and resolving authorization-related claim denials.

• Excellent written and verbal communication skills.
• Strong attention to detail and analytical abilities.
• Ability to establish positive working relationships with patients, providers, and staff.
• Ability to maintain confidentiality and handle sensitive information appropriately.
• Proficiency with computer systems and standard office equipment.

This is a hybrid position that combines remote work with in-office responsibilities as needed. While in the office, employees may have occasional exposure to patients and…