Children's Orthopaedic and Scoliosis Surgery Associates, LLP
Medical Billing Specialist
Children's Orthopaedic and Scoliosis Surgery Associates, LLP, St. Petersburg, Florida, United States, 33739
Join to apply for the
Medical Billing Specialist
role at
Children's Orthopaedic and Scoliosis Surgery Associates, LLP
Job Overview Join our thriving pediatric orthopaedic group! Are you a detail‑oriented insurance collector passionate about ensuring accurate billing in a fast‑paced environment? We are seeking a highly motivated Billing Specialist to join our revenue cycle management team and play a vital role in bringing patient accounts to a zero balance.
Role Overview In this role, you will oversee the billing process for healthcare services, ensuring accurate claim submissions and full payment collection. Your responsibilities will include reviewing rejected claims, making justified adjustments, handling appeals for denied or underpaid claims, creating monthly Accounts Receivable reports, and resolving issues with provider representatives.
Responsibilities
Independently analyze claim denials and take corrective action, including corrected claims, reconsiderations, and appeals.
Apply accurate adjustments based on insurance guidelines and contracts.
Manage secondary insurance and patient responsibility.
Work closely with the team to resolve outstanding insurance payments.
Pull insurance policies and set up system edits and scrubs to prevent future denials.
Correspond with Insurance Verification and Front Desk to input missing data and correct registration errors.
Communicate effectively with patients and front desk regarding balances and collect payments.
Analyze and resolve rejected claims, ensuring accurate coding and modifiers per COSSA and payer policies.
Research, prepare, and submit appeals for denied or underpaid claims.
Draft detailed justification letters supported by documentation and payer policies.
Coordinate with charge entry personnel and revenue cycle specialists to ensure accurate claim processing and resubmission.
Work with providers to optimize appeals and validate adjustments.
Work Environment On‑site (St. Petersburg or Tampa Office Location)
Team Dynamics Join a high‑functioning team that values collaboration, communication, flexibility, and a positive attitude. We seek individuals who contribute positively to team dynamics and foster a supportive work environment.
Values
Patient‑Focused Care: Prioritizing patient needs and well‑being.
Competence: Maintaining high standards and pursuing certification within 2 years.
Credibility: Acting with integrity and honesty.
Innovation: Embracing new ideas to enhance workflows.
Employee Recognition: Valuing individual contributions.
We are committed to the continuous development of our team members by offering opportunities for professional growth, ongoing learning, and skill enhancement through regular feedback, mentorship, and targeted training.
Training Period New hires are required to complete a 90‑day training period to familiarize themselves with our processes and integrate with the team.
Work Hours Standard department hours are from 8:30 AM to 5:00 PM.
Salary & Benefits
Health Benefits: 95% employee premium coverage for Medical (UHC), Dental (Delta), and a $20,000 life insurance policy with no payroll deductions. Coverage starts the first day of the month after your 30‑day anniversary.
Paid Time Off: 16 days of PTO and 5 days of SD/Serious Illness accrued in the first year.
Profit Sharing: Employer contributions begin after one year, with a historical rate of at least 14% annually. No payroll deductions for retirement savings, with vesting 20% annually over five years.
401(k) & Roth 401(k): Employee contribution plan.
Requirements
Minimum of 2 years’ experience as a medical revenue cycle professional.
Proven track record in AR follow‑up, EDI management, coding, medical terminology, and computer skills.
CPC or CPB certification (or willingness to obtain within 2 years – employer paid).
Preferred Qualifications
Experience in insurance verification and pediatrics/orthopaedics.
Familiarity with AthenaPractice, Encoda, or Phreesia.
Knowledge of Florida Medicaid.
Billing companies need not apply. We have a high‑functioning team and have no need to outsource.
Job Details
Seniority level: Entry level
Employment type: Full‑time
Job function: Health Care Provider
Industries: Hospitals and Health Care
Ready to grow your career with a dynamic team? Apply today!
#J-18808-Ljbffr
Medical Billing Specialist
role at
Children's Orthopaedic and Scoliosis Surgery Associates, LLP
Job Overview Join our thriving pediatric orthopaedic group! Are you a detail‑oriented insurance collector passionate about ensuring accurate billing in a fast‑paced environment? We are seeking a highly motivated Billing Specialist to join our revenue cycle management team and play a vital role in bringing patient accounts to a zero balance.
Role Overview In this role, you will oversee the billing process for healthcare services, ensuring accurate claim submissions and full payment collection. Your responsibilities will include reviewing rejected claims, making justified adjustments, handling appeals for denied or underpaid claims, creating monthly Accounts Receivable reports, and resolving issues with provider representatives.
Responsibilities
Independently analyze claim denials and take corrective action, including corrected claims, reconsiderations, and appeals.
Apply accurate adjustments based on insurance guidelines and contracts.
Manage secondary insurance and patient responsibility.
Work closely with the team to resolve outstanding insurance payments.
Pull insurance policies and set up system edits and scrubs to prevent future denials.
Correspond with Insurance Verification and Front Desk to input missing data and correct registration errors.
Communicate effectively with patients and front desk regarding balances and collect payments.
Analyze and resolve rejected claims, ensuring accurate coding and modifiers per COSSA and payer policies.
Research, prepare, and submit appeals for denied or underpaid claims.
Draft detailed justification letters supported by documentation and payer policies.
Coordinate with charge entry personnel and revenue cycle specialists to ensure accurate claim processing and resubmission.
Work with providers to optimize appeals and validate adjustments.
Work Environment On‑site (St. Petersburg or Tampa Office Location)
Team Dynamics Join a high‑functioning team that values collaboration, communication, flexibility, and a positive attitude. We seek individuals who contribute positively to team dynamics and foster a supportive work environment.
Values
Patient‑Focused Care: Prioritizing patient needs and well‑being.
Competence: Maintaining high standards and pursuing certification within 2 years.
Credibility: Acting with integrity and honesty.
Innovation: Embracing new ideas to enhance workflows.
Employee Recognition: Valuing individual contributions.
We are committed to the continuous development of our team members by offering opportunities for professional growth, ongoing learning, and skill enhancement through regular feedback, mentorship, and targeted training.
Training Period New hires are required to complete a 90‑day training period to familiarize themselves with our processes and integrate with the team.
Work Hours Standard department hours are from 8:30 AM to 5:00 PM.
Salary & Benefits
Health Benefits: 95% employee premium coverage for Medical (UHC), Dental (Delta), and a $20,000 life insurance policy with no payroll deductions. Coverage starts the first day of the month after your 30‑day anniversary.
Paid Time Off: 16 days of PTO and 5 days of SD/Serious Illness accrued in the first year.
Profit Sharing: Employer contributions begin after one year, with a historical rate of at least 14% annually. No payroll deductions for retirement savings, with vesting 20% annually over five years.
401(k) & Roth 401(k): Employee contribution plan.
Requirements
Minimum of 2 years’ experience as a medical revenue cycle professional.
Proven track record in AR follow‑up, EDI management, coding, medical terminology, and computer skills.
CPC or CPB certification (or willingness to obtain within 2 years – employer paid).
Preferred Qualifications
Experience in insurance verification and pediatrics/orthopaedics.
Familiarity with AthenaPractice, Encoda, or Phreesia.
Knowledge of Florida Medicaid.
Billing companies need not apply. We have a high‑functioning team and have no need to outsource.
Job Details
Seniority level: Entry level
Employment type: Full‑time
Job function: Health Care Provider
Industries: Hospitals and Health Care
Ready to grow your career with a dynamic team? Apply today!
#J-18808-Ljbffr