Completes prior authorization and predetermination for services and durable medical equipment.

Completes charge entry in the practice management system.

Submits patient statements on a weekly basis and confirms statement count and file upload.

Submits claims on a daily basis including verification of electronic claims submission acceptance.

Reviews outstanding claims and follows-up with insurance carriers regarding denials for specified claims.

Completes payment entry including:

Posts payments to practice management system

Balances batches and runs transaction reports

Creates secondary claims

Post zero pay remittances and denials

Communicates payment denials

Verifies eligibility and provides price estimate information to patients.

Set up payment plans.

Pre-collect for medical services.

Review patient accounts for placement with external collection agencies.

Call patients to collect on past due balances.

Training new associates ensuring competency in designated job titles.

Maintains professional knowledge regarding medical billing, insurance, coding policies and procedures.

Special projects and all other duties as assigned.

Communicates with patients, insurance carriers and other outside entities in a professional manner. Identifies solutions and responds professionally to patient concerns, i.e., pleasant tone of voice, courteous language, etc. Uses appropriate grammar and demonstrates tact and diplomacy in patient interactions, by phone and in person.

Diffuses negative situations with patients and maintains a pleasant and professional tone during stressful circumstances and heavy workload.

Communicates with staff members in a professional, pleasant manner; Shares information relevant to work, no gossiping or disparaging remarks, accepts work without complaint or provides reasons why assignment is unmanageable, asks and answers questions related to improving department performance

Willingly provides coverage, volunteers assistance, and maintains workflows within department as needed without direct instruction/supervision.

Works cooperatively and refrains from participating in negative conversations.

Shares knowledge and insights with co-workers in a constructive manner.

Works to solve problems and address conflicts with appropriate person directly before involving leadership or uninvolved peers.

Is considerate of others in the work environment with regard to taking breaks or meal periods, use of computer and phone, noise level in the department, etc.

Knows and complies with policies and procedures as enumerated in the Orthopedic One Employee Handbook and policies and procedures documents.

Provides assistance and support to leadership in implementing policies and procedures as necessary.

Actively participates in training, and conducting day to day work activity by adhering to all policies and procedures as enumerated in compliance and risk management programs.

High School Diploma or equivalent required with a minimum of two years of medical billing experience. Certified Professional Coder preferred. Candidates must be able to work with high volume of work while maintaining attention to detail and accuracy and demonstrate excellent oral and written communication skills. Computer skills required to operate practice management system (i.e., use Window operating system, conduct Internet searches, communicate by email, etc.)