Job Description

SpineSearch is seeking an experienced surgical biller to join an orthopedic group with offices throughout Union County, NJ.

This is a full time, on-site position offering comprehensive benefits.

Key Responsibilities:

• Surgical Charge Entry: Accurately enter and code complex orthopedic surgical procedures
• Claims Submission: Prepare and submit clean claims for surgical procedures, hospital-based services, and post-operative care. Verify all documentation supports the services billed, including operative reports, consent forms, and prior authorizations.
• Surgical Claims Follow-Up: Monitor outstanding surgical claims and proactively address denials or delays related to authorization issues, global period conflicts, bundling, or modifier errors. Work closely with providers and surgical coordinators to obtain additional documentation or clarifications as needed.
• Patient Account Analysis: Analyze and reconcile patient accounts with a focus on surgical encounters. Identify discrepancies or underpayments related to multiple procedures, assistant surgeon billing, or implant charges. Resolve billing issues quickly to minimize revenue loss.
• Payment Posting & Reconciliation: Post payments, contractual adjustments, and denials related to surgeries from EOBs/ERAs. Ensure accurate allocation of payments across global periods and surgical case bundles.
• Compliance & Documentation: Stay current on changes in orthopedic surgical coding, payer policies, and compliance regulations. Ensure documentation supports medical necessity and accurately reflects the services rendered.

Requirements:

• HS diploma or GED required
• Minimum of 18 months experience in a physician group practice billing department
• Familiar with CPT and ICD-10-CM coding for orthopedic, podiatry & pain management surgery procedures
• Good analytical skills and an affinity for detail
• Knowledge of HIPPA & OSHA guidelines
• Working knowledge of medical practice management systems and electronic medical records
• Basic knowledge of computers and medical terminology is mandatory

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