Surgical Billing and Collections Specialist - OUT-OF-NETWORK EXPERIENCE A PLUS!!!

Job Overview

We are seeking a dynamic and detail-oriented Surgical Billing and Collections Specialist with OUT-OF-NETWORK experience to join our healthcare team. In this role, you will be responsible for managing the billing and collections process for surgical procedures performed outside of insurance networks, ensuring accurate claim submission, follow-up, and resolution of outstanding balances. Your expertise will help optimize revenue cycles, improve patient satisfaction, and ensure compliance with healthcare regulations. If you thrive in a fast-paced environment and possess a passion for medical billing and collections—especially within out-of-network settings—this is the perfect opportunity to elevate your career!

Responsibilities

• Prepare and submit accurate surgical claims using billing software, ensuring compliance with coding standards such as CPT (Current Procedural Terminology), ICD-9, ICD-10, DRG (Diagnosis-Related Group), and ICD coding.
• Follow up on unpaid or denied claims promptly through effective communication with insurance companies and patients.
• Review medical records and documentation to verify the accuracy of billing information and coding details.
• Manage out-of-network billing processes, including patient billing, payment posting, and collections efforts.
• Maintain detailed records of all transactions, claims submissions, appeals, and correspondence in EMR (Electronic Medical Records) or EHR (Electronic Health Records) systems.
• Collaborate with team members, leadership and healthcare providers to clarify documentation requirements and resolve billing discrepancies efficiently.
• Provide excellent customer service by addressing patient inquiries regarding bills, insurance coverage, and payment options.
• Stay updated on healthcare claims management regulations, health insurance policies, and changes in medical coding standards to ensure compliance.

Experience

• Proven experience in medical billing and collections within a healthcare setting, with a strong emphasis on outpatient surgical procedures.
• Out-of-network billing experience is highly preferred; familiarity with the nuances of out-of-network claims enhances success in this role.
• Knowledge of medical terminology, medical records management, and medical coding including CPT, ICD-9/10 codes, DRG classifications, and ICD coding systems.
• Hands-on experience using billing software, EMR/EHR systems, and Microsoft Office tools to manage claims processing efficiently.
• Strong understanding of healthcare claims management processes, health insurance policies, and patient account resolution strategies.
• Excellent communication skills with a customer service-oriented approach to patient interactions and insurance negotiations.

Join us in making a difference by ensuring accurate billing practices that support our mission to deliver exceptional healthcare services!

Pay: From $24.00 per hour

Expected hours: 40.0 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Retirement plan
• Tuition reimbursement
• Vision insurance

Work Location: In person