Billing Specialist

About Plano Orthopedic & Sports Medicine Center

We believe in the power of kindness, the importance of teamwork, and the value of each patients journey. At Plano Orthopedic & Sports Medicine Center, we pride ourselves on our 45+ years of service to the community, delivering exceptional healthcare with a personal touch. Our culture is built on the core values of integrity, respect, compassion, service, a positive attitude, and teamwork . Here, you'll find more than a job, you'll find a supportive environment where your contributions truly matter. If you thrive in a dynamic, patient-centered environment and take pride in delivering exceptional service, this is the organization for you!

About the role

The Billing Specialist is responsible for ensuring accurate and timely processing of billing claims for an orthopedic medical practice. This role includes claim submission, editing, and refiling; posting and reconciling patient payments; insurance eligibility verification; processing refunds; and resolving claim denials or issues with payers. The Billing Specialist plays a key role in maintaining financial accuracy and compliance, while supporting the practices commitment to high?quality patient care.

What you'll do

• Submit, edit, and refile electronic and paper billing claims in compliance with payer requirements.
• Manage daily claims worklist to ensure timely resolution of outstanding or denied claims.
• Post and reconcile patient payments, copays, deductibles, and insurance reimbursements accurately.
• Verify patient insurance coverage and eligibility prior to claim submission when necessary.
• Process patient and payer refunds in accordance with practice policy and regulatory guidelines.
• Research, resolve, and resubmit denied or rejected claims to maximize reimbursement.
• Document billing activities and maintain clear communication with payers and patients regarding account status.
• Ensure compliance with HIPAA and other applicable billing, coding, and healthcare regulations.
• Collaborate with front office and clinical staff to address billing or documentation discrepancies.
• Assist with month?end reporting, account reconciliation, and internal audits as needed.

Qualifications

The pay range for this role is :

20 25 USD per hour (Plano Orthopedic & Sports Medicine Center)

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