Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most patient care. Rooted in the 100-plus-year legacy of its founding partners, the network spans the Northeast with 100 physicians, over 950 employees, and 23 locations from Connecticut, New York, and Massachusetts.

We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other classification protected under applicable Federal, State or Local law.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business.

Summary:

Middlesex Orthopedic & Spine Associates is looking for a Medical Coder/Biller A/R Specialist to join our team in our Middletown CT location. In this position, you will be responsible for the day-to-day billing and follow-up activities on orthopedic claims in the Revenue Cycle Department. Reprocesses and reviews front-end edits and payer rejections from carriers and identify the root cause and problem-solving to ensure claim is resubmitted timely for payment.

Responsibilities include but are not limited to:

• 
  Process claims daily and correct front-end edits timely for submission
• Reprocess rejections, and file appeals for claim denials to ensure maximum reimbursement for services provided
• Contacts insurance companies regarding outstanding insurance balances, identify what is needed for resubmission, checks eligibility, ensures authorization is on file and verifies claim status on payer websites to ensure all necessary billing information has been satisfied to resolve the account balance.
• Contacts patients for updated insurance information when necessary
• Monitors and follows up on Aging
• Communicates internal/external issues causing cash delays timely
• Answers patient calls and responds to questions timely.
• Ensures patient account billing information and account balances are accurate and makes necessary adjustments in the computer system and documents all activity taken on the account for an audit trail.

• 3+ years coding/billing follow up experience in revenue cycle functions for a large orthopedic/spine surgical practice
• Certified Professional Biller, CPB, or dual Biller Coder, CPC through AAPC , or Certified Revenue Cycle Specialist, CRCS through AAHAM, preferred
• Must be well organized, detail-oriented, and able to multitask
• Knowledge of general principles of medical billing including verification, authorization, posting charges, procedures, diagnosis, medical necessity as well as knowledge of federal, and state regulations and billing rules
• Willingness to participate in goal-setting and educational activities for own growth and advancements.

IND2