Healthcare AR Specialist: Claim Follow-Up & Denials (Orthopedic)

Wake Orthopedics a multi-specialty orthopedic group with multiple locations in Wake County, NC is seeking an Account Receivable Denial Management Specialist to fill a full-time hybrid-remote position. We offer a unique work environment promoting personal and professional growth. We offer the highest quality care for pediatric and adult patients. Our practices provide a full range of orthopedic services including advanced diagnostic imaging, innovative treatment options, minimally invasive and traditional procedures, and rehabilitation services. Whether it be recovering from a broken bone, joint replacement surgery, a sports injury or a fracture – our goal is to get patients back to doing the things they love.

The ideal candidate will be highly motivated, team focused and possess critical thinking skills.  Candidate will also have an understanding of current CPT, ICD and Modifiers.  

Primary Duties and Responsibilities will include:

• The Denial Management Specialist is responsible for denial and AR management for the department as defined by their supervisor/manager
• Research and resolve all outstanding denials within work queue and complete all necessary follow up within a timely and accurate manner
• Work Insurance Aged for government, commercial and WorkComp claims.
• Review documentation to ensure appropriate coding.
• Review registration and insurance entry to ensure accurate data.
• Communicate with peers to troubleshoot and share knowledge.
• Review payment posting and identify possible errors.
• Communicate professionally with area hospital staff as needed.
• Communicate with attorneys regarding patient billings.
• Document accurately within our EHR, Epic.
• Travel to other offices as needed to assist in staff training.
• Other duties will be assigned by management as needed.

Qualifications:

• High school diploma or equivalent
• Medical Billing & Coding Certification
• Two years experience in Orthopaedic medical office billing is preferred
• Strong attention to detail and accuracy in coding and billing processes
• Excellent communication skills to interact with patients, insurance companies, and healthcare providers
• Ability to handle confidential information with integrity and professionalism
• Strong organizational skills to manage multiple tasks and prioritize workload effectively