Medical Billing & A/R Specialist – Revenue Cycle

Description BoulderCentre for Orthopedics & Spine is seeking an experienced Medical Billing/Accounts Receivable Specialist to join our Revenue Cycle team. This position plays a key role in managing the medical billing and accounts receivable process, including insurance claim submission, claim follow-up, denial resolution, appeals, and reimbursement. The ideal candidate will have at least three years of accounts receivable experience, including hands-on experience in medical billing or revenue cycle operations.

The successful candidate will have strong knowledge of insurance claims and reimbursement processes, excellent problem-solving skills, and the ability to independently research and resolve complex billing and account issues. Why Join BoulderCentre for Orthopedics & Spine? At BoulderCentre for Orthopedics & Spine, you'll be part of a collaborative team dedicated to providing exceptional orthopedic care throughout the Front Range.

We offer a supportive work environment, competitive compensation, comprehensive benefits, and opportunities for professional growth. Department: Billing Reports to: Revenue Cycle Manager Schedule/Type: Full-Time - Hourly Wage: $22.00 – $30.00 (commensurate with experience) Bonus Eligibility: No. Requirements What You'll Do Manage accounts receivable for insurance and patient accounts, including reviewing aging reports and following up on unpaid, denied, rejected, and underpaid claims.

Review and scrub claims prior to submission to identify billing, coding, eligibility, demographic, and other issues that may delay reimbursement. Contact insurance companies to obtain claim status, resolve claim processing issues, and secure accurate and timely reimbursement. Verify insurance eligibility and benefits and identify issues that may impact claim reimbursement. Prepare and submit corrected claims and appeals to secure appropriate reimbursement.

Perform charge entry and maintain accurate billing records. Review Explanation of Benefits (EOBs) and payer remittance information to identify payment discrepancies, denials, and underpayments. Post and reconcile insurance and patient payments, adjustments, and account activity to ensure accurate account balances. Investigate and resolve billing discrepancies and account issues. Answer patient billing inquiries by phone and in person with professionalism and empathy.

Apply general ICD-10 and CPT coding knowledge to support accurate billing, claims follow-up, and reimbursement activities. Collaborate with providers, staff, prior authorization and coding teams, and insurance carriers to resolve billing and reimbursement issues. Maintain accurate documentation of account activity and follow-up efforts within designated systems. Maintain compliance with HIPAA, Medicare regulations, and organizational policies.

Perform other duties as assigned. Qualifications Required: High school diploma or GED. Minimum of 3 years of accounts receivable experience, including at least 2 years of medical billing or revenue cycle experience. Hands-on experience managing insurance claims and accounts receivable, including claim submission, claim follow-up, denials, corrected claims, appeals, and reimbursement. Experience reviewing insurance eligibility and benefits and resolving issues that may impact claim reimbursement.

Strong customer service, communication, and organizational skills. Ability to prioritize tasks and manage multiple responsibilities effectively. Ability to independently research and resolve billing, claim, and reimbursement issues. Preferred: College degree. Experience in orthopedic, surgical, specialty, or physician practice billing. Experience working with commercial insurance, Medicare, and/or Medicaid.

Knowledge of CPT and ICD-10 coding. AthenaOne or other healthcare practice management/EHR experience. Familiarity with managed care networks and insurance carriers. Experience working with prior authorizations and resolving authorization-related claim denials. Skill