We're looking for an experienced
Accounts Receivable (A/R) Specialist & Payment Posting Specialist to join our growing orthopedic revenue cycle team. In this role, you'll play a vital part in ensuring timely reimbursements by managing insurance follow-up, resolving claim issues, and accurately posting payments. If you have strong orthopedic medical billing experience, are proficient with
Modernizing Medicine (ModMed) EMR/Practice Management, and enjoy solving complex reimbursement challenges, we'd love to hear from you.
Key Responsibilities
Accounts Receivable Management
- Perform insurance follow-up on outstanding claims for commercial, Medicare, Medicaid, Workers Compensation, and managed care payers.
- Investigate, analyze, and resolve denied, rejected, and underpaid claims.
- Prepare and submit claim appeals with supporting documentation based on payer guidelines.
- Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to identify payment discrepancies.
- Monitor aging reports and prioritize accounts to maximize collections and reduce A/R days.
- Document all payer communications accurately within ModMed.
- Ensure timely reimbursement while maintaining clean and accurate patient accounts.
Payment Posting
- Accurately post insurance and patient payments received through ERAs, EOBs, lockboxes, and manual deposits.
- Reconcile posted payments with daily deposits and balancing reports.
- Apply contractual adjustments, denials, refunds, and payment variances appropriately.
- Process credit balances and assist with refund requests in accordance with company policies.
- Identify and escalate payment discrepancies requiring additional review.
Revenue Cycle Support
- Collaborate with billing, coding, and front office teams to resolve claim and billing issues.
- Identify denial trends and recommend process improvements to increase reimbursement efficiency.
- Maintain compliance with HIPAA regulations, payer policies, and organizational standards.
- Meet daily productivity and quality expectations while maintaining exceptional accuracy.
Qualifications
- Minimum 3 years of medical Accounts Receivable (A/R) experience.
- Minimum 2 years of medical payment posting experience.
- Recent experience working in an orthopedic practice.
- Hands-on experience using Modernizing Medicine (ModMed) EMR/Practice Management.
- Strong knowledge of medical billing, insurance follow-up, denial management, and payment reconciliation.
- Experience working with commercial insurance, Medicare, Medicaid, and Workers Compensation claims.
- Ability to interpret EOBs, ERAs, contractual adjustments, and payer reimbursement methodologies.
- Excellent analytical, organizational, and problem-solving skills.
- Strong written and verbal communication skills.
- High level of accuracy with the ability to manage multiple priorities in a fast-paced environment.
- Experience supporting multi-provider orthopedic practices.
- Experience billing for orthopedic surgery, fracture care, sports medicine, spine, or pain management.
- Knowledge of orthopedic modifiers and specialty-specific billing requirements.
- CPC, CPB, or other AAPC/AHIMA certification is an advantage.
Perks
- Permanent Work From Home
- Leave Credits
- Monetary Allowance
- Annual Bonus
- Weekly Paychecks
- Fixed Weekends Off
- Thriving Company Culture with Complete Autonomy
- Exclusive Specialized Training Programs
- Unlock Your Potential with a Highly Competitive Salary
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Who are we
BizForce is one of the fastest-growing global outsourcing companies in the world, founded in the US in Tucson, Arizona and is now operational in PH!
Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.
