Biller - Out of Network Claims

Orlin & Cohen Orthopedic Group - Northwell Health is the premier and fastest-growing orthopedic practice on Long Island, providing comprehensive care that helps thousands of our neighbors and community members live more active lives, free from pain. Orlin & Cohen is one of the largest orthopedics practices in the region, with over 20 offices located in Nassau and Suffolk Counties, Queens, and Staten Island, we have been in business for 30 years.

Job Description

Performs billing, collections, third party reimbursements, computer data entry and retrieval. Helps in posting charges to accounts.

Job Responsibility

• Performs charge and payment entry; also performs coding and ensures accurate completion of coding for all assigned physician specialties.
• Aids review of physician's coding and identify possible conflicts in rules.
• Notifies physician when discrepancies are identified for correction.
• Coordinates incoming mail with open queue charges to maintain queue status.
• Reads and interprets insurance explanation of benefits; responds to insurance payer edits, rejections, and denials; identifies cause of rejections and chooses most appropriate methods to resolve them.
• Creates detailed, well-versed typed letters to insurances and patients.
• Creates effective appeal packages to submit to insurances.
• Communicates in an effective professional manner when speaking with insurances and patients.
• Maintains organized files of incoming and completed work.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• High School Diploma or equivalent required.
• 0-1 years of relevant experience, required.

Additional Details:

• Billing Experience: Entry-level billing experience preferred, with exposure to out-of-network claims processing a plus.
• Coding Knowledge: Familiarity with CPT codes and medical billing practices.
• Software Proficiency: Proficiency in Microsoft Excel and experience with Electronic Medical Records (EMR) systems preferred.
• Teamwork and Demeanor: A positive, easy-going attitude and a strong team-oriented approach are essential.
• Practice Billing Experience: Experience with billing for a medical practice is highly desirable.
• Location: This is an on-site position in Merrick, NY.

*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).