Billing Specialist - Insurance Collections - MUST LIVE IN Tennessee

DescriptionElite Sports + Orthopedics is seeking a detail-oriented and motivated Billing Specialist – Insurance Collections to join our team. This position is responsible for managing insurance accounts receivable, researching and resolving outstanding claims, following up on unpaid and denied claims, and supporting timely and accurate reimbursement.

The ideal candidate is organized, persistent, and comfortable working independently while communicating effectively with both internal teams, insurance payers, and patients.

This position will become fully remote upon completion of training. Until training is successfully completed, the position will train in person at our 2004 Hayes Street, Suite 200 location in Nashville, TN.

Applicants must reside in the state of Tennessee. Remote work is only permitted while physically located within Tennessee. Employees may not work remotely from outside the state of Tennessee.

MINIMUM ESSENTIAL JOB REQUIREMENTS

Work insurance aging with a primary focus on accounts 61 days and older, prioritizing timely and consistent follow-up.
Review, communicate, and accurately document insurance denials within the practice management system.
Follow established practice management system guidelines for claim follow-up, including reason codes and designated follow-up dates.
Submit timely and appropriate appeals for denied claims and monitor their status through resolution.
Research and resolve outstanding claim issues, including missing information, processing errors, payer issues, and other barriers to payment.
Identify underpayments or payments that do not meet the contracted or allowed amount and communicate findings to the appropriate supervisor.
Review payer-specific communications, policies, and updates and communicate relevant information to appropriate team members and departments.
Identify trends or recurring issues related to denials, underpayments, or claim processing and communicate findings to management.
Respond professionally and accurately to written and telephone billing inquiries from patients.
Maintain accurate and thorough documentation of account activity and follow-up efforts.
Collaborate with internal departments and team members to resolve billing and insurance-related issues.
Participate in weekly team meetings and contribute to department goals and process improvement.
Maintain confidentiality of patient and financial information in accordance with applicable policies and regulations.
Perform other miscellaneous duties and responsibilities as assigned by management.

QualificationsKNOWLEDGE, SKILL AND COMPETENCY REQUIREMENTS

High school diploma required
College education or trade school preferred
Experience working in a physician office or hospital billing-type position preferred
Orthopedic claims experience is preferred
Proven record of discussing financial responsibilities and establishing payment plans when necessary
Comfortable using email and interacting various applications
Knowledge of Billing and Collections procedures
Knowledge of CPT and ICD-1O CM coding
Knowledge of MS Office Suite, especially Word, Excel and Outlook
Excellent written and verbal communication abilities
Goal-oriented and strong attention to details
Knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement
Proven knowledge of Explanation of Benefits forms, claim forms and insurance billing process

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, sexual orientation, age, disability, gender identity, marital or veteran status, or any other protected class.