(Hybrid) Medical Billing and Underpayment Specialist

Job Description

Job Description

About Us:
At Agility Billing Services, we are dedicated to providing exceptional care and service in the orthopedic/pain management field. We are looking for a skilled and motivated Accounts Receivable Specialist to join our team. The ideal candidate will have significant experience with collections, medical billing and a deep understanding of various insurance types and companies.

Position Overview:
We are seeking an Accounts Receivable Specialist to join our team and support billing and collections for a busy surgical practice. The ideal candidate will have experience in medical claims follow-up, with understanding of commercial insurance plans. Prior experience in out-of-network billing, orthopedic, spine, or pain management services is highly preferred. Candidates with a foundation in medical billing and a desire to develop expertise in out-of-network workflows are encouraged to apply.

Key Responsibilities:

• Submit and follow up on medical claims with commercial payers, with a focus on specialty and surgical services.
• Monitor outstanding accounts and pursue unpaid or underpaid claims to ensure timely reimbursement.
• Review, appeal, and resolve claim denials or payment discrepancies using payer portals
• Maintain up-to-date knowledge of payer policies, billing regulations, and coding guidelines.
• Collaborate with clinical and administrative teams to ensure accurate documentation and billing practices.
• Maintain organized detailed records of claim activity, account status, and insurance correspondence.

Qualifications:

• Working knowledge of Workers' Compensation, No-Fault, and commercial insurance plans.
• Excellent communication skills, especially when working with insurance reps and internal teams.
• Proficient in ICD-10, CPT, and modifier use.
• Experience in billing for orthopedic, spine, or pain management services is preferred but not required.
• Familiarity with out-of-network billing processes and understanding of the IDR process and appeals is a plus.
• Strong problem-solving and organizational skills.
• Self-motivated with the ability to work independently and meet deadlines.

Education and Experience:

• High school diploma or equivalent required.
• Associate’s Degree in Health Information Technology or a related field preferred.
• Certificate in medical billing or coding is a plus.

Benefits:

• Competitive compensation with consideration for experience, skills, and growth potential
• Opportunities for professional development and advancement in a specialty billing role.
• Supportive and team-oriented work environment.
• This is a hybrid position after 90-day probationary period

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