Benefits:

401(k)

Competitive salary

Health insurance

Paid time off

401(k) matching

Dental insurance

Responsibilities include verifying patient benefits, assigning correct HCPCS and ICD-10 codes, preparing and submitting electronic and paper claims, tracking authorizations, posting payments, and following up on denials or aged accounts. The role serves as the primary liaison between the practice, patients, and payers—clarifying coverage, resolving billing questions, maintaining detailed compliant documentation that meets Medicare, Medicaid, and commercial insurance guidelines. Success requires strong knowledge of O&P coding rules, attention to detail, and excellent communication with the clinical and fabrication teams in a collaborative environment dedicated to exceptional patient care.

General Accountabilities

Insurance Verification & Authorization Confirm patient eligibility, verify benefits, and obtain prior authorizations for all prosthetic and orthotic services.

Accurate Coding & Charge Entry Assign correct HCPCS, CPT, and ICD-10 codes; enter charges promptly to ensure clean, compliant claims.

Claim Preparation & Submission Generate and transmit electronic and paper claims to Medicare, Medicaid, VA, and commercial payers within established timelines.

Payment Posting & Reconciliation Post remittances, reconcile deposits, and balance daily transaction logs against bank statements and accounting records.

Denial Management & Appeals Analyze rejections or underpayments, research root causes, and prepare timely corrections or appeals to secure full reimbursement.

Accounts Receivable (A/R) Monitoring Track aging reports, prioritize follow-up activities, and maintain A/R metrics within practice targets.

Patient Billing & Collections Issue patient statements, explain balances, arrange payment plans, and process point-of-service collections.

Regulatory Compliance & Documentation Maintain thorough billing records that satisfy CMS, HIPAA, and payer-specific requirements; participate in internal audits.

Cross-Functional Communication Coordinate with clinicians, fabrication staff, and front-office personnel to clarify orders, resolve billing issues, and support seamless patient care.

Reporting & Process Improvement Generate periodic revenue and KPI reports for leadership; recommend workflow enhancements to boost accuracy and cash flow.